Potential role of duplex Doppler sonography in acute renal colic

Roy, Catherine; Tuchmann, C.; Pfleger, D; Guth, S.; Saussine, C.; Jacqmin, Didier

doi:10.1002/(sici)1097-0096(199811/12)26:9<427::aid-jcu2>3.0.co;2-p

Cited by 18 publications

(6 citation statements)

References 14 publications

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“…However, in addition, any association between RRI and the functional state of the kidney remains to be proven, and this test could still only be sensibly employed if it was shown to exhibit a high level of intra‐ and interobserver agreement. The available studies on the value of the RRI for stone‐related renal colic are summarized in Table 5[1–23].…”

Section: Discussionmentioning

confidence: 99%

“…The RRI is calculated according to the formula: (maximum systolic flow speed – end‐diastolic flow speed)/maximum systolic flow speed. A mean value was calculated from the three RRI values per side (lower pole, upper pole and mid‐pole) for the corresponding kidney [1–23]. An RRI ≥ 0.70 and a difference in the RRI values (ΔRRI) between the symptomatic and contralateral kidney >0.07 are given in the literature as being suggestive of an obstruction [1–3,5–7,11,12,15,16,20,23].…”

Section: Methodsmentioning

confidence: 99%

“…Assessments of the renal resistive index (RRI) and the hydronephrosis index (HI) comprise two sonographic techniques that can generate useful additional information in patients with acute renal colic in both a primary care setting and during the course of medical expulsive therapy (MET). The RRI represents the reduction in diastolic blood flow speed in relation to systolic flow speed and can be measured, for example, in the Arteriae arcuatae during an obstruction of the pelvicaliceal system [1–23]. The HI represents the relationship between the entire area of the kidney to the area of the pelvicaliceal system, with increasing obstruction resulting in a reduced HI value [24,25].…”

Section: Introductionmentioning

confidence: 99%

“…Until now, they have taken no place in the routine evaluation of patients with acute renal colic. Investigations into the value of these techniques in the diagnosis of acute renal colic have previously only given contradictory results for the RRI [1–23] and remain totally absent for the HI. Studies on the reproducibility of both examination methods in this indication have equally not yet been published.…”

Section: Introductionmentioning

confidence: 99%

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Prospective evaluation of interobserver variability of the hydronephrosis index and the renal resistive index as sonographic examination methods for the evaluation of acute hydronephrosis

Rud¹,

Moersler²,

Peter³

et al. 2012

BJU International

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Study Type – Diagnosis (reliability) Level of Evidence 2b What's known on the subject? and What does the study add? Conventional sonography is the standard imaging technique used in patients with acute renal colic. A decreasing hydronephrosis index (HI) is associated with an increase in obstructive uropathy. Obstructive uropathy leads to an increase in the renal resistive index (RRI). The present study shows that both the RRI and HI methods are easily practicable in patients presenting with stone‐related renal colic. The grade of hydronephrosis correlates positively with the HI but not with the RI. OBJECTIVE To confirm the reliability of assessements of the renal resistive index (RRI) and the hydronephrosis index (HI) comprising two sonographic techniques providing additional information in patients with acute renal colic. PATIENTS AND METHODS Sonographic measurement of hydronephrosis and assessment of common clinical criteria was performed in 22 consecutive patients presenting with unilateral stone‐related renal colic. RRI and HI were separately recorded by two investigators within a prospective study. Interobserver agreement and comparison of sonographic with computed tomography (CT) findings were assessed with the Cohen's kappa statistic (κ) for attributive ordinal characteristics and Spearman's rank correlation/rho (ρ) for attributive metric characteristics. RESULTS There was a significant correlation between HI and the sonographically‐evaluated grade of hydronephrosis, although not between RRI and the grade of hydronephrosis. For all procedures (RRI, HI, sonography and CT), significant differences between the symptomatic and the asymptomatic kidney were assessed. Interobserver agreement was excellent for the grade assessment of hydronephrosis by conventional sonography (κ= 0.82; P < 0.001), good to very good for HI (ρ= 0.60; P= 0.003) and acceptable to good for RRI (ρ= 0.49; P= 0.021). CONCLUSIONS The RRI and HI methods are both easily practicable as stageless examination methods in patients presenting with stone‐related renal colic, and both also reliably distinguish between obstruction and non‐obstruction. Exact thresholds for both methods must still be defined based on further successive studies. Additionally, changes of values under medical expulsive therapy and correlation with the functional status of the obstructed kidney remain to be examined.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prospective evaluation of interobserver variability of the hydronephrosis index and the renal resistive index as sonographic examination methods for the evaluation of acute hydronephrosis

Rud¹,

Moersler²,

Peter³

et al. 2012

BJU International

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“…Die diastolische Geschwindigkeit verringert sich auf der betroffenen Seite und der Widerstandsindex (RI) steigt. Ein Unterschied von mehr als 0,05 wird als signifikant angesehen [36]. Dieses Kriterium ist besonders hilfreich, um eine physiologische Erweiterung des Nierenbecken-Kelch-Systems während der Schwangerschaft von einer Harnwegsobstruktion zu unterscheiden [37].…”

Section: Nieren-und Harnwegserkrankungenunclassified

Ultraschalldiagnostik des nichttraumatischen akuten Abdomens: die Ursachen außerhalb des Gastro-Intestinaltraktes

Meuwly¹,

Vial²,

Vuilleumier³

et al. 2002

Ultraschall in Med

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In recent years, management of abdominal pain in emergency care units (ECU) has undergone a radical change. Chronic work overload of ECU and increase in severity and complexity of cases required an optimal medical imaging method, such as ultrasound, to establish an accurate diagnosis as quickly as possible. A great variety of causes may cause acute abdominal pain and the role of sonography is to accurately distinguish between these aetiologies. For the application of sonography, perhaps more so than with other imaging methods, a perfect knowledge of sonographical characteristics and technical possibilities is essential to achieve an optimal answer. The purpose of this review is to present and discuss the sonographic characteristics of extra-digestive causes of acute abdominal pain such as splenic infarction, thoracic pathologies, urinary and gynaecologic diseases or retroperitoneal pathologies.

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