Grade I hydronephrosis: pulsed Doppler US evaluation.

Scola, Francis H.; Cronan, John J.; Schepps, Barbara

doi:10.1148/radiology.171.2.2649926

Cited by 43 publications

(13 citation statements)

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“…One n o n o bstructed patient did have splitting of the central sinus complex that was evaluated with Doppler ultrasound and found to be a prominent renal vein. This is a simple yet very important procedure as it will eliminate many false positive diagnoses of hydronephrosis [9]. By eliminating the grade I hydronephrosis appearance due to blood vessels, grade I hydronephrosis can be properly emphasized as 7 of 17 patients with varying degrees of acute obstruction presented with grade I hydronephrosis.…”

Section: Discussionmentioning

confidence: 99%

“…Even when hydronephrosis was detected in a clinical setting suspicious for obstruction, misdiagnosis was possible. Not all hydronephrotic kidneys are obstructed and central renal sinus splitting may be due to vascular causes [7][8][9]. Because of these limitations of ultrasound, the intravenous urogram (IVU) has remained the mainstay of diagnosis in the setting of acute colicy obstruction.…”

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confidence: 99%

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New techniques of ultrasound and color Doppler in the prospective evaluation of acute renal obstruction. Do they replace the intravenous urogram?

et al. 1995

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

New techniques of ultrasound and color Doppler in the prospective evaluation of acute renal obstruction. Do they replace the intravenous urogram?

et al. 1995

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“…In contrast, blood vessels account for the sonolucent hilar region in up to 40% of adults and 61 % of children that appear to have mild pelviectasis by real-time ultrasound alone. 9 This difference between fetal and adult kidneys may relate to the high prevalence of normal pelviectasis in the fetus. The etiology of so-called •physiologic• pelviectasis in the fetus has not been established, but it has been postulated that it may relate to increased urine production late in pregnancy, relaxation of collecting system smooth muscle by maternal hormones, and/or vesicoureteral reflux.u · 6 • 10-12 Additionally, the current study did not include fetal kidneys with sonolucent regions less than 2 mm in AP dimension.…”

Section: Discussionmentioning

confidence: 99%

Mild fetal renal pelviectasis. Differentiation from hilar vascularity using color Doppler sonography.

Betz

Hertzberg

Carroll

et al. 1991

Journal of Ultrasound in Medicine

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Ultrasound often detects a sonolucent region in the hilum of the fetal kidney. Although this sonolucency is usually assumed to represent mild dilatation of the fetal renal collecting system, in pediatric and adult kidneys blood vessel lumina can simulate pelviectasis. We used color Doppler ultrasound to differentiate the fetal renal collecting system from hilar blood vessels and to evaluate how often blood vessels account for the sonolucent region of ten demonstrated in the renal hilum during antenatal sonography. Twenty-nine kidneys in fetuses with sonolucent hilar regions greater than 2 mm in anteroposterior (AP) dimension were studied with color Doppler ultrasound. Doppler signal was demonstrated in blood vessels adjacent to, but not A bnormalities of the genitourinary tract account for 14-57% of all fetal structural malformations detected by antenatal real-time ultrasound, and more than half of these are associated with dilated collecting systems. •2 Antenatal detection of a dilated collecting system identifies fetuses at risk for neonatal urosepsis, renal scarring, and end-stage renal disease, and in selected cases, leads to antenatal or early postnatal therapeutic interventions?A sonolucent area measuring 1-2 mm in anteroposterior (AP) dimension is present in the renal hilum of approximately 41 3 of fetal kidneys beyond 24 weeks gestation, and in approximately 18% of fetal kidneys, the area measures between 3 and 11 mm.4 In the majority of cases, this area is thought to represent Received August 6, 1990, from the Department of Radiology, Duke University Medical Center, Durham, North Carolina. Revised manuscript accepted for publication November 13, 1990.Address correspondence and reprint requests to Dr. Barbara S. Hertzberg: Department of Radiology, Duke University Medical Cen· ter, Durham, NC 27710. within, the sonolucent area in the hilum of all 29 kidneys. Based on the absence of color signal in the sonolucent hilar regions studied, with color signal seen in adjacent blood vessels, these regions were felt to represent mildly dilated collecting systems rather than renal vasculature. We conclude that color Doppler ultrasound can differentiate mild pelviectasis from hilar blood vessels in the fetal kidney. Sonolucent areas measuring 2 mm or greater in AP dimension are unlikely to be attributable to renal vasculature. KEY WORDS: fetus, US studies; fetus, genitourinary system; ultrasound, Doppler studies; kidney, US studies. (/ Ultrasound Med 10: 243, 1991) normal, mild dilatation of the fetal renal collecting system. 2 ·4-8 However, Doppler evaluation has shown that in children and adults blood vessels can simulate mild pelviectasis. 9 The etiology of the sonolucent area in the hilum of the fetal kidney has not been similarly investigated. The goals of this study were to determine if color Doppler ultrasound could differentiate the fetal collecting system from hilar vascularity and to evaluate how often blood vessels account for the sonolucent hilar regions depicted by antenatal sonography. MATERIALS ...

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“…Its use is limited if there is no pyelocaliectasis, and it cannot differentiate between obstructive and nonobstructive dilatation of the renal collecting system. 5,7,[10][11][12][13][14] Studies have shown that 2 hours after onset of a renal obstruction, renal vascular resistance (RVR) increases and renal blood flow (RBF) decreases. [15][16][17][18] Doppler sonography can provide information about these hemodynamic changes.…”

mentioning

confidence: 99%

“…When the central echo complex was separated minimally by distended anechoic calyceal structures, the kidneys were classified as hydronephrotic (grade 1) 11,14 ; otherwise, they were categorized as nondilated.…”

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confidence: 99%