title: The renal resistive index as a predictor of acute hydronephrosis in patients with renal colic.
abstract: BACKGROUND
  The objective of this study was to determine whether the renal resistive index (RI) can predict hydronephrosis in patients with renal colic (RC) and whether or not its performance is time-dependent.
  
  
  METHODS
  The study population was composed of 54 patients admitted for unilateral RC. At the time of the first observation (time point I, tpI), each patient underwent routine examinations, abdominal ultrasonography, and renal color Doppler ultrasound (CDUS) with measurement of the RI. The two imaging studies were repeated 6, 12, 18, 24, 36, and 48 h later (tpII, tpIII, tpIV, tpV, tpVI, tpVII). In addition, each patient underwent non-contrast urinary tract CT 48-60 h after admission. A mean renal RI of >0.70 (mRI+) for the symptomatic kidney was considered indicative of obstruction. Patients were retrospectively divided into two groups: those who developed dilatation (group A) and those who did not (group B).
  
  
  RESULTS
  A mRI+ on CDUS predicted the onset of hydronephrosis with 100% sensitivity, 84% specificity, 92.6% accuracy, PPV and NPV of 87.9% and 100%, and diagnostic efficiency of 84%. In group A, mRI+ were always observed before onset of hydronephrosis in a time-dependent manner. In group B, mRI+ were observed occasionally in 4/25 patients (16%) and all were recorded at tpII. In these cases, the RI had returned to normal by tpIII.
  
  
  CONCLUSIONS
  In our RC patients, renal RI obtained with CDUS predicted the onset of acute dilatation with higher sensitivity, specificity, accuracy, and diagnostic efficiency than ultrasonography, and it can be used routinely in the emergency department to supplement ultrasound findings.
authors.affiliation: General Surgery Unit, San Camillo Clinic, Messina, Italy.
authors.forename: E M S
authors.initials: EM
authors.lastname: Piazzese
authors.forename: G I
authors.initials: GI
authors.lastname: Mazzeo
authors.forename: S
authors.initials: S
authors.lastname: Galipò
authors.forename: F
authors.initials: F
authors.lastname: Fiumara
authors.forename: C
authors.initials: C
authors.lastname: Canfora
authors.forename: L G
authors.initials: LG
authors.lastname: Angiò
keywords: Hydronephrosis; Renal colic; Renal color Doppler ultrasound; Renal resistive index