Objective: To prospectively evaluate the diagnostic accuracy of twinkling artifacts in the detection of nephrolithiasis, with CT KUB as a gold standard.
Methodology: This cross-sectional study was conducted at The University of Lahore Teaching Hospital, Lahore from December 2019 to June 2020. It included 200 patients undergoing CT scans for nephrolithiasis and were evaluated by Ultrasound (grayscale and Doppler) which was performed by an experienced radiologist who was blinded to the results of unenhanced CT KUB. The presence, number, location, and size of renal twinkling artifacts and size of renal calculi were recorded. Sonographic findings were then correlated with unenhanced CT.
Results: The presence of sonographic renal twinkling artifact, in general, had an 80% positive predictive value for detecting nephrolithiasis with sensitivity of 75.6% and specificity of 46.1%. The negative predictive value (NPV) of doppler US vs. CT-KUB in diagnosing nephrolithiasis was 40.0% with a diagnostic accuracy of 68%.
Conclusion: Renal twinkling artifact can be reliably used for the screening and detection of nephrolithiasis in patients with renal calculi.
Key words: CT-KUB, nephrolithiasis, doppler US, twinkling artifact.
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