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Distinction between obstructive and nonobstructive hydronephrosis: value of diuresis duplex Doppler sonography
R Mallek1, A A Bankier, A Etele-Hainz
1Department of Radiology, University of Vienna, Austria.
AJR. American Journal of Roentgenology
|January 1, 1996
Summary
Diuresis duplex Doppler sonography accurately distinguishes obstructive from nonobstructive hydronephrosis. This method shows high accuracy, especially for indeterminate cases identified by diuretic renography.
Area of Science:
- Nephrology
- Radiology
- Medical Imaging
Background:
- Hydronephrosis diagnosis can be challenging.
- Differentiating obstructive from nonobstructive causes is crucial for patient management.
- Diuretic renography is a standard but sometimes indeterminate diagnostic tool.
Purpose of the Study:
- To assess the diagnostic accuracy of diuresis duplex Doppler sonography.
- To differentiate obstructive from nonobstructive hydronephrosis.
- To evaluate resistive index changes after furosemide administration.
Main Methods:
- Prospective study of 48 kidneys in 26 patients with suspected renal obstruction.
- Duplex Doppler sonography and diuretic renography performed before and after furosemide.
- Calculation of resistive indexes and ROC curve analysis for diagnostic value.
Main Results:
- Significant differences in resistive indexes were observed between obstructive, nonobstructive, and normal kidneys post-furosemide.
- Obstructive kidneys showed a significant resistive index increase after furosemide.
- A diuresis resistive index of 0.75 achieved 95% accuracy in diagnosing renal obstruction.
Conclusions:
- Diuresis duplex Doppler sonography is an accurate method for differentiating renal obstruction.
- This technique aids in distinguishing obstructive from nonobstructive hydronephrosis.
- It is particularly useful for indeterminate cases identified by diuretic renography.