Aims and objectives
Duplex Doppler ultrasound is a safe and useful modality for evaluation of children with hydronephrosis.
It may be used to improve the ability of conventional ultrasound in distinguishing between obstructive and non-obstructive hydronephrosis.
Resistive index (RI) is the most valuable duplex index reflecting the renal obstructive conditions.
Diagnostic value of RI has been shown in the evaluation of hydronephrosis in children as well as in adults.
In children with unilateral ureteropelvic junction obstruction (UPJO) increase of RI in intraparenchymal arteries may be a noticeable finding....
Methods and materials
In a prospective studybetween January 2014 and March 2015,children referred to radiology department of EmamHosein Children hospital (a tertiary center in Isfahan,
Iran) for evaluation of unilateral hydronephrosis were enrolled,
consecutively.
The patients with the evidence of UPJO in grey-scale ultrasound were offered for supplementary Doppler study.
In duplex Doppler study mean of RI of arcuate arteries in upper,
middle and lower parts of both kidneys of each patient were obtained.
Then RI ratio and difference of RI between kidneys of each patient (dRI) were...
Results
Of the 51 patients with primary diagnosis of UPJO in grey scale ultrasound,
27 were confirmed as UPJO by diuretic renal scintigraphy,
and the others had various degrees of decrease in renal function and perfusion or had normal scan.
UPJO patients were 16 (59.3%) male and 11 (40.7) female aged 2 months to 9 years.
Rate of non-complete and complete UPJO were 85.2% and 14.8%,
respectively.
Mean RI in kidneys with complete UPJO was 0.77 ± 0.09 and in kidneys with non-complete UPJO was 0.68...
Conclusion
Using RI,
RI ratio and dRI can provide a non-ionizing convenient method for predicting complete UPJO and may be used for supporting the results of DPTA scan especially in challenging diuretic renograms.
Larger studies are needed to validate our findings.
Personal information
Maryam Riahinezhad MD,
Radiologist,
Emam Hosein Children hospital,
Isfahan University of Medical Sciences,
Isfahan,
Iran;
[email protected]
Amir Hossein Sarrami MD,
Resident of Radiology,
Emam Hosein Children hospital,
Isfahan University of Medical Sciences,Isfahan,
Iran;
[email protected]
Maryam Farghadani MD,
Radiologist,
Alzahra hospital,
Isfahan University of Medical Sciences,Isfahan,
Iran;
[email protected]
References
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2- Lim GY,Jang HS,Lee EJ,Lim YS,Jung SE,Lee JM,et al.Utilityof theresistanceindexratioindifferentiatingobstructivefromnonobstructivehydronephrosisinchildren.J Clin Ultrasound.1999;27(4):187-93.
3- Okada T,Yoshida H,Iwai J,Matsunaga T,Yoshino K,Ohtsuka Y,et al.PulsedDopplersonography ofthehilarrenalartery:differentiationofobstructivefromnonobstructivehydronephrosisinchildren.J Pediatr Surg.2001;36(3):416-20.
4- Brkljacić B,Kuzmić AC,Dmitrović R,Rados M,Vidjak V.Dopplersonographicrenalresistance index and resistance index ratio inchildrenand adolescents with unilateralhydronephrosis.Eur Radiol.2002;12(11):2747-51.
