Accuracy of sonography with a hydration test in differentiating between excretory renal obstruction and renal sinus cysts.
OBJECTIVE
The aim of this prospective study was to determine whether sonography with a hydration test to induce diuresis can be used to reliably differentiate between excretory renal obstruction and renal sinus cysts.


METHODS
We performed sonographic examination of all patients diagnosed with minimal or moderate obstruction of the intrarenal collecting system or renal sinus cysts on the basis of excretory urography, CT, or both between September 1, 1998, and October 31, 1999. The largest fluid-filled structures in the renal sinus were sonographically measured before and after each patient ingested 1.5 l of water. Cases in which the maximum diameters of the largest anechoic structures increased by at least 10% after hydration were diagnosed with excretory renal obstruction. The sonographic diagnoses were compared with the final diagnoses on excretory urography, CT, or both.


RESULTS
Both kidneys were affected in 16 of the 36 patients examined, for a total of 52 kidneys. The sonographic diagnosis was consistent with the results of urography or CT in 48 (92%) of the 52 kidneys. The sonographic approach had a specificity of 92% and a sensitivity of 93% for the diagnosis of excretory renal obstruction, with only 1 false-negative and 3 false-positive results.


CONCLUSIONS
When used with the stimulated diuresis test, sonography can reliably distinguish between excretory renal obstruction and renal sinus cysts and can be used as an alternative to other imaging techniques such as urography.
Nicolau
Carlos
C
Imaging Diagnosis Center, Clinic Hospital, University of Barcelona, Villarroel 170, 08036 Barcelona, Spain.
Vilana
Ramon
R
Del Amo
Montse
M
Anguera
Albert
A
Sala
Xavier
X
Pages
Mario
M
Arguis
Pedro
P
Brú
Concepcio
C
D000368:Aged; D004231:Diuresis; D005260:Female; D006801:Humans; D052177:Kidney Diseases, Cystic / Q000000981:diagnostic imaging*; D008297:Male; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014463:Ultrasonography; D014517:Ureteral Obstruction / Q000000981:diagnostic imaging*; D014867:Water
D014867:Water