What type of study is this?

This is a Cross-sectional study.

September 10, 2025Indus journal of bioscience research.0 citationsOpen Access

Diagnostic Accuracy of Twinkling Artefact on Color Doppler Ultrasound to Diagnose Urinary Tract Stones taking Unenhanced CT-KUB as Gold Standard

TRTabassum RasulThe Women University Multan ALAtif LatifCombined Military Hospital TRTauseef Ur RehmanIslamia University of Bahawalpur

Key Points

Twinkling artefact on ultrasound diagnosed urinary tract stones in 87% of patients compared to 84% with unenhanced CT-KUB.
The sensitivity of twinkling artefact was 95%, providing a strong alternative to unenhanced CT-KUB for diagnosis.
Diagnostic accuracy of twinkling artefact color Doppler ultrasound reached 89%, with a notable positive predictive value of 92%.
This study included 170 patients aged 20-65 years with urinary tract stone symptoms, supporting the need for alternative imaging to reduce radiation exposure.

Abstract

Background: The Unenhanced CT-KUB has remained the gold standard for diagnosing urolithiasis with high level of diagnostic accuracy. There are, however, concerns about radiation exposure and higher cost which arises the need for alternative imaging techniques. The twinkling artifact color Doppler ultrasound has gained attention as a potential technique in the diagnosis of urinary tract stones without these concerns. This study was therefore planned to determine the diagnostic accuracy of this technique in the diagnosis of urinary tract stones taking unenhanced CT-KUB as gold standard. Material and methods: This cross-sectional (validation) study was carried out at the Department of Diagnostic Radiology, CMH Multan, from July 2024 to December 2024. A total of 170 patients aged between 20 to 65 years, with complaints of flank pain, hematuria or dysuria for ≤ 7-days were added in this study. All the patients underwent twinkling artefact on color Doppler ultrasound and unenhanced CT-KUB for the diagnosis of urolithiasis. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of twinkling artefact on color Doppler ultrasound were determined taking unenhanced CT-KUB as Gold standard. Results: Age range of patients was 25-65 years with mean age of 43.2±10.4 years. Male comprised of 63% of total study population while females comprised of 37%. Twinkling artefact on color Doppler ultrasound diagnosed 148 (87%) patients while unenhanced CT-KUB diagnosed 143 (84%) of patients with urinary track kidney stones. Doppler twinkling artefact demonstrated sensitivity of 95%, specificity of 56%, positive predictive value 92%, negative predictive value 68% and diagnostic accuracy of 89% (p ˂0.0001). Conclusion: Twinkling artifact color Doppler ultrasound demonstrates high sensitivity and diagnostic accuracy for urinary track stones, offering a promising alternative to unenhanced CT-KUB.

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