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A Study on the Value of Measuring Resistive Index of the Intrarenal Arterial Blood Flow for diagnosing the Acute Unilateral Obstructive Uropathy

Author Affiliations

  • 1Kermanshah University of Medical Science, Kermanshah, IRAn

Res. J. Recent Sci., Volume 4, Issue (12), Pages 29-36, December,2 (2015)

Abstract

The accurate diagnosis of the acute obstructive uropathy is vital because it will be followed by complications such as urinary infections, blood pressure, and renal failure. Normal sonography, plain abdominal radiography, kidney under bladder (KUB), intra venous urography (IVC), and CT are the common diagnostic methods for the mentioned disease; however, the certain diagnosis of it is not possible. Being exposed to the ionizing radiation is hazardous for the fetus, therefore, KUB, IVC, and CT cannot be used for the pregnant women. Regarding the normal sonography, the pelvis dilatation and renal calyces (hydronephrosis) are the symptoms of obstruction. Over the pregnancy, the hydronephrosis is observed at the right side as a result of the uterine pressure on the ureter. Therefore, it is not possible to understand whether hydronephrosis is normal in a case or abnormal. Since RI reversible complications of obstruction associated with pregnancy are caused in a short period of time, it is necessary to diagnose this kind of obstruction accurately and quickly. IVU is forbidden for patients who are sensitive to the contrast material. Sometimes, stones are not observed in KUB, and ultrasonography has also some limitations. The present paper investigates role of duplex Dopplerultrasonography(US) via intrarenal arterial resistive index (RI) in the diagnosis of the acute obstructive uropathy. The common methods have limitations; therefore, it is essential to apply another diagnostic method. In the population under study, the mean resistive index (RI) was 0.680.07 for the group with obstruction, and it was 0.62 0.07 for the group with normal kidney. The average of index difference was 0.058 0.07. Factors of specificity, sensitivity, accuracy, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio have been measured at five threshold levels of index (0.55, 0.6, 0.65, 0.7, 0.8), the results are presented in the present paper.

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