Doppler sonography in congenital ureteropelvic junction obstruction

Autor: Michael Riccabona, Ekkehard Ring, Vilits P, G. Fueger, P. Petritsch
Rok vydání: 1996
Předmět:
Zdroj: European Journal of Ultrasound. 3:203-209
ISSN: 0929-8266
DOI: 10.1016/0929-8266(95)00151-g
Popis: Objective: The accurate diagnosis of severe obstruction in congenital ureteropelvic junction obstruction (UPJO) and the indication for surgical intervention are still a matter of debate. This study tries to analyze the value of Doppler sonography (DS) for the assessment of obstruction in congenital UPJO. Methods: We examined 43 healthy children (mean age = 33.4 months), with a normal Resistance Index (RI) (RI = 66.8% ± 2.1% S.D.), 20 healthy neonates with a physiologically higher mean RI of 74% ± 3.2% S.D., 24 children (mean age = 6.7 years) who had a pyeloplasty at least 1 year before (mean RI = 67.4% ± 1.2% S.D.) and 67 children (mean age = 37 months) with UPJO using DS measuring the RI in both kidneys at the segmental renal arteries. Twelve infants with prenatally diagnosed UPJO showed severe obstruction on diuretic renography within the first 4 weeks of life and were treated surgically. Thirteen older children (mean age = 3.4 years) also suffered from decompensated UPJO on scintigraphy and underwent pyeloplasty. Results: The children with decompensated UPJO preoperatively showed a significantly increased mean RI of 75% ± 3.4% S.D. with asymmetric values, which returned to normal after operation (RI = 68.3% ± 2.1% S.D.). All 42 patients (mean age = 2.6 years) with a moderate UPJO without indication for surgery on diuretic renography showed a normal and symmetrical mean RI of 67.5% ± 2.2% S.D. Conclusion: Our results indicate that Doppler sonography may serve as an additional functional parameter to assess the degree of obstruction in UPJO and could influence the decision for surgical intervention.
Databáze: OpenAIRE
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