THE VALUE
OF RENAL DUPLEX DOPPLER ULTRASONOGRAPHY IN CHILDREN WITH OBSTRUCTIVE
HYDRONEPHROSIS
Wang
Q, Quan XM, Wei GH, et al.
Children’s
Hospital, Chongqing University of Medical Sciences, China
Objective: Since last few years,
the renal duplex Doppler Ultrasonography (US) has been used to determine
obstructive hydronephrosis or physiology in adult. Now, our study aimed to
evaluate the feasibility and diagnostic value of this method in children
with obstructive uropathy.
Methods: From January 1998 to
January 2001,32 patients (23 male, 9 female) with unilateral or bilateral
hydronephrosis (38 kidneys), were examined by renal color doppler US. The
velocity and the resistive index (RI) of intrarenal arterial blood flow
(AF) were measured. The data on the healthy side and diseased side of the
renal were compared. 22 of them were operated. 8 patients were evaluated by
US postoperatively.
Results: The AF velocity ranged
from 0.21m/s to 0.74m/s(mean 0.48m/s)and RI was 0.75±0.05,of the affected renal in 32 patients. Those
of the opposite normal renal, the AF velocity ranged from 0.87m/s to
1.01m/s ( mean 0.94m/s;p<0.001 ),RI was 0.63±0.06( p<0.05 ). The difference of RI (dRI)
between the diseased and healthy side was > 0.1. After surgery, the mean
AF velocity increased to 0.73m/s (0.66～0.80m/s),
RI decreased to 0.64±0.055
and dRI was less than 0.1, with statistical differences (Ps<0.05).
Selected RI≥0.7 and
dRI>0.1 as an indicative value of obstruction, the sensitivity was 93.5%
and specificity was 85.8%.
Conclusion: The AF velocity of the
renal with obstructive hydronephrosis was markedly decreased and RI was
significantly higher than that of normal renal. These results suggest that
the renal duplex color doppler US be a useful examination and an accurate
method for diagnosing pediatric obstructive hydronephrosis.