Application of renal Doppler sonography in the diagnosis of obstructive uropathy in patients with spinal cord injury.
OBJECTIVE
To assess renal resistive index (RI) changes in patients with spinal cord injury (SCI) who have obstructive uropathy and to determine if an RI of 0.7 or more is useful in identifying such patients.


METHODS
Prospective cross-sectional study.


METHODS
Rehabilitation hospital affiliated with a medical university.


METHODS
A convenience sample of 99 kidneys of 51 SCI patients (38 men, 13 women; mean age, 38.8+/-14.0 y) with neuropathic bladder dysfunction.


METHODS
Ultrasonic examination to assess the degree of hydronephrosis, Doppler sonography to calculate renal vascular RIs, and radioisotopic renography to assess renal function and to determine excretory curves. Kidneys were assigned to control or obstructive uropathy groups, and RIs were compared for statistical significance (Student t test) and to assess whether an RI of 0.7 is a distinguishing criterion.


METHODS
RI and sensitivity.


RESULTS
Average RIs were .58+/-.07 in the control group (71 kidneys) and .65+/-.08 in the uropathy group (28 kidneys) (P<.001). The sensitivity of using an RI of 0.7 or more to identify patients with obstructive uropathy was 39%. The c statistic of the receiver operating characteristic curve was .72.


CONCLUSIONS
RIs increased in SCI patients with obstructive uropathy. In patients with SCI, urinary findings fit the chronic partial obstruction pattern. A renal RI of 0.7 or more was a poor indicator of obstructive uropathy in such patients.
Tseng
Fan-Fei
FF
Department of Rehabilitation Medicine, Chung Shan Medical University, Taichung City, Taiwan.
Bih
Liu-Ing
LI
Tsai
Su-Ju
SJ
Huang
Yu-Hui
YH
Wu
Yao-Ting
YT
Chen
Yaw-Zen
YZ
D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D003937:Diagnosis, Differential; D016002:Discriminant Analysis; D005260:Female; D006801:Humans; D006869:Hydronephrosis / Q000145:classification / Q000000981:diagnostic imaging* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012372:ROC Curve; D012079:Renal Circulation; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013119:Spinal Cord Injuries / Q000150:complications*; D018608:Ultrasonography, Doppler / Q000379:methods* / Q000592:standards; D014517:Ureteral Obstruction / Q000145:classification / Q000000981:diagnostic imaging* / Q000209:etiology; D014563:Urodynamics; D014567:Urography / Q000379:methods / Q000592:standards; D014655:Vascular Resistance