Document Detail


Evaluation of Doppler ultrasonography and dynamic contrast-enhanced CT in acute and chronic renal obstruction.
MedLine Citation:
PMID:  9048291     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The development of a reliable, minimally invasive method of distinguishing physiologically significant renal obstruction from dilation without obstruction would have important clinical implications. As it is well known that renal blood flow decreases over time in the presence of obstruction, we investigated the ability of color flow Doppler ultrasonography and dynamic contrast-enhanced CT scanning to detect changes in blood flow in unilaterally obstructed porcine kidneys. In the initial phase of this study, the effect of acute unilateral obstruction were studied in nine pigs. The resistive index (RI) was measured with Doppler ultrasonography, and renal blood flow was quantitated with dynamic CT using tracer kinetic principles and deconvolution. The RI measurements were unable to distinguish between the obstructed kidneys and their controls. Dynamic CT scanning demonstrated a greater fall in blood flow in the obstructed kidney, and this change was significantly different from baseline. The same findings were supported by radiolabelled microsphere blood-flow measurement. In the chronic portion of the study, after surgical creation of a partial ureteric obstruction, the kidneys were studied by both techniques at 1, 2, and 3 weeks. Again, RI was unable to demonstrate any difference between obstructed and unobstructed kidneys, while CT showed a progressive fall in blood flow in each successive week that was statistically significant. Dynamic contrast-enhanced CT scanning is a promising diagnostic tool that might be used to distinguish a functionally significant renal obstruction from nonobstructive dilation. Further clinical studies to validate this technique are warranted.
Authors:
R K Singal; T Y Lee; H A Razvi; H Mosalei; J D Denstedt; S S Chun; J Bennett; W Romano; M Toll
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of endourology / Endourological Society     Volume:  11     ISSN:  0892-7790     ISO Abbreviation:  J. Endourol.     Publication Date:  1997 Feb 
Date Detail:
Created Date:  1997-05-15     Completed Date:  1997-05-15     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8807503     Medline TA:  J Endourol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  5-13     Citation Subset:  IM    
Affiliation:
Division of Urology, St. Joseph's Health Centre Lawson Research Institute, University of Western Ontario, London, Canada.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Animals
Blood Flow Velocity / physiology
Chronic Disease
Contrast Media / administration & dosage
Female
Infusions, Intravenous
Kidney / blood supply*,  radiography,  ultrasonography
Microspheres
Swine
Tomography, X-Ray Computed*
Ultrasonography, Doppler, Color*
Ureteral Obstruction / diagnosis*,  physiopathology
Chemical
Reg. No./Substance:
0/Contrast Media

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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