ArticleCureus2019
Diagnostic Accuracy of Doppler Twinkling Artifact for Identifying Urinary Tract Calculi.
Article in Cureus, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
2 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.
- Diagnostic accuracy of Doppler twinkling artifact for identifying urolithiasis: a systematic review and meta-analysis.Journal of ultrasound · 2023Pooled it
- Gender and side distribution of urinary calculi using ultrasound imaging.Journal of family medicine and primary care · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Introduction Flank pain is a frequent cause of emergency department visits and is often due to renal or ureteric colic. Ultrasound is often the initial imaging study used for the detection of urinary tract calculi. Twinkling artifact is a Doppler artifact usually seen on echogenic rough surfaces such as calculi. Its presence can improve the sensitivity and specificity of ultrasound in stone detection. The objective of the current study was to determine the diagnostic accuracy of the Doppler twinkling artifact for detecting urinary calculi using non-contrast computed tomography as the gold standard. Materials and methods In this cross-sectional study, both male and female patients of any age having flank pain, burning micturition with or without hematuria were included. Ultrasound was performed and the presence or absence of Doppler twinkling artifact on calculus was noted. Following ultrasound, patients underwent plain CT scan and findings of stones were documented. Sensitivity, specificity, positive and negative predictive values, and diagnostic accuracy of Doppler twinkling artifact was calculated considering CT findings as the gold standard. Results Out of the total 221 patients, 146 (66.1%) were males and 75 (33.9%) were females. The mean age of the patients was 45.98 ± 16.30 years. Urinary tract calculi on ultrasound were observed in 74 (33.50%) patients, while on CT urinary tract calculi were observed in 127 (57.50%) patients. Diagnostic accuracy of Doppler twinkling artifact was found to be 71.49% with sensitivity, specificity, positive predictive value, and negative predictive value of 54.33%, 94.68%, 93.24%, and 60.54%, respectively. Conclusion Doppler twinkling artifact has low sensitivity, high specificity, and suboptimal diagnostic accuracy for the diagnosis of urinary tract calculi. Integration of this artifact has a lower sensitivity as compared to non-contrast CT scan. Multicentric studies with larger sample size and focusing on interobserver and intraobserver variability are recommended to have a consensus regarding Doppler twinkling artifact in the evaluation of renal and ureteric calculi.
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