Diagnostic Accuracy of Twinkling Artefect in Diagnosis of Ureteric Calculus Keeping Non-Contrast CT as A Gold Standard
DOI:
https://doi.org/10.51985/JBUMDC2025660Keywords:
Accuracy, Doppler ultrasound, Non contrast enhanced CT, Sensitivity, Specificity, Twinkling artifact, Ureteric stonesAbstract
Objective: To determine the diagnostic accuracy of the twinkling artifact on Doppler ultrasound using non-contrast CT
as the gold standard for detecting ureteric stones.
Study Design & Setting: This cross-sectional diagnostic accuracy study was conducted at the Department of Radiology,
a tertiary care hospital, from 2 October 2021 to 1April 2022.
Methodology: A total of 141 patients with clinically suspected ureteric colic were enrolled. All underwent Doppler
ultrasound followed by Non contrast enhanced CT. Findings of twinkling artifact were recorded and compared with Non
contrast enhanced CT outcomes. Diagnostic parameters including sensitivity, specificity, positive predictive value (PPV),
negative predictive value (NPV), and accuracy were calculated. Subgroup analysis was performed based on age, gender,
and stone size.
Results: The mean age was 38.59 ± 9.97 years; 55.3% were male. The twinkling artifact was observed in 94 (66.7%)
patients. Non contrast enhanced CT confirmed ureteric stones in 81 (57.4%) cases. Sensitivity, specificity, PPV, NPV, and
overall accuracy of the twinkling artifact were 90.1%, 93.3%, 94.8%, 87.5%, and 91.5%, respectively. Stratified analysis
showed diagnostic accuracy above 89% across all subgroups.
Conclusion: The twinkling artifact on Doppler ultrasound demonstrated excellent diagnostic accuracy and can be considered
a reliable, radiation-free alternative to Non contrast enhanced CT for detecting ureteric stones.
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