Value of Duplex Doppler Ultrasonography in Renal Colic

Objectives: The aim of our study was to determine the value of duplex Doppler ultrasonography (DDU) in the patients’ evolution with renal colic. The study of the resistive index (RI), difference of the RI (ΔRI) associated with a DDU intravesical recording (ureteral jets) were compared with renographic findings in renal colic. Patients and Methods: Between October 1998 and January 2001 we studied 377 cases with suspected renal colic by intravenous pyelography (IVP), grey-scale ultrasonography and DDU with determination of the RI, the difference between the RI of ipsilateral and contralateral kidneys (ΔRI) and the amplitude (maximum length of the intravesical ureteral jet), velocity and frequency of the urine bolus. We considered normal values RI≤0.70 and ΔRI≤0.06. IVP was used as a referee investigation and the ureteral intravesical jets were determined in standard conditions. All patients came to the hospital between 4 and 12h after the onset of the renal colic. Results: We found four series of patients: 1, acute (complete) obstructed kidney (IVP nonfunctional) and dilatation at normal grey-scale, with normal contralateral kidney (n=153). In this series we found RI≥0.70 in 87%, ΔRI>0.06 in 90% and absent ureteral intravesical jet of the obstructed kidney site in 89%; 2, acute (complete) obstructed kidney (IVP nonfunctional) without abnormalities at normal grey-scale, with normal contralateral kidney (n=57). In this series we found RI≥0.70 in 73.5%, ΔRI>0.06 in 82.5% of patients, absent or asymmetric ureteral intravesical jet in 80.7% of cases; 3, incomplete obstructed kidney (IVP with various degree of uretero-hydronephrosis) with normal contralateral kidney (n=96). In this series we found RI≥0.70 in 58.3% and ΔRI>0.06 in 64.5% of patients, asymmetric ureteral intravesical jets in 74% of cases; 4, normal both kidneys (normal IVP) were found in 71 cases (18.8%). In this series we found RI≤0.70 in 80.2%, ΔRI≤0.06 in 89% of cases, normal ureteral intravesical jets in 93% of cases. The mean RI was 0.76 (0.05) in 306 obstructed kidneys, significantly higher than the mean RI of 0.62 (0.05) in 448 normal kidneys (P