The potential use of diuresis Doppler sonography in PUJ obstruction

Three cases of proven PUJ (pelvi-ureteric junction) obstruction in whom duplex Doppler sonography was performed are described. In one case, there was a duplex transplant kidney with PUJ obstruction of the lower pole moiety. The resistive index of an interlobar lower pole artery was markedly elevated compared to that of an artery in the upper unobstructed moiety. In the other two cases, the resistive index of interlobar arteries of native kidneys increased significantly following intravenous frusemide simultaneous with an increase in the degree of pelvicalyceal dilatation. It is proposed that diuresis Doppler sonography may provide additional diagnostic information in patients with PUJ obstruction, and that the method warrants further evaluation.