Doppler sonographic evaluation of resistive index of intra-renal arteries in acute ureteric obstruction
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ORIGINAL PAPER
Doppler sonographic evaluation of resistive index of intra‑renal arteries in acute ureteric obstruction Maheswaran Viyannan1 · Shamsa Kappumughath Mohamed1 · Elango Nagappan1 · Devanand Balalakshmoji2 Received: 13 August 2020 / Accepted: 30 October 2020 © Società Italiana di Ultrasonologia in Medicina e Biologia (SIUMB) 2020
Abstract Background Acute ureteric colic is one of the most commonly encountered acute abdominal conditions. Diagnosis of obstruction caused by ureteric calculus occasionally becomes challenging if there is inadequate dilation of the urinary tract proximal to obstruction. In such a situation, intra-renal artery Doppler parameters can be used as a diagnostic tool. Our study compared intra-renal arterial Doppler in patients with obstructed and non-obstructed kidneys presenting within 24 h of onset of symptoms of unilateral acute renal colic. Results The resistivity index (RI) in the segmental arteries of all 54 patients with obstructed kidneys was significantly higher than in those with non-obstructed kidney: 0.75 vs. 0.56, with a p value less than 0.001, a sensitivity of 85% and a specificity of 93%. Conclusion Doppler ultrasound is a useful diagnostic tool in the evaluation of acute renal obstruction, thus enabling practitioners to avoid ordering unnecessary CT and exposing patients to ionizing radiation. An RI value > 0.7 has good sensitivity and specificity in our study. The results obtained in the study were comparable to those of pioneer studies conducted worldwide. Keywords Acute renal colic · Renal artery Doppler · Resistive index Abbreviations ARC Acute renal failure ER Emergency room USG Ultrasonography US Ultrasound RI Resistive index CT Computed tomography. NSAID Non-steroidal anti-inflammatory drugs GFR Glomerular filtration rate * Maheswaran Viyannan [email protected] Shamsa Kappumughath Mohamed [email protected] Elango Nagappan [email protected] Devanand Balalakshmoji [email protected] 1
Department of Radiology, No.3 Aaradhana, Gandhi Nagar, Masakalipalayam, Uppilipalayam, Coimbatore 641015, Tamilnadu, India
Department of Radiology, PSG Institute of Medical Sciences and Research, Peelamedu, Coimbatore, India
2
eGFR Estimated glomerular filtration rate. Tc99m DTPA Technetium−99 m- Diethylene-triaminepenta-acetate CDUS Color Doppler Ultrasound MPR Multiplanar reconstruction ROC Receiver operating characteristic curve PCS Pelvicalyceal system
Background Acute renal colic (ARC) is one of the common causes of patients presenting to the emergency room (ER). It accounts for 30–35% of urologic emergencies [1, 2]. The recurrence rate over a period of 5 years is 30–40% [2]. Ultrasonography (US) remains the most commonly used modality in the initial evaluation of patients presenting with acute abdomen, especially in children [3], and the utility of ultrasound in the diagnosis of ARC cannot be overstated in cases where ARC is one of the most common pathologies presenting as acute abdomen. Absence of significant dilatation of the
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