Diagnostic accuracy of Doppler twinkling artifact for identifying urolithiasis: a systematic review and meta-analysis

The goal of this study was to perform a comprehensive meta-analysis to assess the overall diagnostic value of Doppler twinkling for the diagnosis of urolithiasis. We systematically searched the PubMed, EMBASE, and Cochrane Library databases from inception through May 31, 2021. Studies including patients with urolithiasis who underwent color flow Doppler sampling to highlight the twinkling artifact and computed tomography were included. Diagnostic test meta-analysis was performed with a bivariate model. We used summary receiver operating characteristic curves to summarize the overall diagnostic performance. The weighted sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio were calculated. Sixteen studies involving 4572 patients were included in the systematic review and meta-analysis. The weighted sensitivity was 0.86 (95% confidence interval [CI] 0.72–0.94), specificity 0.92 (95% CI 0.75–0.98), positive likelihood ratio 11.3, negative likelihood ratio 0.2, and diagnostic odds ratio 75.5. The Doppler twinkling artifact has good diagnostic value for the diagnosis of urolithiasis and should be used as a complementary tool in the diagnosis of urolithiasis.