Role of doppler sonographic evaluation of intra-renal hemodynamic changes in diagnosis of obstructive uropathy and in differentiation of acute and chronic obstructive uropathy
Journal Title: Medpulse International Journal of Radiology - Year 2018, Vol 5, Issue 3
Abstract
Background: Sonography is the most commonly used modality for initial evaluation and diagnosis of renal obstruction. Gray scale sonography can detect hydronephrosis and hydroureter proximal to the level of obstruction and Doppler helps in differentiating acute obstruction from chronic obstruction. The Aim of our study is to determine usefulness of the renal Doppler especially venous impedance index in evaluating obstructive uropathy and to differentiate acute obstruction from chronic cases. Methods: Twenty patients were enrolled which include eight patients with acute renal colic from unilateral stone disease, four patients with unilateral chronic obstruction due to various causes and eight normal persons. The diagnosis was confirmed by computed tomography in all cases. All patients were examined prospectively by conventional and Doppler sonography. The impedance indices and peak flow signals of the interlobar arteries and veins of both kidneys were calculated from spectral Doppler waveforms in all three groups. Results: The mean venous impedance index on the acutely obstructed side was lower than the index on the unobstructed side: 0.26 ± 0.06 and 0.53 ± 0.3 (mean ± SD). The mean venous impedance index on the acutely obstructed side was less than the indices both on the chronically obstructed side and in the control subjects. In acute cases, the mean arterial resistive index on the obstructed side was higher than the index on the unobstructed side: 0.62 ± 0.06 and 0.57 ±0.06, respectively. No statistically significant difference was detected between other parameters evaluated for the test and control groups. Conclusion: Renal venous impedance index values may be helpful in differentiating acute obstruction from chronic cases when used along with the arterial resistive index
Authors and Affiliations
Ketan Rathod, Nandish Kumar, Nandini Bahri
Keywords
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