title: Intrarenal Doppler indices in acute ureteric obstruction.
abstract: BACKGROUND
  Urolithiasis remains a major health problem despite advances in therapy. Obstruction results in an increase in pressure within the urinary tract, causing structural and physiologic changes. This study aimed to calculate the intra renal Resistivity Index (RI) of acutely obstructed kidney, to determine the significance of Resistivity Index Ratio (RIR) and difference in Resistivity Index of obstructed and contralateral non obstructed kidney.
  
  
  METHODS
  Prospective study with renal Doppler for patients presenting with acute unilateral ureteric obstruction. Seventy two patients between the age group 20-45 y presenting to the Department of Radiodiagnosis, between January - December 2006 with acute unilateral ureteric obstruction were included in the study. Gray scale and Doppler evaluation of the kidneys done; with assessment of the ureteric calculus. Renal Doppler indices calculated and follow up of the same done after relief of obstruction.
  
  
  METHODS
  Statistical analysis was done using SPSS Software V13 and p-value <0.05 was considered as statistically significant.
  
  
  RESULTS
  Forty two patients (58.33%) had mild, 28 (38.89%) moderate and 2 (2.78%) severe hydronephrosis. The mean RI of the obstructed kidney was 0.66±0.88 and that of contralateral non obstructed kidney was 0.569±0.05. Delta RI between the obstructed and contralateral non obstructed kidney was 0.08±0.03. The mean RIR between the obstructed and non obstructed kidney was 1.12±0.04 and the same after relief of obstruction was 1.03±0.06.
  
  
  CONCLUSIONS
  The intrarenal Resistivity indices are less sensitive indicators in predicting the diagnosis of acute ureteric obstruction, although Resistivity Index Ratio appears to be a better parameter. The indices within the normal range do not rule out the absence of obstruction. Hence these parameters should not be interpreted in isolation.
authors: Assistant Professor, Department of Radiodiagnosis, Sri Manakula Vinayagar Medical College and Hospital , Madagadipet, Puducherry, India .
authors: Umamageswari
authors: U
authors: Amirthalingam
keywords: Doppler indices; Ureteric obstruction
references: J Urol. 1993 Oct;150(4):1192-4
references: 8371388
references: J Pak Med Assoc. 2013 Dec;63(12 ):1511-5
references: 24397096
references: Int Urol Nephrol. 2003;35(2):135-40
references: 15072483
references: Radiol Clin North Am. 1991 May;29(3):527-42
references: 2024004
references: Int J Nephrol Renovasc Dis. 2012;5:15-21
references: 22334796
references: Clin Nephrol. 2009 Jun;71(6):680-6
references: 19473637
references: Radiology. 1993 Mar;186(3):685-8
references: 8430174