Comparative analysis of ultrasound and Computed tomography; A focus on diagnostic accuracy in the patients of urolithiasis

Objective: An analysis of ultrasound and computed tomography focusing on their diagnostic accuracy in patients with urolithiasis Study design: It was a descriptive cross sectional study. Place and duration of study: The study was conducted at Sonex Diagnostic Centre, in Rawalpindi, from April to September 2024. Material and Methods: A total of 113 patients were studied for the research purpose. Detailed examinations were performed including USG and CT. Results: The results of study showed that out of 113 patients, 78 (69.02%) patients were male and 35(30.97%) were female. Out of total 113 patients, those in the age group 31-40 years were more likely diagnosed with disease. In this study, the positive and negative results obtained from ultrasound diagnostics were evaluated across different anatomical locations (N/L, V/L, U/L, PUJ, and VUJ). To understand the effectiveness of ultrasound, the positive ultrasound results were compared to CT scan findings, which were considered the reference standard. Ultrasound detected 48 positive cases of nephrolithiasis and missed 17 cases (negative on ultrasound but potentially positive on CT). The nephrolithiasis site had the highest number of positive findings. For V/L (Vesicle Lithiasis), 5 cases were identified as positive, with only 1 false negative. For U/L (Ureterolithiasis), ultrasound detected 15 positive cases, while 11 cases were missed. For VUJ (Vesicoureteric Junction), 6 positive cases were detected, with no negatives recorded. Out of 113 patients, 9 patients were negative on both USG and CT, while 1 patient was suspected of having ureterolithiasis on USG but was not confirmed to have a stone on CT. Conclusion: The ultrasound’s performance varies significantly across different anatomical regions, indicating that it may be more effective for certain locations and less reliable for others. Overall, ultrasound shows high sensitivity for detecting positive cases in the N/L and VUJ regions. It may not always provide the necessary accuracy for diagnosing all types of urinary tract stones, particularly in areas like the PUJ and U/L. The overall sensitivity and specificity of CT are greater than US technique. Therefore, a combined approach using CT scanning as the reference standard may improve the diagnostic accuracy, especially for patients with symptoms or risk factors for stones in regions where ultrasound sensitivity is limited. This highlights the importance of using ultrasound in conjunction with other imaging modalities to ensure a thorough and accurate assessment of urological conditions.