Study on the Role of Doppler Ultrasonography and Resistive Index in Obstructive Uropathy.

Saravanan, P R (2006) Study on the Role of Doppler Ultrasonography and Resistive Index in Obstructive Uropathy. Masters thesis, Madras Medical College, Chennai.


Download (110kB) | Preview


INTRODUCTION : Despite recent advances in the field of Urological Ultrasonographycertain diseases of Upper Urinary Tract such as obstructive dilatationremain elusive to conventional imaging techniques.While conventional US is a sensitive method fordetecting Upper Urinary Tract dilatation with upto 98% sensitivityreported in earlier studies it lacks the ability to provide significantphysiological data on renal status and, hence cannot specifically assessthe cause of obstructive dilatation. This lack is especially relevant inthe paediatric age group in which the obstruction, and when propermanagement depends on detecting the underlying cause of dilatation.However with the advent of DU new insight into the physiology of thekidney has emerged, enabling the detecting of subtle renal blood flowchanges associated with various pathophysiological conditions. Thesechanges may be semiquantified by calculating the Intrarenal VascularResistive Index. AIM: The role of resistive index in the diagnosis of acute renal colic andobstructive uropathy is yet to be clearly defined inspite of a plethoraof literature.The following are the aims of this study:- the primary aim is to determine whether the resistive index is sensitive andspecific in diagnosing acute renal colic.To determine whether resistive index measurements are affected by ageand sex. To delineate the influence of site of obstruction on the resistive indexmeasurements. To determine the extent of variation of resistive index with the duration ofobstruction. To determine the role of inter-renal resistive index difference in diagnosingacute renal colic. MATERIAL AND METHODS : The study was conducted on patients who attended the outpatientdepartment of Madras Medical College and Government General Hospital during the period August2003 to July 2005The study included 36 patients (30 male and 6 female, mean age range) with72 kidneys, who presented with unilateral loin pain suspected of being renalcolic.Immediately on presentation all patients were prospectively evaluated withrenal ultrasonography(US) followed by intravenous urography (IVU).USstudies were carried out during the attack of loin pain in all patients andbefore giving any medications in most. CONCLUSION : In conclusion from the study it is evident that the resistive indexmeasurement by Doppler ultrasound has a high sensitivity and specificity indetecting acute renal colic.The sensitivity and specificity of resistive index in our studycorrelates with the finding of Platt et al, Shokeir et al ,Malitec et al.The most recent study conducted by Corderica et al also validates our findings.As in previous studies inter-renal difference in resistive index ismore sensitive and specific than resistive index and probably may play animportant role in the diagnosis of obstruction in patients with medical renaldisease and in patients who present early when the resistive index is yet toincrease. RI measurements are not significantly influenced by age and sexin our patients who were in the age group of 20-40 years. Neither the site of obstruction nor the duration of obstructionsignificantly influenced the resistive index.In conclusion resistive index measurement by doppler ultrasound is a sensitive and a highly specific test that can contribute significantly to thediagnosis and management of acute unilateral renal obstruction, particularlyin situations in which IVU is undesirable or contraindicated as in pregnancy,contrast allergy or compromised renal function.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Doppler Ultrasonography ; Resistive Index ; Obstructive Uropathy.
Subjects: MEDICAL > Urology
Depositing User: Kambaraman B
Date Deposited: 09 Aug 2017 03:50
Last Modified: 09 Aug 2017 03:50

Actions (login required)

View Item View Item