Abstract:

Aim: To investigate the utility of corticomedullary strain ratio (SR) in the diagnosis and follow-up of urinary obstruction Material and Methods: Forty volunteer patients (26 male, 14 female) aged between 18-60 years, who were admitted to our outpatient 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 patients were accepted as control group. The age, gender, duration of renal colic, blood pressure and BMI of 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 average of these three measurements was used in statistical analysis. Strain ratio (SR) was measured by marking the region of interest in the medulla and cortex determined in B mode during the decompression phase. Results: No difference was observed in terms of age between the groups. We found a positive correlation between renal pelvic diameter and RI in obstructed kidney (p=0.006 and r=0.446). There was a statistically significant difference between average corticomedullary SR values of hydronephrotic kidneys (0.38 ± 0.43) and average SR values of contralateral intact kidneys (0.61 ± 0.69) (p=0.025). Also, we observed statistically significant difference between the average arterial doppler values of the hydronephrotic kidneys (0.64 ± 0. 06) and the arterial doppler values of intact kidneys (0.60 ± 0.05) (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. This finding is supported by increased arterial RI data in urinary obstruction described in the literature.

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