THE ACCURACY OF DOPPLER ULTRASONOGRAPHY IN THE FOLLOWUP OF PYELOPLASTY FOR CONGENITAL PELVIURETERIC JUNCTION OBSTRUCTION
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 91
Abstract
BACKGROUND Congenital pelviureteric junction obstruction (PUJO) is a common condition needing surgery for the improvement of renal function. Followup after surgery requires imaging modalities involving radiation exposure. Doppler sonography is an alternative, which can avoid radiation. The aim of this study is to evaluate the accuracy of Doppler ultrasonography in the followup of patients with pelviureteric junction obstruction (PUJO) undergoing open pyeloplasty. Setting and Design- This prospective observational study was conducted in a tertiary care teaching hospital. MATERIALS AND METHODS This study comprised of 31 patients with unilateral PUJO, who underwent open pyeloplasty. The diagnosis of PUJO was made by findings on IVU or diuretic renogram. The Renal Resistive Index was evaluated using Duplex Doppler ultrasonography. A renal RI >0.7 was considered diagnostic of obstruction. Resistive Index Ratio was calculated as the ratio of RRI of obstructed to that of opposite kidney. RIR value more than 1.11 was considered as obstruction. All patients were followed up with Doppler at 3 months after surgery and the RRI value was measured. DTPA renogram was repeated at 3 months after surgery. The data was collected and sensitivity and specificity of Doppler as a diagnostic test was calculated using DTPA renogram as the standard. RESULTS Among the 31 patients, preoperative renogram showed obstruction in 19 patients and equivocal result in 12 patients. Doppler ultrasonography showed obstruction in 16 of the 19 patients with obstructive renogram. RRI of the opposite kidney showed nonobstructive value in all patients, as did the renogram. Preoperative RIR value showed obstruction in 17 out of 19 patients. Among the 12 patients with equivocal pattern who underwent pyeloplasty, preoperative RRI was suggestive of obstruction in 8 patients, while RIR showed obstruction in 9 patients. Postoperative renogram showed non-obstructive pattern in 29 patients and obstruction in 2 patients. Twenty eight out of the 29 patients with relieved obstruction had RRI < 0.70, while 1 patient showed persistently elevated RRI as well as RIR. CONCLUSION Renogram is useful for the followup of patients who have undergone pyeloplasty and for monitoring patients with hydronephrosis under observation.
Authors and Affiliations
Suresh Bhat, Sachin Joseph, Fredrick Paul, Suyog Shetty
Keywords
Related Articles
- EP ID EP278293
- DOI 10.14260/jemds/2017/1393
- Views 111
- Downloads 0
OUTCOMES OF BABIES ON BUBBLE CPAP ADMITTED IN SNCU (LEVEL II) AT ACSR GMC, NELLORE, INDIA
BACKGROUND India contributes to one-fifth of the global live births and of the 25 million babies born in India every year 1 million die. India alone contributes to 25% of neonatal mortality around the world. The aim of t...
STUDY OF GENITAL TUBERCULOSIS IN INFERTILE WOMEN
AIM To determine the incidence of female Genital Tuberculosis (GTB) and to analyse clinicopathological features for GTB and comparison of Polymerase Chain Reaction (PCR), Acid Fast Bacillus (AFB) staining and...
A PROSPECTIVE RANDOMIZED TRIAL OF VACUUM-ASSISTED CLOSURE VERSUS STANDARD THERAPY OF CHRONIC NON-HEALING WOUNDS
BACKGROUND The application of controlled levels of negative pressure has been shown to accelerate debridement and promote healing in many different types of wounds. The optimum level of negative pressure appears...
COMPLICATIONS OF PANCREATITIS- CT EVALUATION
BACKGROUND Acute pancreatitis is a common condition with variable clinical course. Imaging studies play an important role in diagnosis and management of acute pancreatitis. Computed Tomography (CT) is undertaken to deter...
GOITRE PREVALENCE SURVEY IN SCHOOL GOING CHILDREN (6-12 YEARS) OF SRINAGAR DISTRICT OF J & K.
Research question: what is the prevalence of goitre in school going children? [b]OBJECTIVE[/b]: To assess the magnitude of goitre in the age group of 6-12 years in district Srinagar. [b]STUDY DESIGN[/b]: 30-clu...