Objective: To investigate the utility of corticomedullary strain ratio (SR) in the di- agnosis and follow-up of urinary obstruction. Material and
Methods: Forty volunteer patients (26 males, 14 females) aged between 18-60 years, who were admitted to our out- patient urology clinic with renal colic due to stone and diagnosed as unilateral urinary tract obstruction via CT, were included in the study. Contralateral intact kidneys of the same pa- tients were accepted as control group. Namely, two groups were formed as hydronephrotic kidneys (group 1) and contralateral intact kidneys (group 2). The age, gender, duration of renal colic, blood pressure and BMI of the all patients were also recorded. Patients were examined with renal ultrasonography, doppler ultrasonography and Real Time Elastography (RTE) by a single radiologist with 8 years of experience in abdominal radiology. The aver- age of these three measurements was used in statistical analysis. Strain ratio (SR) was mea- sured by marking the region of interest in the medulla and cortex determined in B mode during the decompression phase.
Results: Mean age of the patients was 43.17 ± 11.39 years. We found a positive corre- lation between renal pelvic diameter and RI in obstructed kidney (p=0.006 ve r=0.446). There was a significant difference in terms of mean corticomedullary SR values between group 1 (0,225(0,01-2,40)) and group 2 (0,385(0,09- 3,27)) (p=0.025). Also, we observed statisti- cally significant difference between group 1
(0.64 ± 0.06) and group 2 (0.60 ± 0.05) in terms of the mean arterial doppler values (p=0.026).
Conclusion: The measurement of renal corticomedullary SR by RTE, which is a noninvasive method, can be used in the diagnosis and follow-up of urinary obstruction. These findings are supported by increased arterial RI data in urinary obstruction described in the literature.
Keywords: Elastography, Corticomedullary Strain Ratio, Uri- nary Tract Obstruction
Abstract
Objective: To investigate the utility of corticomedullary strain ratio (SR) in the di- agnosis and follow-up of urinary obstruction. Material and
Methods: Forty volunteer patients (26 males, 14 females) aged between 18-60 years, who were admitted to our out- patient urology clinic with renal colic due to stone and diagnosed as unilateral urinary tract obstruction via CT, were included in the study. Contralateral intact kidneys of the same pa- tients were accepted as control group. Namely, two groups were formed as hydronephrotic kidneys (group 1) and contralateral intact kidneys (group 2). The age, gender, duration of renal colic, blood pressure and BMI of the all patients were also recorded. Patients were examined with renal ultrasonography, doppler ultrasonography and Real Time Elastography (RTE) by a single radiologist with 8 years of experience in abdominal radiology. The aver- age of these three measurements was used in statistical analysis. Strain ratio (SR) was mea- sured by marking the region of interest in the medulla and cortex determined in B mode during the decompression phase.
Results: Mean age of the patients was 43.17 ± 11.39 years. We found a positive corre- lation between renal pelvic diameter and RI in obstructed kidney (p=0.006 ve r=0.446). There was a significant difference in terms of mean corticomedullary SR values between group 1 (0,225(0,01-2,40)) and group 2 (0,385(0,09- 3,27)) (p=0.025). Also, we observed statisti- cally significant difference between group 1
(0.64 ± 0.06) and group 2 (0.60 ± 0.05) in terms of the mean arterial doppler values (p=0.026).
Conclusion: The measurement of renal corticomedullary SR by RTE, which is a noninvasive method, can be used in the diagnosis and follow-up of urinary obstruction. These findings are supported by increased arterial RI data in urinary obstruction described in the literature.
Keywords: Elastography, Corticomedullary Strain Ratio, Uri- nary Tract Obstruction