Skip to main content
SpringerLink
Log in

Assessment of ureterovesical jet dynamics in obstructed ureter by urinary stone with color Doppler and duplex Doppler examinations

  • Original Paper
  • Published:
Urolithiasis Aims and scope Submit manuscript

Abstract

This study was designed to evaluate ureterovesical jet dynamics in obstructed ureter and to compare it with those of contralateral unobstructed side. Forty-six patients with diagnosis of ureteral stone, based on imaging findings in computed tomography were enrolled in this study. The gray-scale ultrasound exam from both kidneys and urinary bladder was performed. Then, ureterovesical jet characteristics including ureteral jet frequency, duration and peak velocity were assessed by color Doppler and duplex Doppler studies in both obstructed and unobstructed ureters by a radiologist, 15–30 min after oral hydration with 750–1,000 mL of water. When compared with contralateral normal side, the ureterovesical jet in obstructed ureter showed less frequency (0.59 vs. 3.04 jets/min; P < 0.05), shorter duration (1.24 vs. 5.26 s; P < 0.05) and lower peak velocity (5.41 vs. 32.09 cm/s; P < 0.05). The cut-off points of 1.5 jets/min, 2.5 s and 19.5 cm/s for difference of ureteral jet frequency, duration and peak velocity between obstructed and contralateral normal ureters yielded sensitivities of 97.8, 95.6 and 100 % and specificities of 87, 87.9 and 97.8 %, respectively for diagnosis of ureteral obstruction. Given the safety of Doppler study and significant differences in flow dynamics of obstructed versus unobstructed ureters, our findings demonstrated the utility of Doppler ultrasound examination as a useful adjunct to gray-scale ultrasound by improving the accuracy of ultrasound exam in diagnosis of ureteral obstruction.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Clark JY, Thompson IM, Optenberg SA (1995) Economic impact of urolithiasis in the United States. J Urol 154(6):2020–2024

    Article  PubMed  CAS  Google Scholar 

  2. Patlas M, Farkas A, Fisher D, Zaghal I, Hadas-Halpern I (2001) Ultrasound vs. CT for the detection of ureteric stones in patients with renal colic. Br J Radiol 74:901–904

    PubMed  CAS  Google Scholar 

  3. Cox IH, Erickson SJ, Foley WD, Dewire DM (1992) Ureteric jets: evaluation of normal flow dynamics with color Doppler sonography. AJR Am J Roentgenol 158:1051–1055

    Article  PubMed  CAS  Google Scholar 

  4. Burge HJ, Middleton WD, McClennan BL, Hildebolt CF (1991) Ureteral jets in healthy subjects and in patients with unilateral ureteral calculi: comparison with color Doppler US. Radiology 180:437–442

    PubMed  CAS  Google Scholar 

  5. Ciftci H, Cece H, Dusak A, Savas M, Verit A, Yeni E (2010) Study of the ureterovesical jet flow by means of duplex Doppler ultrasonography in patients with residual ureteral stone after extracorporeal shock wave lithotripsy. Urol Res 38:47–50

    Article  PubMed  Google Scholar 

  6. Karabulut N, Karabulut A (2002) Colour Doppler evaluation of ureteral jets in normal second and third trimester pregnancy: effect of patient position. Br J Radiol 75:351–355

    PubMed  CAS  Google Scholar 

  7. Sakate M, Teixeira A, Sakate A et al (2006) study of the ureterovesical jet by means of color Doppler in patients with and without vesicoureteral reflux. Radiol Bras 39(6):425–428

    Article  Google Scholar 

  8. Ellenbogen PH, Scheible FW, Tainer LB, Leopold GR (1978) Sensitivity of gray scale ultrasound in detecting urinary tract obstruction. AJR Am J Roentgenol 130:731–733

    Article  PubMed  CAS  Google Scholar 

  9. Kalmon EH, Albers DD, Dunn JH (1955) Ureteral jet phenomenon; stream of opaque medium simulating an anomalous configuration of the ureter. Radiology 65:933–935

    PubMed  CAS  Google Scholar 

  10. Price CI, Adler RS, Rubin JM (1989) Ultrasound detection of differences in density: explanation of the ureteric jet phenomenon and implications for new ultrasound applications. Invest Radiol 24:876–883

    Article  PubMed  CAS  Google Scholar 

  11. Kremer H, Dobrinski W, Mikyska M, Baumgartner M, Zollner N (1982) Ultrasonic in vivo and in vitro studies on the nature of the ureteral jet phenomenon. Radiology 142:175–177

    PubMed  CAS  Google Scholar 

  12. Brenner BM (1996) The kidney. WB Saunders, Philadelphia

    Google Scholar 

  13. Strehlau J, Winkler P, la Roche J (1997) The uretero-vesical jet as a functional diagnostic tool in childhood hydronephrosis. Pediatr Nephrol 11:460–467

    Article  PubMed  CAS  Google Scholar 

  14. Dubbins PA, Kurtz AB, Derby J, Goldberg BB (1981) Ureteric jet effect: the echographic appearance of urine entering the bladder. Radiology 140:513–515

    PubMed  CAS  Google Scholar 

  15. Bakler SM, Middleton WD (1992) Color Doppler sonography of ureteral jets in normal volunteers: importance of the relative specific gravity of urine in the ureter and bladder. AJR Am J Roentgenol 159:773–775

    Article  Google Scholar 

  16. Asrat T, Roossin MC, Miller EI (1998) Ultrasonographic detection of ureteral jets in normal pregnancy. Am J Obstet Gynecol 178:1194–1198

    Article  PubMed  CAS  Google Scholar 

  17. Burke BJ, Washowich TL (1998) Ureteral jets in normal secondand third-trimester pregnancy. J Clin Ultrasound 26:423–426

    Article  PubMed  CAS  Google Scholar 

Download references

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Radiology, Poursina Hospital, Guilan University of Medical Sciences, Rasht, Iran

    Ali Babaei Jandaghi, Ahmad Alizadeh, Alireza Rajabzadeh Kanafi & Amin Keshavarz Zirak

  2. Urology Research Center, Guilan University of Medical Sciences, Rasht, Iran

    Siavash Falahatkar & Samaneh Esmaeili

  3. Department of Radiology, Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, 1989934148, Tehran, Iran

    Ramin Pourghorban

  4. Department of Radiology, 501 University Hospital, AJA University of Medical Sciences, Tehran, Iran

    Babak Shekarchi

Authors
  1. Ali Babaei Jandaghi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Siavash Falahatkar
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ahmad Alizadeh
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Alireza Rajabzadeh Kanafi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ramin Pourghorban
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Babak Shekarchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Amin Keshavarz Zirak
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Samaneh Esmaeili
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ramin Pourghorban.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Jandaghi, A.B., Falahatkar, S., Alizadeh, A. et al. Assessment of ureterovesical jet dynamics in obstructed ureter by urinary stone with color Doppler and duplex Doppler examinations. Urolithiasis 41, 159–163 (2013). https://doi.org/10.1007/s00240-012-0542-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00240-012-0542-7

Keywords

Search

Navigation