Ureteral jets in healthy subjects and in patients with unilateral ureteral calculi: comparison with color Doppler US.

Abstract

Color Doppler ultrasound was used to image the ureteral jets in 17 healthy subjects and 26 patients with ureteral calculi proved with intravenous urography. In patients with ureteral calculi, three patterns of ureteral jets were seen: no detectable urine flow from the symptomatic side (12 patients), low-level continuous flow from the symptomatic side (four patients), and periodic ureteral jets on the symptomatic side that were not significantly different from ureteral jets of healthy subjects (10 patients). Of the 12 patients with high-grade obstruction on urograms, 11 had ureteral jets significantly different from those of healthy subjects (either no detectable ureteral jets or continuous low-level jets on the symptomatic side). Only three of the 11 patients with low-grade obstruction or nonobstructing stones had ureteral jets that were different from those of healthy subjects. It is concluded that analysis of ureteral jets with color Doppler can enable detection and qualitative determination of the degree of ureteral obstruction in many patients with unilateral ureteral calculi.

Ureteric jets: evaluation of normal flow dynamics with color Doppler sonography.

“…The distinction between a long jet and a short episode of streaming was easily made in this and prior studies [3]. The measured peak velocity is slightly lower than the true velocity at the ureteric orifice.…”

“…The bladder quickly refilled but with dilute urine identical to that subsequently delivered by the ureters, and no jets could be imaged. Burge et al [3] encountered nonvisualization of jets in four of 47 subjects and attributed this to inadequate hydration or insufficient delay after hydration.…”

“…Several authors [2, 3,7] have ascribed physiologic information to the "size" or maximum spatial length and width of uretericjets as they appear on sonographic images. However, several independent factors affect the conspicuity and hence the size of jets: flow rate (volume per unit time), velocity of jet, orientation of jet to transducer, difference in specific gravity (ureter vs bladder), and flow sensitivity of the unit.…”

Evaluation of ureteric jet flow with Doppler ultrasonography during manual compression

“…[8,9] Color Doppler examination of ureteric jet flows is a non-invasive method that has been used to study a wide spectrum of pathologies, with significant results. [10][11][12][13][14] In this study, we examined the grade of obstruction in patients with urinary tract dilation, by evaluating the ureterovesical jet flows in the Doppler US window with manual renal compression.…”

Acurária do estudo dos jatos ureterais à ultra-sonografia do Doppler Colorido no diagnóstico das hidronefroses

“…Os jatos ureterais podem ser observados já à ultra-sonografia convencional, entretanto a avaliação com Doppler colorido é mais sensível na detecção do jato ureteral (Burge et al,1991) O Doppler colorido é preferível ao "Power Doppler" pois permite a visibilização dos fluxos líquidos em um campo visual maior e é menos susceptível às alterações produzidas por mudanças de angulação do Deste modo, ainda no século XXI, muitas decisões terapêuticas são tomadas de maneira subjetiva e empírica.…”