Document Detail

Renal vein Doppler sonography of obstructive uropathy.
MedLine Citation:
PMID:  11906873     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Obstructive uropathy in the early stages can be difficult to diagnose using either standard sonography or the arterial resistive index. We tested the hypothesis that acute obstruction of the renal collecting system reduces the intraparenchymal renal compliance, which affects the intraparenchymal venous blood flow to a greater degree than the arterial flow. SUBJECTS AND METHODS: Twelve patients with clinical evidence of acute obstructive uropathy were referred for helical CT to confirm the diagnosis and to provide a gold standard by which we could evaluate the sonographic findings in the 12 test patients. Twelve patients without renal disease served as a control group. Doppler sonography of the interlobar arteries and veins of both kidneys then was performed, with the sonographer unaware of which kidney had an obstruction. Peak venous flow measurements and arterial resistive and venous impedance indexes were obtained. The impedance indexes of the obstructed and unobstructed kidney were compared for each patient. RESULTS: The mean arterial resistive indexes of the obstructed kidneys were larger than those of the unobstructed kidneys, 0.67 +/- 0.08 and 0.62 +/- 0.05, respectively (p = 0.05). The venous impedance indexes comparing obstructed and unobstructed sides were 0.38 +/- 0.25 and 0.80 +/- 0.25, respectively, a statistically significant result (p = 0.0002). On average, the peak venous flow signal in the obstructed kidney was 69% higher than that of the unobstructed kidney (p = 0.04) and 86% higher than that of the peak venous flow signal in the control group (p = 0.005). CONCLUSION: Renal obstruction alters the venous flow to a greater extent than the arterial flow, and a comparison between the venous flow in the obstructed and unobstructed kidneys may improve diagnostic accuracy.
Grant A Bateman; Ramesh Cuganesan
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  AJR. American journal of roentgenology     Volume:  178     ISSN:  0361-803X     ISO Abbreviation:  AJR Am J Roentgenol     Publication Date:  2002 Apr 
Date Detail:
Created Date:  2002-03-21     Completed Date:  2002-04-12     Revised Date:  2008-02-15    
Medline Journal Info:
Nlm Unique ID:  7708173     Medline TA:  AJR Am J Roentgenol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  921-5     Citation Subset:  AIM; IM    
Discipline of Medicine, University of Newcastle, Callaghan Campus, Callaghan, New South Wales, 2308 Australia.
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MeSH Terms
Acute Disease
Blood Flow Velocity*
Hydronephrosis / etiology,  ultrasonography*
Middle Aged
Renal Artery / ultrasonography
Renal Veins / ultrasonography*
Ultrasonography, Doppler*
Ureteral Obstruction / complications,  physiopathology,  ultrasonography
Vascular Resistance

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