Abstract
BACKGROUND: Hydronephrosis is the most common congenital anomalies of the urinary tract. There are various diagnostic modalities which are currently used for diagnosis and follow-up such as ultrasound, renal scintigraphy, intravenous urography, and magnetic resonance urography. Renal arterial Doppler resistance index can be used as a complimentary tool. MATERIALS AND METHODS: A prospective observational study of 30 infants and children with unilateral hydronephrosis were selected using consecutive sampling. Ultrasonography with renal biometry for diagnosis and Technetium 99m-diethylene triamine penta-acetic acid (99mTc-DTPA) Renogram was used for functional assessment. Doppler ultrasonography was done in all on to determine mean resistive index in each subject. RESULTS: Altogether 30 patients have been studied in this series, out of which 7 are females and 23 males. Fourteen patients had left-sided ureteropelvic junction (UPJ) obstruction and 16 had right-sided UPJ obstruction. Operative procedure (Anderson-Hyne's pyeloplasty) was done in all 30 patients. Preoperatively differential renal function was assessed by renal scintigraphy using 99 mTc-DTPA and Doppler ultrasonography done to measure renal resistive index (RRI). In this study, in preoperative group mean peak systolic velocity (PSV) - 52.663 cm/s, mean end diastolic velocity (EDV) - 10.305 cm/s, mean RRI - 0.797, mean DTPA - 43.630. In the postoperative period after 3 months, mean PSV - 41.223, mean EDV - 14.640, mean DTPA - 47.449, and mean RRI - 0.638. CONCLUSION: This study has shown that the mean renal arterial resistive index was higher (mean RRI - 0.797) in preoperative period and decreased after intervention (mean RRI - 0.638). These values correlate well with DTPA result. Hence, this is a reliable tool for diagnosis and follow-up after intervention.