COMPARATION OF DIAGNOSTIC VALUE B-MODE ULTRASOUND WITH COLOR DOPPLER TWINKLING ARTIFACT FOR DETECTING RESIDUAL STONE AFTER PCNL
Abstract: To compare the
accuracy of B-Mode US and color Doppler twinkling artifact for detecting
residual stone after Percutaneous Nephrolithotomy (PCNL) with Non-contrast CT
(NCCT) as the standard diagnostic. Material & methods: In this prospective
study, 30 patients who underwent Percutaneous Nephrolithotomy (PCNL) were
examined with US and NCCT. In US, echogenicity and posterior-shadow (PS)
parameters were evaluated and compared with color-Doppler ultrasonography
(CDUS) twinkling artifact and NCCT signs. The results then analyzed
statistically with Kappa and McNemar tests. Results: More positive residual
stone results with color Doppler twinkling artifact in 14 patients than B-Mode
US in 11. NCCT detected 17 residual stone with the most location in inferior
calyx. (n=10, 58.8%). The sensitivity, specificity and difference
positive-negative likehood ratio of B-Mode US were 64.7%, 92.3% and 8.02, both
Kappa test was significant (p=0.125) and McNemar tests was significant
(p=0.002). The color Doppler twinkling artifact has 82.3%, 92.3%, and 10.5 for
sensitivity, specificity and difference positive-negative likehood ratio, the
Kappa test was significant (p=0.00), McNemar test was not significant (p=1.00).
Conclusion: Color Doppler twinkling artifact was valid, highly sensitive and
accuracy better than B-mode US in detecting residual stone after PCNL
procedure.
Keywords: Percutaneous
nephrolithotomy; residual stone; B-mode US; color Doppler US; twinkling
artifact; non-contrast CT
Author: Sonny Andikha
Wardhana, Fikri Rizaldi, Tarmono Djojodimedjo, Sunaryo Hardjowijoto
Journal Code: jpkedokterangg170020
