The usefulness of Doppler ultrasonography in diagnostic of urolithiasis in children

• Published in: Ultraschall in der Medizin - European Journal of Ultrasound
• Main Authors: Zaleska-Dorobisz, U, Apoznañski, W, Bednorz, R, Jañczak, K, Dorobisz, TA
• Format: Conference Proceeding
• Language: English
• Published: 15.05.2008
• ISSN: 0172-4614; 1438-8782
• DOI: 10.1055/s-2008-1079964

Purpose: In recent years the frequency of diagnosing urolithiasis in children has been steadily increasing. We assessed the usefulness of Doppler ultrasonography (US), with a special attention to the resistance index (RI) values in diagnosing and postoperative monitoring in children with urolithiasis Material and methods: 280 children with urolithiasis (renal calculi –87%, ureteral –13%), 183 girls and 97 boys, aged from 4 months to 17 years (mean: 9.5 years) were evaluated. In all children Doppler US with RI evaluation of interlobular arteries was performed before and after treatment, in both kidneys. The ultrasonographic findings were correlated with IVU and labortory results (GFR, serum creatinine) Results: 195 children showed evidence of single or multiple stones of the diameter range between 3 and 5mm; 85 children presented larger calculi of the diameter above 5mm. In 85% of children with acute renal colic symptoms the RI value was significantly increased (p<0.001) in the affected kidney, compared to the contralateral one (DRI>0.018). 45 children demonstrated remarkable RI augmentation in the presence of active urinary tract infection, expansive hydronephrosis as well as if the symptoms lasted for more than 12 hours or the pelvic A-P diameter exeeded 20mm. On the basis of imaging results, children were referred to conservative (stone diameter <5mm) or surgical (>5mm) therapy of different type. Conclusions: RI value is an useful and accurate indicator in renal dysfunction monitoring in children with acute obstructive renal dysfunction.