This study was undertaken to determine whether the presence of blood vessels could mimic the appearance of grade I hydronephrosis on sonograms and thus cause false-positive readings. One hundred consecutive patients with grade I hydronephrosis were examined. Sample volumes were obtained with pulsed Doppler ultrasonography (US) at the site of the greatest separation of the central renal sinus echoes to determine if the separation was fluid accumulating in the collecting system, as in obstruction, or if the separation was actually caused by vessels that mimic hydronephrosis. Vascular structures accounted for the separation of the sinus echoes in 43% of patients. In patients 12 years of age or younger, this frequency rose to 61%. The simple procedure of evaluating the renal sinus echo separation with pulsed Doppler US should decrease the frequency of false-positive diagnoses of hydronephrosis and thus diminish the need for further confirmatory testing.
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