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Open AccessArticle

Diuretic Enhanced Ultrasonography in the Diagnosis of Pyeloureteral Obstruction

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Clinic of Gastroenterology, Nephrourology and Surgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, 08406 Vilnius, Lithuania
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Clinic of Radiology, Vilnius University, 08406 Vilnius, Lithuania
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Clinic of Surgery and Vascular Surgery, Department of Urology, Vilnius City Clinical Hospital, 10007 Vilnius, Lithuania
*
Author to whom correspondence should be addressed.
Medicina 2019, 55(10), 670; https://doi.org/10.3390/medicina55100670
Received: 4 September 2019 / Revised: 26 September 2019 / Accepted: 30 September 2019 / Published: 3 October 2019
Background and Objectives: To determine the value of diuretic ultrasonography for the diagnosis of obstructive hydronephrosis. Materials and Methods: Diuretic enhanced ultrasonography was used routinely as a part of examination of patients with hydronephrosis in our Department. There were 72 patients (42 males, 30 females; aged 2 months to 17 years; median age 7.07 years) with a sonoscopic diagnosis of hydronephrosis included from January 2006 until October 2011. The anteroposterior diameter (AD) of renal pelvis was measured sonoscopically before and at sixty minutes after furosemide injection. A weight-adjusted dose of 1 mg/kg of furosemide was administered intravenously. Results: Patients were operated on if pyeloureteral obstruction was suspected because of low or deteriorating differential renal function, increasing hydronephrosis or symptoms thereof. Hydronephrosis was unilateral in 61 (84.7%) and bilateral in 11 (15.3%) patients. The median AD of pelvis before furosemide injection was 22 mm in operated and 17 mm in non-operated patients (p = 0.005). Sixty minutes after furosemide injection, the AD of pelvis in operated patients was 35.5 mm and 25.8 mm in non-operated—25.8 mm (p < 0.001). Logistic regression model demonstrated that significant factors for surgery were: AD 60 min after furosemide infection and ultrasonographic parenchymal sclerosis. Conclusion: Ultrasound measurement of the AD of renal pelvis 1 h after the injection of furosemide used as an additional investigation can help in predicting obstructive hydronephrosis. View Full-Text
Keywords: diuretic ultrasonography; hydronephrosis; pyeloureteral junction obstruction; pyeloplasty; diuretic renal scan diuretic ultrasonography; hydronephrosis; pyeloureteral junction obstruction; pyeloplasty; diuretic renal scan
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Kazlauskas, V.; Cekuolis, A.; Bilius, V.; Anglickis, M.; Verkauskas, G. Diuretic Enhanced Ultrasonography in the Diagnosis of Pyeloureteral Obstruction. Medicina 2019, 55, 670.

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