Duplex sonography in obstructive uropathy

Abstract EN

Purpose : Assessment of the sensitivity of Duplex sonography (gray-scale ultrasound and color Doppler sonography) in the diagnosis of patients with upper obstructive uropathy and in differentiating these patients from other patients With non-obstructive dilated pelvi-calyceal system (PCS).

Patients & Methods : Our research included 47 patients.

The sex distribution was 23 male (48.9 %) and 24 female (51.1 %).

All patients underwent US, color Doppler and plain X-ray examinations.

Excretory urography was done for 36 cases of our patients while ascending pyelography was done for 3 patients.

These patients were classified into 3 groups: complete obstruction group including 20 patients (42.5 %), partial obstruction group including 13 patients (27.7 %) and non-obstructive dilated pelvi-calyceal system (PCS) group including 14 case (29.8 %).

Five cases with equivocal results (complete obstruction or partial), were examined with color Doppler sonography twice (pre and post injection of diuretics).

Results : Plain X ray detected stones in 17 / 33 case (51 % sensitivity) with complete and partial obstruction.

US detected stones (opaque and radiolucent) in 25 / 33 case (75 % sensitivity).

The resistive index (Rl) in complete obstruction group ranged between (0.7-1), in partial obstruction group ranged between (0.44-0.67) and in non-obstructive dilated PCS group, it was between (0.47-0.50).

Postoperative color Doppler follow up was done for 4 cases of complete obstructive group.

Conclusion : Both color and power Doppler US have an important role in differentiation between obstructive and nonobstructive dilated upper uropathy by measurement of the Rl.

In addition, US is useful in diagnosing cases with stricture ureter and chronic ureteric reflux.