AI Article Synopsis

  • The study aimed to assess how Doppler ultrasound (DUS) can help predict the success of shock wave lithotripsy (SWL) treatment for ureteral stones, focusing on factors that influence stone clearance and impaction.
  • Researchers analyzed various patient factors, including demographics and DUS measurements like resistive index (RI) and ureteric jets, in 93 patients who underwent SWL.
  • Results showed that the presence of ureteric jets, lower RI, and lower ureteral wall thickness were key indicators of treatment success, while higher RI correlated with stone impaction, making DUS a valuable non-invasive diagnostic tool.

Article Abstract

Purpose: To identify the role of Doppler US (DUS) in the prediction of factors affecting stone-clearance post-SWL for ureteral stones in addition to its role in prediction of pretreatment stone impaction.

Methods: We prospectively included patients with ureteric stone for SWL between October 2018 and September 2019. Patient's demographics were collected. Using DUS, resistive index (RI), Δ RI, and ureteric jets were evaluated in both kidneys. Also, stone site, volume, density, skin to stone distance, degree of hydronephrosis, ureteral wall thickness (UWT) were evaluated by NCCT. Univariate and multivariate logistic regression analyses were performed to identify factors that contribute to treatment success. Correlation between ipsilateral RI with other radiological findings predicting stone impaction was done.

Results: A total of 93 patients were finally included (61 males and 32 females). The mean age was 31.4 ± 7.7 years. The success rate (absence of significant residuals post 1 month by NCCT) was 51.6%. In multivariate analysis, the presence of ureteric jet, ipsilateral lower RI, and ipsilateral lower UWT were independent factors for treatment success (P = 0.0001, 0.002, and 0.03, respectively). Also, ipsilateral absence of ureteric jet, increased hydronephrosis, and increased UWT were correlated with higher ipsilateral RI in prediction of stone impaction. Ipsilateral higher RI was found to achieve higher accuracy in stone impaction prediction (PPV of 94.8%).

Conclusion: Pretreatment DUS is a useful, non-invasive with a less irradiative tool for prediction of stone impaction and stone-free rate post-SWL for ureteric stones.

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Source
http://dx.doi.org/10.1007/s11255-020-02465-3DOI Listing

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