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Role of resistive index in renal colic

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Abstract

We studied the role of duplex Doppler ultrasonography in the diagnosis of renal obstruction caused by ureteral calculi. Using duplex Doppler sonography, we evaluated the intrarenal hemodynamics of 27 patients who presented to the emergency department with renal colic. We performed Doppler ultrasonography on patients in whom US did not reveal any pathology causing renal colic and calculated and compared mean RI values of normal and obstructed kidneys and ΔRI values of each group. Threshold levels for the diagnosis of urinary tract obstruction (mean RI ≥ 0.70 and ΔRI ≥ 0.08) were used to determine the sensitivity and specificity of Doppler sonography for the diagnosis of urinary tract obstruction. Patients were investigated for revealing calculi diagnosis either by stone excretion history, intravenous pyelography or non contrast enhanced urinary computed tomography. A total of 162 intrarenal arterial Doppler recordings were made on 54 kidneys. Of the 16 patients with urinary obstruction, 11 (68%) had sonographic evidence of pelvicalyceal dilatation. The mean RI of the 16 obstructed and 11 unobstructed kidneys was 0.69 ± 0.04 and 0.61 ± 0.06 (mean ± standard deviation), respectively. The difference between the mean RI values for each group was statistically significant (P < 0.05). Mean RI values of the contralateral kidneys in the obstructed group and unobstructed group were 0.61 ± 0.03 and 0.59 ± 0.05, respectively. Also ΔRI value (0.07 ± 0.02) of obstructed kidney group was statistically higher than the ΔRI value (0.01 ± 0.03) of the unobstructed group (P < 0.05). The mean RI of the 16 obstructed kidneys (0.69 ± 0.04) was significantly greater than that of the 16 unobstructed contralateral kidneys (0.61 ± 0.03) (P < 0.05). This study supplements the existing evidence that, in acutely obstructed kidneys, renal Doppler recording can demonstrate altered renal perfusion before pelvicalyceal system dilatation and distinguish obstructed and unobstructed kidneys evaluated with suspicion of renal colic.

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References

  1. Rodgers PM, Bates JA, Irving HC (1992) Intrarenal Doppler ultrasound studies in normal and acutely obstructed kidneys. Br J Radiol 65:207–212

    Article  PubMed  CAS  Google Scholar 

  2. Platt JF, Rubin JM, Ellis HM et al (1989) Duplex Doppler US of the kidney:differentiation of obstructive from non-obstructive dilatation. Radiology 17:515–517

    Google Scholar 

  3. Shokeir AA, Provoost AP, El-Azab M et al (1997) Renal Doppler ultrasound in children with obstructive uropathy: effect of intravenous normal saline fluid load and furosemide. Br J Urol 80:313–318

    PubMed  CAS  Google Scholar 

  4. Shokeir AA, Nijman RJ, El-Azab M et al (1997) Partial ureteral obstruction: effect of intravenous normal saline and furosemide upon the renal resistive index. J Urol 157(3):1074–1077

    Article  PubMed  CAS  Google Scholar 

  5. Rawashdeh YF, Djurhuus JC, Mortensen J et al (2001) The intrarenal resistive index as a pathophysiological marker of obstructive uropathy. J Urol 165:1397–1404

    Article  PubMed  CAS  Google Scholar 

  6. Aslaksen A, Gothlin JH (1990) Ultrasonic diagnosis of ureteral calculi in patients with acute flank pain. Eur J Radiol 11:87–90

    Article  PubMed  CAS  Google Scholar 

  7. Platt JF, Rubin JM, Ellis JH (1993) Acute renal obstruction: evaluation with intrarenal duplex Doppler and conventional US. Radiology 186:685–688

    PubMed  CAS  Google Scholar 

  8. Erwin BC, Carroll BA, Sommer FG (1984) Renal colic: the role of ultrasound in initial evaluation. Radiology 152:147–150

    PubMed  CAS  Google Scholar 

  9. Laing FC, Jeffrey RB Jr, Wing VW (1985) Ultrasound versus excretory urography in evaluating acute flank pain. Radiology 154:613–616

    PubMed  CAS  Google Scholar 

  10. Hill MC, Rich JI, Mardiat JG, Finder CA (1985) Sonography vs. excretory urography in acute flank pain. AJR Am J Roentgenol 144:1235–1238

    PubMed  CAS  Google Scholar 

  11. Amis ES, Cronan JJ, Pfister RC, Yoder IC (1982) Ultrasonic inaccuracies in diagnosing renal obstruction. Urology 19:101–105

    Article  PubMed  Google Scholar 

  12. Rascoff JH, Golden RA, Spinowitz BS, Charytan C (1983) Non-dilated obstructive nephropathy. Arch Intern Med 143:696–698

    Article  PubMed  CAS  Google Scholar 

  13. Webb JAW (2000) Ultrasonography and Doppler studies in the diagnosis of renal obstruction. BJU Int 86(Suppl 1):25–32

    Article  PubMed  Google Scholar 

  14. Chen JH, Pu YS, Liu SP, Chiu TY (1993) Renal hemodynamics in patients with obstructive uropathy evaluated by duplex Doppler soography. J Urol 150:18–21

    PubMed  CAS  Google Scholar 

  15. Dodd GD, Kaufman PN, Bracken RB (1991) Renal arterial duplex Doppler ultrasound in dogs with urinary obstruction. J Urol 145:644–646

    PubMed  Google Scholar 

  16. Ulrich JC, York JP, Koff SA (1995) The renal vascular response to acutely elevated intrapelvic pressure: resistive index measurements in experimental obstruction. J Urol 154:1202–1204

    Article  PubMed  CAS  Google Scholar 

  17. Opdenakker L, Oyen R, Vervloessen I et al (1998) Acute obstruction of the renal collecting system: the intrarenal resistive index is a useful yet time-dependent parameter for diagnosis. Eur Radiol 8:1429–1432

    Article  PubMed  CAS  Google Scholar 

  18. Sauvain JL, Pierrat V, Chambers R et al (1989) Ultrasound and pulsed Doppler in the study of the arteries of the renal parenchyma during obstructive syndromes and dilatation of the excretory cavities of the kidney. J Radiol 70:389–398

    PubMed  CAS  Google Scholar 

  19. Haroun A (2003) Duplex Doppler sonography in patients with acute renal colic: prospective study and literature review. Int Urol Nephrol 35:135–140

    Article  PubMed  Google Scholar 

  20. Akçar N, Özkan IR, Adapınar B, Kaya T (2004) Doppler sonography in the diagnosis of urinary tract obstruction by stone. J Clin Ultrasound 32:286–293

    Article  PubMed  Google Scholar 

  21. Ichikawa I, Brenner BM (1979) Local intrarenal vasoconstrictor–vasodilator interactions in mild partial ureteral obstruction. Am J Physiol 236:F131

    PubMed  CAS  Google Scholar 

  22. Miletic D, Fuckar Z, Sustic A et al (1998) Resistance and pulsatility indices in acute renal obstruction. J Clin Ultrasound 26:79

    Article  PubMed  CAS  Google Scholar 

  23. Platt JF, Ellis JH, Rubin JM (1995) Role of renal Doppler imaging in the evaluation of acute renal obstruction. Am J Roentgen 164:379–380

    CAS  Google Scholar 

  24. Shokeir AA, Abdulmaaboud M (1999) Resistive index in renal colic: a prospective study. BJU Int 83:378–382

    Article  PubMed  CAS  Google Scholar 

  25. Shokeir AA, Provoost AP, Nijman RJM (1997) Resistive index in obstructive uropathy. Br J Urol 80:195–200

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Kovancılar Government Hospital, Department of Radiology, Kovancılar, Elazig, Turkey

    Mehmet Ruhi Onur

  2. Faculty of Medicine, Department of Radiology, Akdeniz University, Antalya, Turkey

    Metin Cubuk & Gokhan Arslan

  3. Faculty of Medicine, Department of Radiology, Gaziantep University, Gaziantep, Turkey

    Cagatay Andic

  4. Faculty of Medicine, Department of Emergency Medicine, Akdeniz University, Antalya, Turkey

    Mutlu Kartal

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  1. Mehmet Ruhi Onur
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  2. Metin Cubuk
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  3. Cagatay Andic
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  4. Mutlu Kartal
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  5. Gokhan Arslan
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Correspondence to Mehmet Ruhi Onur.

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Onur, M.R., Cubuk, M., Andic, C. et al. Role of resistive index in renal colic. Urol Res 35, 307–312 (2007). https://doi.org/10.1007/s00240-007-0116-2

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  • DOI: https://doi.org/10.1007/s00240-007-0116-2

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