Ultrasonography contribution in detection of reno-urinary anomalies: a cohort study.

Aims: The current study aims to assess the role of ultrasound (US) parameters in explaining the variance of hydronephrosis grades in reno-urinary anomalies, as well as their performance in quantifying the incidence of patients with uropathies.

Methods: In this study 196 patients were prospectively included. All of them had renal/urinary tract anomalies and were recruited from 5992 US examined hospitalized patients. Fifty patients were referred also to renal 99mTc- DMSA or 99mTc-DTPA scintigraphy. The diagnostic performance of renal ultrasound and scintigrafy parameters was assessed.

Results: Pelvis antero-posterior diameter (APD) values were strongly correlated with other investigated parameters. They correlated with measurements of US parenchyma values (r=0.59, p=0.001), pelvis area (r=0.76, p=0.001) and with scintigraphy long axis measurements (r=0.89, p=0.001). In multiple regression analysis, the pelvis APD is the only independent predictor of high grades hydronephrosis (p=0.001) and explained 62.4% of the variance of hydronephrosis grades. The cut-off values for detection of significant hydronephrosis (grades 3,4) was 11 mm or more, and for detection of severe, in need of surgery, hydronephrosis was 19 mm or more.

Conclusions: The diagnostic performance of ultrasound was good, similar to those previously published by other authors. US detected pelvis APD is the main predictor for high grades hydronephrosis but other parameters also influence the uropathy grades.