Nuri Bodakci Mehmet, Kemal Hatipoglu Namik, Ozler Ali, Turgut Abdulkadir, Hamidi Cihad, Hatipoglu Nebahat, Alan Bircan
1Department of Urology, University of Dicle, 2Department of Gynecology and Obstetrics, University of Dicle, 3Department of Radiology, Diyarbakir Obstetrics and Gynecology and Children Diseases Hospital, 4Department of Radiology, Diyarbakir Education and Research Hospital, Diyarbakir, Turkey.
Med Glas (Zenica). 2014 Feb;11(1):165-9.
To evaluate the role of doppler ultrasonographorin managing hydronephrosis during pregnancy.
The study included 27 pregnant patients with unilateral symptomatic persistent hydronephrosis (group 1) and 38 pregnant patients with physiological hydronephrosis of pregnancy (group 2). All pregnant patients underwent Doppler Ultrasonography to determine the Resistive Index (RI) and the difference between the RI of the corresponding and contralateral kidney (Delta Resistive Index = delta RI).
There were no statistical differences between the two groups in terms of age, mean gestational period, or number of pregnancies. The mean renal RI of the hydronephrosis side was 0.68 ± 0.05 in group 1 and 0.60 ± 0.05 in group 2 (p less than 0.001). The mean delta RI of group 1 was significantly higher than the mean delta RI of group 2 (0.07 ± 0.03 versus 0.02 ± 0.01, respectively, p less than 0.001). The RI and delta RI were considered positive with values of more than 0.70 and more than 0.04, respectively, and the RI was sensitive in 44.4% and specific in 92.1% for intervention treatment. The corresponding values for delta RI were 88.9% and 89.5%. The positive predictive value and negative predictive value of delta RI for intervention were 85.7% and 91.9%, respectively.
It is much better to consider delta RI than RI when deciding on interventional treatment in hydronephrosis during pregnancy.
评估多普勒超声检查在孕期肾积水管理中的作用。
该研究纳入了27例单侧症状性持续性肾积水的孕妇（第1组）和38例孕期生理性肾积水的孕妇（第2组）。所有孕妇均接受多普勒超声检查以确定阻力指数（RI）以及患侧与对侧肾脏RI的差值（Δ阻力指数=ΔRI）。
两组在年龄、平均孕周或妊娠次数方面无统计学差异。第1组肾积水侧的平均肾RI为0.68±0.05，第2组为0.60±0.05（p<0.001）。第1组的平均ΔRI显著高于第2组（分别为0.07±0.03和0.02±0.01，p<0.001）。当RI值大于0.70且ΔRI值大于0.04时被认为呈阳性，RI对干预治疗的敏感性为44.4%，特异性为92.1%。ΔRI的相应值分别为88.9%和89.5%。ΔRI对干预的阳性预测值和阴性预测值分别为85.7%和91.9%。
在决定孕期肾积水的介入治疗时，考虑ΔRI比RI要好得多。
