Objectives: The ultrasonographic diagnosis of renal lithiasis colic is suggested by the existence of hydronephrosis, but the certainty is given by the direct visualization of the ureteral calculus. The aim of this study is to assess the performance of ultrasound in identifying ureteral calculi compared to other imaging methods (abdominal X-ray, urography and computed tomography).
Material and method: We performed ultrasonographic examination (one or multiple examinations) in 217 patients with renal colic and ureterolithiasis. The calculus was identified by abdominal radiography, urography, computed tomography or by eliminating the calculus
Results: Ureteral calculi were ultrasonographically identified in 159 of the examined patients: 121 in the initial examination, 38 in the additional reexaminations (73.27% sensitivity compared to 48.39% X-ray, 68.37% urography, and 91.11% CT). Hydronephrosis was identified in 193 patients (88.94%). None of the imaging methods managed to identify ureteral calculus in 4 of the patients (1.84%), the diagnosis being retrospective, based on the urinary elimination of the calculus. The calculi were located 12.58% in the pelviureteric junction, 10.69% in the proximal ureter, 6.91% in the mid ureter, 28.93% in the distal ureter, and 40.88% in the pelviureteric junction.
Conclusions: Ultrasound is a sensitive method for detecting UL in renal colic and can be used as the initial imaging method in investigating these patients. The presence or absence of hydronephrosis can not be considered as a discriminatory factor for the diagnosis of ureterolithiasis.