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Year : 1998  |  Volume : 14  |  Issue : 1  |  Page : 17-21

Renal resistive index : differentiation of obstructive from nonobstructive hydronephrosis

Departments of Urology and Radiology Institute of Medical Sciences, Banaras Hindu University, Varanasi

Correspondence Address:
U S Dwivedi
Departments of Urology and Radiology Institute of Medical Sciences, Banaras Hindu University, Varanasi

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Source of Support: None, Conflict of Interest: None

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Recently Doppler sonography is used to identify an alteration in renal arterial blood flow in obstructed hydronephrotic kidney which is helpful to distinguish obstructed I from nonobstructed collecting system dilatation by measuring resistive index(RI) of arcuate arteries. Both control and unilateral chronic hydronephrotic cases were studied by Doppler ultrasound taking 25 cases in each group. In control group the normal RI is less than0.65 in all cases. There was no false positive increased RI incontrol group. 22 cases (88 percent) have raised RI more than0.70, in simple Doppler (20 cases) and diuretic Doppler (2 cases). All 22 cases of raised RI was compared by Whitaker's test and found obstructive (100 percent specificity). Diuretic Doppler USwas done in 4 equivocal cases (RI 0.65 to 0.70). After release of obstructions by DJ stenting or surgery there was decrease of RI in all cases except one where pyeloplasty had failed. We conclude from our study that renal arterial duplex Doppler sonography and RI can detect change in renal perfusion in chronic urinary obstruction with 100 percent specificity, 88 percent sensitivity and very good noninvasive simple modality to reliably distinguish obstructive from non-obstructive collecting system dilatation.

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