Diagnostic accuracy of color Doppler sonographic study of the ureteric jets in evaluation of hydronephrosis

Júnior, José de Bessa; Dénes, Francisco Tibor; Chammas, Maria Cristina; Cerri, Luciana Mendes de Oliveira; Monteiro, Edison Daniel Schneider; Buchpiguel, Carlos Alberto; Cerri, Giovanni Guido; Srougi, Miguel

doi:10.1016/j.jpurol.2007.10.013

Cited by 27 publications

(23 citation statements)

References 19 publications

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“…DRUS can help the discrimination of obstructive nonrefluxing from nonobstructive, nonrefluxing hydroureter with the cutoff value of 22 % for the D ratio other hand, the application of CTU has been limited to adult patients [15]. De Bessa et al [17] explored the efficacy of color Doppler sonography in discriminating between obstructive and nonobstructive hydronephrosis in children and indicated that a relative jet frequency less than 25 % could be a good indicator of obstruction in severe unilateral hydronephrosis. Nevertheless, its value as an independent predictor of obstruction is yet to be defined; moreover, the study was investigated to merely determine obstruction at proximal ureter and not the distal ureter that is observed in obstructed hydroureter.…”

Section: Discussionmentioning

confidence: 99%

Drainage-related ultrasonography (DRUS): a novel technique for discriminating obstructive and nonobstructive hydroureters in children

et al. 2014

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Background Despite advances in urologic imaging, the paucity of an optimal technique that accurately clarifies obstructive and nonobstructive hydroureter exists. Objective This study was conducted to introduce a novel and modified ultrasonographic technique, known as drainage-related ultrasonography (DRUS), discriminating obstructive and nonobstructive, nonrefluxing hydroureter. Materials and methods A total of 358 children (mean age, 3.7 years) with 418 nonrefluxing hydroureter were included. These children were composed of two groups of obstructive nonrefluxing (141 children with 157 dilated ureters) and nonobstructive, nonrefluxing (217 children with 261 hydroureter). The definite diagnosis regarding the subtype of hydroureter was derived from appropriate investigation. The maximum diameter of the dilated ureter, which was observed on ultrasonography, was recorded before and after 3 h of catheterization, as D1 and D2, respectively. To assess the D ratio, a formula was developed, that is, [(|D1 -D2|)/D1] 9 100. Values were recorded and cutoff points were set to discriminate between subtypes. Results Obstructive versus nonobstructive subtypes of nonrefluxing hydroureter were clarified with 78.5 % sensitivity and 83.4 % specificity, by setting a cutoff point of 22 % for the D ratio. Regardless of the cutoff point assigned to the reduction in D (D2 compared with D1), DRUS revealed 93.9 % sensitivity, 80.6 % specificity, 63.2 % positive predictive value, and 97.4 % negative predictive value in discriminating upper from lower obstruction. Conclusion DRUS affords favorable results in terms of differentiating between obstructive and nonobstructive, nonrefluxing hydroureter, as well as between upper and lower obstruction in obstructive cases. It has the potential to become an efficient imaging modality in the diagnostic algorithm of hydroureter.Keywords Urinary tract obstruction Á Hydroureter Á Technetium-99 m DTPA Á Radioisotope renography Á Urinary bladder Á Drainage Sommario Background Nonostante i progressi nella diagnostica per immagini urologica, vi è la mancanza di una tecnica ottimale che definisca con precisione l'idrouretere ostruttivo e non-ostruttivo. Obiettivi Questo studio è stato condotto per introdurre una nuova e modificata tecnica ecografica (US), conosciuta (2015) 18:117-125 DOI 10.1007/s40477-014-0128-z come drenaggio correlato all'ecografia (DRUS), per discriminare l'idrourete ostruttivo da quello non-ostruttivo. Materiali e metodi Un totale di 358 bambini (età media: 3,7 anni) con 418 idroureteri senza reflussi sono stati inclusi nello studio. Questi bambini sono stati divisi in due gruppi, con forme ostruttive, senza reflusso (141 bambini con 157 ureteri dilatati) e con forme non-ostruttive, senza reflusso (217 bambini con 261 idroureteri). La diagnosi definitiva riguardo il sottotipo di idrouretere è stata fatta con indagini appropriate. Il diametro massimo dell'uretere dilatato misurato con ecografia, è stato registrato prima e tre ore dopo la cateterizzazione, rispettivamente come D1...

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Section: Discussionmentioning

confidence: 99%

Drainage-related ultrasonography (DRUS): a novel technique for discriminating obstructive and nonobstructive hydroureters in children

et al. 2014

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Section: Clinical Application Of Ureteric Jets Doppler Waveformsmentioning

confidence: 99%

“…Most healthy people have a ureteric jet frequency of two or more per minute on either side [14,16]. Absence of ureteric jets during the10 more minutes of observation in the steady diuresis phase could be a sign of complete obstruction [14,16], and the ureteric jet frequency of less than two per minute may indicate partial obstruction [14]. Except for complete ureteral obstruction, absence of ureteric jets is also present in cases with poor renal plasma flow, that is, impaired unilateral renal circulation, such as in the case of renal cell carcinoma complicated with renal vein occlusion from tumor invasion or tumor thromboembolism [10].…”

Section: Clinical Application Of Ureteric Jets Doppler Waveformsmentioning

confidence: 99%

“…As for the average urine ejaculation velocity (Vmean) of UJDW, cases without evidence of obstructive uropathy, but undergoing well hydration, usually have a UJDW Vmean of 20e60 cm/second (about 85% [16]) or more (totally more than 95% [16]) ( Table 2). Cases with obstructive uropathy or renoureteral diseases would likely have a lower UJDW Vmean (>60% [7]) or absence or UJDW within 10 or more minutes during observation [7,14,16]. Besides, urine ejaculation duration through the ureteral orifice (D) can be normally !4 seconds, with a majority of duration !6.0 seconds (>80% [16]) ( Table 3); cases with obstructive uropathy usually demonstrate a shorter jet duration [7].…”

Section: Clinical Application Of Ureteric Jets Doppler Waveformsmentioning

confidence: 99%

“…Besides, urine ejaculation duration through the ureteral orifice (D) can be normally !4 seconds, with a majority of duration !6.0 seconds (>80% [16]) ( Table 3); cases with obstructive uropathy usually demonstrate a shorter jet duration [7]. As a whole, more than 80% (the sensitivity) of cases with obstructive uropathy have at least one sign of UJDW abnormality, including no jets, monophasic or flattened pattern of UJDW, jet Vmean of <20 cm/second, jet duration of <4.0 seconds, and jet frequency of less than two per minute [7,14]. Whereas, cases with normal ureterodynamics usually have a jet Vmean of !20 cm/second, * Data from Ref.…”

Section: Clinical Application Of Ureteric Jets Doppler Waveformsmentioning

confidence: 99%

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Ureteric Jet

2010

Journal of Medical Ultrasound

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Color Doppler Ultrasound's Utility in Detecting Vesicoureteral Reflux Using the Ureteral Jet Angle

Zadeh

Sadeghi‐Bojd

Ansari‐Moghaddam

et al. 2022

J of Ultrasound Medicine

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Objectives This study hypothesizes using color Doppler ultrasound to measure ureteral jet angles (UJA) as a diagnostic screening tool for reflux. Methods The present prospective cohort study included 122 patients and 238 renal unit pediatric patients suspected of VUR who presented to our hospital between 2019 and 2021. All patients underwent ultrasonography and VCUG, and the UJA was measured color Doppler evaluation of the ureteral jet. The UJA was compared with the VCUG findings in patients with and without reflux. SPSS 26 was used to analyze the data. Results A total of 96 patients and 139 renal units exhibited reflux. The mean ureteral jet angle in refluxing units was 60.47 + 16.66 degrees, whereas, it was 42.59 + 13.26 degrees in non‐refluxing units, a significant difference between the two groups (P < .001). The mean ureteral jet angle was 42.59, 45.89, 60.32, 68.23, and 56.16, for reflux grading from 0 to 5 (except grade 1), respectively. The angle value in each reflux grade increased significantly except for grade 5. For reflux detection (grade I–V), a cut‐off angle of 50 degrees was associated with sensitivity and specificity of 70 and 79, respectively. Grade IV/V reflux can be diagnosed with a sensitivity of 70% and specificity of 84% using a cut‐off angle of 68 degrees or greater. Conclusions UJA detection via color Doppler ultrasound demonstrates high accuracy, is non‐invasive method can be utilized as an alternative primary diagnostic tool or in follow‐up cases of VUR in children.

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Diagnostic accuracy of color Doppler sonographic study of the ureteric jets in evaluation of hydronephrosis

Cited by 27 publications

References 19 publications

Drainage-related ultrasonography (DRUS): a novel technique for discriminating obstructive and nonobstructive hydroureters in children

Drainage-related ultrasonography (DRUS): a novel technique for discriminating obstructive and nonobstructive hydroureters in children

Ureteric Jet

Color Doppler Ultrasound's Utility in Detecting Vesicoureteral Reflux Using the Ureteral Jet Angle

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