The Turkish Journal of Pediatrics 2006 , Vol 48 , Num 3
Can renal Doppler sonography replace diuretic radionuclide renography in infants with hydronephrosis?
1Departments of Nuclear Medicine, University Hospital Dresden, Dresden, Germany
2Departments of Pediatrics, University Hospital Dresden, Dresden, Germany
Liepe K, Taut-Sack H. Can renal Doppler sonography replace diuretic radionuclide renography in infants with hydronephrosis? Turk J Pediatr 2006; 48: 221-227.

Reliable differentiation between obstructive and non-obstructive hydronephrosis is decisive for the further therapeutic management in infants. The results of renal Doppler sonography were compared with diuretic radionuclide renography and with the follow-up results in 33 patients (range: 21 to 98 days). In Doppler sonography, a resistive index (RI) of >0.9 was considered to be abnormal in the sense of an obstruction. In diuretic renography, a T½ value (time until a 50% decrease in activity in the kidneys was observed after injection of furosemide) of >20 min was appraised as obstructive hydronephrosis. In six patients an obstructive (T½ >20 min) and in 27 patients a non-obstructive (T½ <20 min) hydronephrosis was found. All patients with obstruction in diuretic renography showed an abnormal RI (>0.9) in Doppler sonography. In addition, all patients with surgery and obstruction in diuretic radionuclide renography showed an improvement in hydronephrosis. However, seven patients had a false-positive result in Doppler sonography. All patients with non-obstruction in diuretic radionuclide renography showed no worsening of hydronephrosis without surgery in the follow-up. We found a RI of 0.84±0.07 in the non-obstructive group and of 0.96±0.05 (p=0.018) in the obstructive group. Doppler sonography showed discrepant results compared to diuretic radionuclide renography and therefore cannot replace this method. Keywords : diuretic radionuclide renography, renal Doppler sonography, hydronephrosis, resistive index

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