Pulsed Doppler sonography of the hilar renal artery: Differentiation of obstructive from nonobstructive hydronephrosis in children

Background/Purpose: It is difficult to detect the arcuate or cortical renal arteries when performing pulsed Doppler sonography (PDS) for congenital hy dronephrosis. This study was undergone to assess the usefulness of PDS of t he hilar renal artery to differentiate obstructive from nonobstructive hydr onephrosis. Methods: The authors performed PDS of the hilar renal artery in 80 normal c hildren: 20 aged 0 to 1 months (group I), 20 aged 1 to 12 months (group II) , 20 aged 1 to 6 years (group III), and 20 aged 7 to 15 years (group IV). B ased on diuretic renography findings, 22 kidneys from 19 children with a ur eteropelvic junction (UPJ) stricture were divided into 7 dilated obstructed and 15 dilated nonobstructed kidneys. The peak-systolic velocity (PSV), en d-diastolic velocity (EDV), mean average velocity (Vm) and the resistive in dex (RI = [PSV - EDV]/PSV) were measured at the hilar renal artery. Results: There was a significant difference in the RI of the hilar renal ar tery between obstructive and nonobstructive hydronephrosis. Conclusion: A pulsed Doppler evaluation of the hilar renal artery is useful for detecting an obstructive UPJ stricture compared with assessing arcuate or cortical renal arteries. J Pediatr Surg 36:416-420. Copyright (C) 2001 by W.B. Saunders Company.