DIAGNOSTIC VALUE OF DOPPLER US RESISTIVE
INDICE MEASUREMENT IN LOWER
AND UPPER URINARY TRACT INFECTIONS
Ozcelik G1, POLAT TB1, Hatipoglu S1,
Aktas S2, Calıskan C2, Cetinkaya F1
1Department of Pediatrics
2 Department of Radiology,
Sisli Etfal Training
and Research Hospital, Istanbul, Turkey
Objective: Determination of renal doppler US
resistive indice(RI) values in the discrimination of lower and upper
urinary tract infections(UTI)
Methods: 39 patients who were diagnosed to have UTI
according to clinical and laboratory examinations were involved in the
trial. 33 of the cases were girls, 6 were boys and their mean age was
5,09+/-3,94 years. Resetive indices were measured from the renal arteries
with doppler US accopmaniment in the first 42-72 hours. DMSA scanning was
performed in the first week and voiding cystoretrography was carried out
trhree weeks later.
Results: 20n patients were diagnosed to have lower UTI
(group 2) according to clinical and laborarory parameters. Fever was the
most common symptom in cases with upper UTI (17 patients). Leucocytosis (17
patients) and increased CRP (17 patients) were the most common laboratory
findings. No statistically significant difference was found between RI of
right and left kidneys in both groups. Mean resistive indice values were
found to be 0,70+/-0,08 in the group with upper UTI and 0,59+/-0,1 in the
group with lower UTI’s. Resistive indice values were found to be
significantly high in the firsr group (p<0,01).
Conclusion: Fever, leucocytosis and CRP elevation
still hold an important place in the discrimination of upper and lower
UTI’s in children. It was concluded that the high resistive indice values
in upper UTI’s might be valuable in the diagnosis of acute pyelonephritis.