Doppler-duplex ultrasound in renal colic

Toledo, L. Sarría Octavio de; Asensio, T.; Cabrejas, Rosa Cozcolluela; Gregorio, Miguel Ángel De; Cortina, Pilar Pardina; Saldías, L. Ripa

doi:10.1016/0720-048x(96)01055-8

Cited by 35 publications

(44 citation statements)

References 19 publications

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“…Data in the scientific literature confirm that this marker is more sensitive in the diagnosis of complete rather than partial obstructions [31,34,35]. de Toledo et al [36], for example, reported a sensitivity of 91.8% in patients with complete obstruction but only 48.1% in those with partial obstruction. In the latter case, the intraureteral pressure is not high enough to increase intrarenal vascular resistance [35,36].…”

Section: Discussionmentioning

confidence: 92%

“…Platt [30] found that in patients whose obstruction had been present for 12 h, the RI is not significantly higher than that observed in the presence of more recent obstruction. On the other hand, de Toledo [36] reported that the RI was significantly higher in patients whose renal colic had lasted at least 24 h. These differences may be related to the duration of the obstruction and the clinical course. We found that in all patients who developed hydronephrosis, the rise in RI occurred before the onset of dilation (at least 6e12 h in 93% of the cases).…”

Section: Discussionmentioning

confidence: 96%

“…de Toledo et al [36], for example, reported a sensitivity of 91.8% in patients with complete obstruction but only 48.1% in those with partial obstruction. In the latter case, the intraureteral pressure is not high enough to increase intrarenal vascular resistance [35,36]. These considerations might also explain the cases of false positivity observed in our study: in all probability, these cases were characterized by partial and/or transient obstruction that caused only a temporary increase in the intraluminal pressure (and consequently of the RI as well), which was not sufficient to produce permanent dilation.…”

Section: Discussionmentioning

confidence: 99%

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The renal resistive index as a predictor of acute hydronephrosis in patients with renal colic

Piazzese

Mazzeo

Galipo

et al. 2012

Journal of Ultrasound

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KEYWORDSRenal colic; Hydronephrosis; Renal color Doppler ultrasound; Renal resistive index.Abstract Introduction: The objective of this study was to determine whether the renal resistive index (RI) can predict hydronephrosis in patients with renal colic (RC) and whether or not its performance is time-dependent. Materials and methods: The study population was composed of 54 patients admitted for unilateral RC. At the time of the first observation (time point I, tpI), each patient underwent routine examinations, abdominal ultrasonography, and renal color Doppler ultrasound (CDUS) with measurement of the RI. The two imaging studies were repeated 6,12,18,24,36, and 48 h later (tpII, tpIII, tpIV, tpV, tpVI, tpVII). In addition, each patient underwent noncontrast urinary tract CT 48e60 h after admission. A mean renal RI of >0.70 (mRIþ) for the symptomatic kidney was considered indicative of obstruction. Patients were retrospectively divided into two groups: those who developed dilatation (group A) and those who did not (group B). Results: A mRIþ on CDUS predicted the onset of hydronephrosis with 100% sensitivity, 84% specificity, 92.6% accuracy, PPV and NPV of 87.9% and 100%, and diagnostic efficiency of 84%. In group A, mRIþ were always observed before onset of hydronephrosis in a timedependent manner. In group B, mRIþ were observed occasionally in 4/25 patients (16%) and all were recorded at tpII. In these cases, the RI had returned to normal by tpIII. Conclusions: In our RC patients, renal RI obtained with CDUS predicted the onset of acute dilatation with higher sensitivity, specificity, accuracy, and diagnostic efficiency than ultrasonography, and it can be used routinely in the emergency department to supplement ultrasound findings. Sommario Introduzione: Obiettivo di questo studio è stato verificare se l'Indice di Resistenza Renale (IR) possa essere considerato un parametro predittivo dell'insorgenza dell'idronefrosi (IN) in caso di colica renale (CR) monolaterale e se esso è tempo correlato. Materiali e metodi: Lo studio ha incluso 54 pazienti ricoverati per CR monolaterale. Al momento della prima osservazione (time point I) tutti i pazienti sono stati sottoposti a esami routinari, a Ecografia addome e a Eco color Doppler renale (ECD) bilaterale con misurazione dell'IR. Dopo 6 (tpII), 12 (tpIII), 18 (tpIV), 24 (tpV), 36 (tpVI) e 48 (tpVII) ore è stata ripetuta l'ecografia dell'apparato urinario e l'ECD con la misurazione bilaterale dell'IR. A 48e60 ore dal ricovero inoltre tutti i pazienti sono stati sottoposti a TC dell'apparato urinario senza mezzo di contrasto. Un valore medio di IR maggiore di 0,70 (mRIþ) a livello del rene sintomatico è stato considerato come suggestivo di ostruzione. I pazienti, in relazione allo sviluppo di IN, sono stati suddivisi a posteriori in gruppo A (dilatazione presente) e B (dilatazione assente). Risultati: L'ECD con il rilevamento dei valori mRIþ ha mostrato un significativo valore diagnostico relativamente all'insorgenza dell'IN con una sensibilità del 100%, specificità 84%, ...

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

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The renal resistive index as a predictor of acute hydronephrosis in patients with renal colic

Piazzese

Mazzeo

Galipo

et al. 2012

Journal of Ultrasound

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“…30 MRI is also found to be less sensitive in partial obstruction in certain studies compared to the complete obstruction. 29,31 It has also been reported that the increase in the MRI is dependent on the time following the obstruction. As seen in the present study, the rise in MRI is seen from 6-48 hours which is corroborated by other studies.…”

Section: Discussionmentioning

confidence: 99%

“…This variation was said to be due to the clinical symptoms which may not necessarily correlate to the anatomical obstruction. 29 Inspite of the above positive results, the diagnosis with MRI has a lot of limitations. It is influenced by factors such as age, plasma renin levels, presence of diabetes, hypertension or heart disease.…”

Section: Discussionmentioning

confidence: 99%

Mean resistive index as a prognostic tool for hydronephrosis in patients with acute renal colic: a study in a tertiary care

Ravindernath

Reddy

2017

Int J Adv Med

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Background: Uretolithiasis is one of the most common cause of urinary tract obstruction which leads to the admission into the emergency ward. The detection of urolithiasis or acute renal colic is by the radiography, conventional ultrasonography (US) and intravenous urography (IVU). A colour Doppler USG measures this change as a resistive index (RI) of the arcuate arteries at the corticomedullary junction or the interlobar arteries.Methods: 84 patients between the ages 15-50 years, who were admitted to the Emergency department of our hospital with unilateral renal colic were included into our study. Detailed demographic data was collected from all the patients and they were all subjected to a thorough physical and clinical examination. Bladder ultrasound was taken along with color Doppler for all the patients at the time of admission for every 6 hours. Thus, an increased RI index signifies an obstruction without a dilatation.Results: Left flank pain was slightly more than the right flank pain, although this was not found to be significant. Most of the patients were presented with vomiting or nausea and dysuria was seen in 48 patients. there were 41 cases of hydronephrosis in total and all of them were positive for mean RI. The specificity with the mean resistive index with color Doppler was 90%, while the sensitivity was 100%. Around 95% of the prediction was accurate with mean resistive index, with more than 90% efficiency.Conclusions: The mean resistive index is a very good tool for the diagnosis of hydronephrosis, with a very high level of specificity and sensitivity.

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