Rui X et al. (2008) Ultrasonographic diagnosis and typing of renal tuberculosis. Int J Urol 15: 135–139
The value of ultrasonography for diagnosing renal tuberculosis is controversial, with several published reports showing notably varied results. Nonetheless, B-mode ultrasonography is widely used for this purpose on account of its convenience, low cost and noninvasive nature. Rui and colleagues retrospectively analyzed ultrasound images from 258 patients with renal tuberculosis, and evaluated the clinical value of ultrasonography for diagnosing and classifying this disease.
The patients (mean age 45.3 years, range 17–73 years) were diagnosed between 1993 and 2005; 120 and 118 patients had left and right kidney tuberculosis, respectively, and the remaining 20 patients had bilateral kidney tuberculosis. Some patients, in addition to ultrasonography, underwent one or more other investigations to confirm their diagnosis, including intravenous urography, retrograde pyeloureterography, CT and cystoscopy.
Analysis of ultrasound images correctly diagnosed renal tuberculosis in 152 (58.9%) of 258 patients. In comparison, 113 (46.1%) of 245 patients who underwent intravenous urography or retrograde pyeloureterography and 87 (63.0%) of 138 patients who underwent CT were correctly diagnosed. The authors defined six pathologic subtypes of renal tuberculosis on the basis of specific features of the ultrasound images, which improved clinical diagnosis and also facilitated selection of an appropriate treatment strategy.
The authors conclude that ultrasonography has definite advantages for the diagnosis of renal tuberculosis, although multimodal diagnostic work-up is still required to confirm the presence of this disease and avoid misdiagnosis. Furthermore, ultrasonography is particularly useful for monitoring disease progression in patients receiving antituberculosis chemotherapy.
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Clinical value of ultrasonography in diagnosis of renal tuberculosis. Nat Rev Urol 5, 237 (2008). https://doi.org/10.1038/ncpuro1088