title: Pelvis/cortex ratio: an early marker of success following pyeloplasty in children.
abstract: OBJECTIVE
  To document the change in anterio-posterior pelvic diameter (APPD), cortical thickness (CT) and pelvis/cortex ratio (P/C ratio) following pyeloplasty, and determine the usefulness of each of these parameters in assessing postoperative outcome.
  
  
  METHODS
  Twenty-four children with unilateral pelvi-ureteric junction obstruction who underwent standard dismembered pyeloplasty with stent were prospectively studied (median age 13 months; range 2 months-5 years). Maximum APPD, CT and P/C ratio values were compared pre- and postoperatively.
  
  
  RESULTS
  Mean APPD was 40.70 mm preoperatively, and 30.04 mm at 3 months and 12.75 mm at 1 year postoperatively. The reduction in size at 3 months was not significant (P = 0.34), but was significant at 1 year (P < 0.01). Mean CT was 4.41 mm preoperatively, 6.29 mm at 3 months and 9.45 mm at 1 year. The increase in CT was not significant at 3 months (P = 0.44), but was significant at 1 year (P < 0.01). The P/C ratio was 13.48 mm preoperatively, 5.73 mm at 3 months and 1.45 mm at 1 year. The reduction in P/C ratio was significant at 3 months (P < 0.01) as well as at 1 year (P < 0.01). Sonographic resolution rate did not correlate with outcomes on radionuclide scans.
  
  
  CONCLUSIONS
  P/C ratio could be used as an early marker of success following pyeloplasty. Improvement in other sonographic criteria or on radionuclide scans may be useful only in the long term.
authors.affiliation: Department of Pediatric Urology, Sri Ramachandra Medical College and Research Institute, Sri Ramachandra University, Porur, Chennai 600116, India. drrameshbabu1@dataone.in
authors.forename: Ramesh
authors.initials: R
authors.lastname: Babu
authors.forename: Venkata
authors.initials: V
authors.lastname: Sai
mesh_terms: D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007672:Kidney Cortex / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D007682:Kidney Pelvis / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D011446:Prospective Studies; D011859:Radiography; D011877:Radionuclide Imaging; D015607:Stents; D016896:Treatment Outcome; D014463:Ultrasonography; D014517:Ureteral Obstruction / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*