The usefulness of agent emission imaging - high mechanical index ultrasound mode in the diagnosis of urolithiasis: a prospective preliminary study

PURPOSE:We aimed to determine the feasibility and effectiveness of agent emission imaging - high mechanical index (AEI-High MI) mode ultrasonography (US) compared with gray-scale and color Doppler US, alone or in combination, for the diagnosis of urolithiasis with reference to unenhanced computed to...

Full description

Bibliographic Details
Main Authors: Artur Salmaslıoğlu, Mesut Bulakçı, Barış Bakır, Ravza Yılmaz, Yunus Emre Akpınar, Tzevat Tefik, Öner Şanlı, Sevda Özel, Bülent Acunas
Format: Article
Language:English
Published: Galenos Publishing House 2018-05-01
Series:Diagnostic and Interventional Radiology
Online Access: http://www.dirjournal.org/archives/archive-detail/article-preview/the-usefulness-of-agent-emission-imaging---high-me/55126
_version_ 1797691218635784192
author Artur Salmaslıoğlu
Mesut Bulakçı
Barış Bakır
Ravza Yılmaz
Yunus Emre Akpınar
Tzevat Tefik
Öner Şanlı
Sevda Özel
Bülent Acunas
author_facet Artur Salmaslıoğlu
Mesut Bulakçı
Barış Bakır
Ravza Yılmaz
Yunus Emre Akpınar
Tzevat Tefik
Öner Şanlı
Sevda Özel
Bülent Acunas
author_sort Artur Salmaslıoğlu
collection DOAJ
description PURPOSE:We aimed to determine the feasibility and effectiveness of agent emission imaging - high mechanical index (AEI-High MI) mode ultrasonography (US) compared with gray-scale and color Doppler US, alone or in combination, for the diagnosis of urolithiasis with reference to unenhanced computed tomography (CT).METHODS:This prospective study included 72 consecutive patients (40 males, 32 females; mean age, 45.9±14.7 years) referred by the department of urology for acute or elective symptoms of urolithiasis and confirmed to have urinary calculi on unenhanced abdominal CT, between January 2015 and June 2015. Gray-scale, color Doppler, and AEI-High MI US were performed by two radiologists to determine the effectiveness of these methods in the diagnosis of urinary stones and to compare them with the reference modality.RESULTS:A total of 189 calculi were detected on CT examination. Gray-scale US had a sensitivity of 66.1% and positive predictive value (PPV) of 88.7% for detecting calculi, while twinkling artifact of color Doppler had a sensitivity of 70.4% and PPV of 94.3%. The scintillation artifact of AEI-High MI mode had a sensitivity of 75.1% and PPV of 95.9%. When all ultrasound-based modalities were combined, the sensitivity and PPV rose to 83.1% and 88.2%, respectively. When calculi were grouped according to their size (<5 mm, 5–10 mm, >10 mm), AEI-High MI mode had a higher sensitivity (60%) compared with gray-scale (32.5%) and color Doppler (41.3%) for calculi <5 mm.CONCLUSION:AEI-High MI mode had a higher sensitivity compared with gray-scale and color Doppler for the detection of calculi smaller than 5 mm, but it did not make a significant contribution to detection of larger calculi. The combined use of gray-scale US with AEI-High MI mode could increase the detection rate of calculi smaller than 5 mm and provide a method for verification of suspected calculi on gray-scale US.
first_indexed 2024-03-12T02:11:16Z
format Article
id doaj.art-810dfc378bb44c27b671c39a9a4b07a8
institution Directory Open Access Journal
issn 1305-3825
1305-3612
language English
last_indexed 2024-03-12T02:11:16Z
publishDate 2018-05-01
publisher Galenos Publishing House
record_format Article
series Diagnostic and Interventional Radiology
spelling doaj.art-810dfc378bb44c27b671c39a9a4b07a82023-09-06T13:19:11ZengGalenos Publishing HouseDiagnostic and Interventional Radiology1305-38251305-36122018-05-0124316917410.5152/dir.2018.1800513049054The usefulness of agent emission imaging - high mechanical index ultrasound mode in the diagnosis of urolithiasis: a prospective preliminary studyArtur Salmaslıoğlu0Mesut Bulakçı1Barış Bakır2Ravza Yılmaz3Yunus Emre Akpınar4Tzevat Tefik5Öner Şanlı6Sevda Özel7Bülent Acunas8 Department of Radiology, İstanbul University İstanbul School of Medicine, İstanbul, Turkey Department of Radiology, İstanbul University İstanbul School of Medicine, İstanbul, Turkey Department of Radiology, İstanbul University İstanbul School of Medicine, İstanbul, Turkey Department of Radiology, İstanbul University İstanbul School of Medicine, İstanbul, Turkey Department of Radiology, İstanbul University İstanbul School of Medicine, İstanbul, Turkey Department of Urology, İstanbul University İstanbul School of Medicine, İstanbul, Turkey Department of Urology, İstanbul University İstanbul School of Medicine, İstanbul, Turkey Department of Biostatistics, İstanbul University İstanbul School of Medicine, İstanbul, Turkey Department of Radiology, İstanbul University İstanbul School of Medicine, İstanbul, Turkey PURPOSE:We aimed to determine the feasibility and effectiveness of agent emission imaging - high mechanical index (AEI-High MI) mode ultrasonography (US) compared with gray-scale and color Doppler US, alone or in combination, for the diagnosis of urolithiasis with reference to unenhanced computed tomography (CT).METHODS:This prospective study included 72 consecutive patients (40 males, 32 females; mean age, 45.9±14.7 years) referred by the department of urology for acute or elective symptoms of urolithiasis and confirmed to have urinary calculi on unenhanced abdominal CT, between January 2015 and June 2015. Gray-scale, color Doppler, and AEI-High MI US were performed by two radiologists to determine the effectiveness of these methods in the diagnosis of urinary stones and to compare them with the reference modality.RESULTS:A total of 189 calculi were detected on CT examination. Gray-scale US had a sensitivity of 66.1% and positive predictive value (PPV) of 88.7% for detecting calculi, while twinkling artifact of color Doppler had a sensitivity of 70.4% and PPV of 94.3%. The scintillation artifact of AEI-High MI mode had a sensitivity of 75.1% and PPV of 95.9%. When all ultrasound-based modalities were combined, the sensitivity and PPV rose to 83.1% and 88.2%, respectively. When calculi were grouped according to their size (<5 mm, 5–10 mm, >10 mm), AEI-High MI mode had a higher sensitivity (60%) compared with gray-scale (32.5%) and color Doppler (41.3%) for calculi <5 mm.CONCLUSION:AEI-High MI mode had a higher sensitivity compared with gray-scale and color Doppler for the detection of calculi smaller than 5 mm, but it did not make a significant contribution to detection of larger calculi. The combined use of gray-scale US with AEI-High MI mode could increase the detection rate of calculi smaller than 5 mm and provide a method for verification of suspected calculi on gray-scale US. http://www.dirjournal.org/archives/archive-detail/article-preview/the-usefulness-of-agent-emission-imaging---high-me/55126
spellingShingle Artur Salmaslıoğlu
Mesut Bulakçı
Barış Bakır
Ravza Yılmaz
Yunus Emre Akpınar
Tzevat Tefik
Öner Şanlı
Sevda Özel
Bülent Acunas
The usefulness of agent emission imaging - high mechanical index ultrasound mode in the diagnosis of urolithiasis: a prospective preliminary study
Diagnostic and Interventional Radiology
title The usefulness of agent emission imaging - high mechanical index ultrasound mode in the diagnosis of urolithiasis: a prospective preliminary study
title_full The usefulness of agent emission imaging - high mechanical index ultrasound mode in the diagnosis of urolithiasis: a prospective preliminary study
title_fullStr The usefulness of agent emission imaging - high mechanical index ultrasound mode in the diagnosis of urolithiasis: a prospective preliminary study
title_full_unstemmed The usefulness of agent emission imaging - high mechanical index ultrasound mode in the diagnosis of urolithiasis: a prospective preliminary study
title_short The usefulness of agent emission imaging - high mechanical index ultrasound mode in the diagnosis of urolithiasis: a prospective preliminary study
title_sort usefulness of agent emission imaging high mechanical index ultrasound mode in the diagnosis of urolithiasis a prospective preliminary study
url http://www.dirjournal.org/archives/archive-detail/article-preview/the-usefulness-of-agent-emission-imaging---high-me/55126
work_keys_str_mv AT artursalmaslıoglu theusefulnessofagentemissionimaginghighmechanicalindexultrasoundmodeinthediagnosisofurolithiasisaprospectivepreliminarystudy
AT mesutbulakcı theusefulnessofagentemissionimaginghighmechanicalindexultrasoundmodeinthediagnosisofurolithiasisaprospectivepreliminarystudy
AT barısbakır theusefulnessofagentemissionimaginghighmechanicalindexultrasoundmodeinthediagnosisofurolithiasisaprospectivepreliminarystudy
AT ravzayılmaz theusefulnessofagentemissionimaginghighmechanicalindexultrasoundmodeinthediagnosisofurolithiasisaprospectivepreliminarystudy
AT yunusemreakpınar theusefulnessofagentemissionimaginghighmechanicalindexultrasoundmodeinthediagnosisofurolithiasisaprospectivepreliminarystudy
AT tzevattefik theusefulnessofagentemissionimaginghighmechanicalindexultrasoundmodeinthediagnosisofurolithiasisaprospectivepreliminarystudy
AT onersanlı theusefulnessofagentemissionimaginghighmechanicalindexultrasoundmodeinthediagnosisofurolithiasisaprospectivepreliminarystudy
AT sevdaozel theusefulnessofagentemissionimaginghighmechanicalindexultrasoundmodeinthediagnosisofurolithiasisaprospectivepreliminarystudy
AT bulentacunas theusefulnessofagentemissionimaginghighmechanicalindexultrasoundmodeinthediagnosisofurolithiasisaprospectivepreliminarystudy
AT artursalmaslıoglu usefulnessofagentemissionimaginghighmechanicalindexultrasoundmodeinthediagnosisofurolithiasisaprospectivepreliminarystudy
AT mesutbulakcı usefulnessofagentemissionimaginghighmechanicalindexultrasoundmodeinthediagnosisofurolithiasisaprospectivepreliminarystudy
AT barısbakır usefulnessofagentemissionimaginghighmechanicalindexultrasoundmodeinthediagnosisofurolithiasisaprospectivepreliminarystudy
AT ravzayılmaz usefulnessofagentemissionimaginghighmechanicalindexultrasoundmodeinthediagnosisofurolithiasisaprospectivepreliminarystudy
AT yunusemreakpınar usefulnessofagentemissionimaginghighmechanicalindexultrasoundmodeinthediagnosisofurolithiasisaprospectivepreliminarystudy
AT tzevattefik usefulnessofagentemissionimaginghighmechanicalindexultrasoundmodeinthediagnosisofurolithiasisaprospectivepreliminarystudy
AT onersanlı usefulnessofagentemissionimaginghighmechanicalindexultrasoundmodeinthediagnosisofurolithiasisaprospectivepreliminarystudy
AT sevdaozel usefulnessofagentemissionimaginghighmechanicalindexultrasoundmodeinthediagnosisofurolithiasisaprospectivepreliminarystudy
AT bulentacunas usefulnessofagentemissionimaginghighmechanicalindexultrasoundmodeinthediagnosisofurolithiasisaprospectivepreliminarystudy