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经多普勒超声评价急性输尿管梗阻肾内动脉阻力指数。

Doppler sonographic evaluation of resistive index of intra-renal arteries in acute ureteric obstruction.

机构信息

Department of Radiology, No.3 Aaradhana, Gandhi Nagar, Masakalipalayam, Uppilipalayam, Coimbatore, 641015, Tamilnadu, India.

Department of Radiology, PSG Institute of Medical Sciences and Research, Peelamedu, Coimbatore, India.

出版信息

J Ultrasound. 2021 Dec;24(4):481-488. doi: 10.1007/s40477-020-00539-7. Epub 2020 Nov 18.

Abstract

BACKGROUND

Acute ureteric colic is one of the most commonly encountered acute abdominal conditions. Diagnosis of obstruction caused by ureteric calculus occasionally becomes challenging if there is inadequate dilation of the urinary tract proximal to obstruction. In such a situation, intra-renal artery Doppler parameters can be used as a diagnostic tool. Our study compared intra-renal arterial Doppler in patients with obstructed and non-obstructed kidneys presenting within 24 h of onset of symptoms of unilateral acute renal colic.

RESULTS

The resistivity index (RI) in the segmental arteries of all 54 patients with obstructed kidneys was significantly higher than in those with non-obstructed kidney: 0.75 vs. 0.56, with a p value less than 0.001, a sensitivity of 85% and a specificity of 93%.

CONCLUSION

Doppler ultrasound is a useful diagnostic tool in the evaluation of acute renal obstruction, thus enabling practitioners to avoid ordering unnecessary CT and exposing patients to ionizing radiation. An RI value > 0.7 has good sensitivity and specificity in our study. The results obtained in the study were comparable to those of pioneer studies conducted worldwide.

摘要

背景

急性输尿管绞痛是最常见的急性腹痛病症之一。如果梗阻部位近端的泌尿道扩张不足,偶尔会对由输尿管结石引起的梗阻进行诊断,具有一定挑战性。在这种情况下,可以将肾内动脉多普勒参数用作诊断工具。我们的研究比较了在单侧急性肾绞痛发作 24 小时内就诊的梗阻性和非梗阻性肾脏患者的肾内动脉多普勒。

结果

54 例梗阻性肾脏患者的节段动脉阻力指数(RI)明显高于非梗阻性肾脏患者:0.75 比 0.56,p 值<0.001,灵敏度为 85%,特异性为 93%。

结论

多普勒超声是评估急性肾梗阻的有用诊断工具,从而使医生能够避免开出不必要的 CT 检查,并使患者免受电离辐射。在我们的研究中,RI 值>0.7 具有良好的灵敏度和特异性。研究结果与全球开展的先驱研究结果相当。

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本文引用的文献

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Factors determining renal impairment in unilateral ureteral colic secondary to calcular disease: a prospective study.
Int Urol Nephrol. 2015 Jul;47(7):1085-90. doi: 10.1007/s11255-015-0986-0. Epub 2015 Apr 30.
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Resistive intrarenal index: myth or reality?肾内电阻指数:是神话还是现实?
Br J Radiol. 2014 Jun;87(1038):20140004. doi: 10.1259/bjr.20140004. Epub 2014 Apr 15.

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