COMPARATIVE ASSESSMENT OF UROLITHIASIS DETECTION BY ULTRASOUND AND X-RAY OF KIDNEY, URETER AND BLADDER AMONG ADULT PATIENTS AT IRFAN GENERAL HOSPITAL PESHAWAR

Abstract

In the current study the aim of study was to compare the stone detection rate and stone size distribution between Ultrasound KUB and Plain X-ray KUB radiography in adult patients with suspected urolithiasis who were presented to Irfan General Hospital, (IGH), Peshawar. Fifteen hundred adult patients with clinical suspicion of urolithiasis were included in this cross-sectional comparative study over six-month period. The patients were divided into two parallel diagnostic groups of 75 patients in each group who were evaluated with Plain X-ray KUB and Ultrasound KUB, respectively. Data regarding demography, clinical history, stones, stone size (<5 mm, 5–10 mm, >10 mm), and anatomical location were documented and analyzed in SPSS version 22. One hundred and fourteen patients (76.0%) had urinary stones detected. Calculi were detected by ultrasound KUB in 63 (84.0%) patients and by X-ray KUB in 51 (68.0%) patients. There was a statistically significant difference in the rate of stone detection between imaging modality (5.263, p = 0.022$). Among all detected stones across both modalities (n = 114), 47 (31.3%) were <5 mm, 42 (28.0%) were 5–10 mm, and 25 (16.7%) were >10 mm. There was no statistically significant difference between the two modalities in stone-size distribution (chi^2 = 0.237, p = 0.888$). The most frequent anatomical site (22.0%) was ureteric calculi, followed by calyces (19.3%), renal pelvis (17.3%) and urinary bladder (17.3%). The ability of ultrasound KUB to detect stones was found to be significantly superior to Plain X-ray KUB in urolithiasis suspected patients. Due to its non- Ultrasound KUB is recommended as the first imaging modality to use if able to do so in resource-limited clinical settings.

Keywords: Kidney stones, Nephrolithiasis, Ultrasound (USG), X-ray KUB, CT.