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Open AccessArticle

Diuretic Enhanced Ultrasonography in the Diagnosis of Pyeloureteral Obstruction

Clinic of Gastroenterology, Nephrourology and Surgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, 08406 Vilnius, Lithuania
Clinic of Radiology, Vilnius University, 08406 Vilnius, Lithuania
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;
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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