Abstract

INTRODUCTION

There are several studies reporting of urinary stones composition that can be detected by imaging techniques. In this study we aimed to determine the association between the composition of the kidney stones with the twinkling artifact in Color Doppler Ultrasound, and the mean density in the non-contrast-enhanced computed tomography (NCECT).

METHODS

49 patients are included in this prospective study who have kidney stones with an indication for surgery. All patients were examined with the NCECT for the mean density measurement in Hounsfield unit, and with Color Doppler ultrasound for the twinkling artifact before the surgery.

RESULTS

The kidney stones that have single composition calcium and non-calcium are found to have different mean densities in NCECT, and the cut-off value was calculated 644.5 Hounsfield Unit (p < 0.001). After analyzing kidney stones according to this cut-off value, there was a statistically significant association between the composition and the twinkling artifact with the stones which have a lower mean density than the cut-off value (p = 0.014). The kidney stones with a mean density below this cut off value with grade 0-1 twinkling artifact were uric acid stones, and those with grade 2 twinkling artifact were cystine stones. The kidney stones that have a mean density above the cut off value, there was no significant association between the twinkling artifact and composition of the stones (p = 0.203), but all kidney stones with grade 1 twinkling artifact are found to be calcium oxalate monohydrate, as well as the 83.3% of the grade 2 twinkling artifact are found to be calcium oxalate monohydrate stones.

DISCUSSION AND CONCLUSION

The twinkling artifact of the kidney stones in Color Doppler Ultrasound and the mean density in NCECT, can be used for the characterization of the kidney stones and it is helpful for the right treatment of choice.