Urologic radiology

, 3:1 | Cite as

How accurate is ultrasonography in detecting hydronephrosis in azotemic patients?

  • Lee B. Talner
  • William Scheible
  • Paul H. Ellenbogen
  • Clyde H. Beck
  • Barbara B. Gosink


Screening for hydronephrosis continues to be an essential part of the evaluation of patients with azotemia of unknown cause. To determine whether sonography is as reliable as nephrotomography for screening purposes, we carried out a prospective, comparative study. Sixty-two patients were evaluated. Mean serum creatinine was 4.3 mg/dl. Of 116 kidneys, 45 were obstructed according to urographic criteria and 42 of these were correctly called hydronephrotic by sonography. The 3 false negative sonographic studies occurred in 2 patients. All 3 kidneys contained radiopaque calculi visible on the plain abdominal film. Of the 71 nonobstructed kidneys, 5 were mistakenly called hydronephrotic by ultrasound, giving a false positive rate of 7%. We believe it is appropriate to use gray-scale ultrasound as a screening test for urinary obstruction in azotemic patients providing the plain abdominal radiograph shows no calcifications.

Key words

Renal failure Hydronephrosis Ultrasound accuracy Urinary obstruction 


  1. 1.
    Ellenbogen PH, Scheible FW, Talner LB, Leopold GR: Sensitivity of gray scale ultrasound in detecting urinary tract obstruction.AJR 130:731–733, 1978PubMedGoogle Scholar
  2. 2.
    Sanders RC, Bearman S: B-scan ultrasound in the diagnosis of hydronephrosis.Radiology 108:375–382, 1973PubMedGoogle Scholar
  3. 3.
    Sanders RC, Jeck DL: B-scan ultrasound in the evaluation of renal failure.Radiology 119:199–202, 1976PubMedGoogle Scholar
  4. 4.
    Dhar SK, Chandrasekhar H, Smith EC: Renosonogram in diagnosis of renal failure.Clin Nephrol 7:15–20, 1979Google Scholar
  5. 5.
    Rosenfield AT, Taylor KJW: Obstructive uropathy in the transplanted kidney: evaluation by gray-scale sonography.J Urol 116: 101–102, 1976PubMedGoogle Scholar
  6. 6.
    Taylor KJW, Kraus V: Gray-scale ultrasound imaging: assessment of acute hydronephrosis.Br J Urol 47:593–597, 1975PubMedCrossRefGoogle Scholar
  7. 7.
    Sanders RC, Conrad MR: The ultrasonic characteristics of the renal pelvicalyceal echo complex.J. Clin Ultrasound 5:372–377, 1977PubMedCrossRefGoogle Scholar
  8. 8.
    Winston M, Pritchard J, Paulin P: Ultrasonography in the management of unexplained renal failure.J Clin Ultrasound 6:23–27, 1978PubMedCrossRefGoogle Scholar
  9. 9.
    Fry IK, Cattell WR: Excretion urography in advanced renal failure.Br J Radiol 44:198–201, 1971PubMedCrossRefGoogle Scholar
  10. 10.
    McClennan BL: Current approaches to the azotemic patient.Radiol Clin North Am 17:197–211, 1979PubMedGoogle Scholar
  11. 11.
    Milman N, Stage P: High dose urography in advanced renal failure. II. Influence on renal and hepatic function.Acta Radiol (Stockh) 15:104–112, 1974Google Scholar
  12. 12.
    Byrd L, Sherman RL: Radiocontrast-induced acute renal failure: a clinical and pathophysiologic review.Medicine (Baltimore) 58: 270–279, 1979CrossRefGoogle Scholar
  13. 13.
    Morin ME, Baker DA: The influence of hydration and bladder distension on the sonographic diagnosis of hydronephrosis.J Clin Ultrasound 7:192–194, 1979PubMedCrossRefGoogle Scholar
  14. 14.
    Lalli AF: Retroperitoneal fibrosis and inapparent obstructive uropathy.Radiology 122:339–42, 1977PubMedGoogle Scholar
  15. 15.
    Rosenfield AT, Taylor KJW, Dembner AG, Jacobson P: Ultrasound of renal sinus: new observations.AJR 133:441–448, 1979PubMedGoogle Scholar
  16. 16.
    Scheible FW, Talner LB: Gray scale ultrasound and the genitourinary tract.Radiol Clin North Am 17:281–300, 1979PubMedGoogle Scholar
  17. 17.
    Fry IK, Cattell WR: The nephrographic pattern during excretion urography.Br Med Bull 28:227–232, 1972PubMedGoogle Scholar
  18. 18.
    Newhouse JH, Pfister RC: The nephrogram.Radiol Clin North Am 17:213–226, 1979PubMedGoogle Scholar
  19. 19.
    Pollack HM, Arger PH, Goldberg BB, Mulholland SG: Ultrasonic detection of nonopaque renal calculi.Radiology 127:233–237, 1978PubMedGoogle Scholar
  20. 20.
    Edell S, Zegel H: Ultrasonic evaluation of renal calculi.AJR 130:261–263, 1978PubMedGoogle Scholar

Copyright information

© Springer-Verlag 1981

Authors and Affiliations

  • Lee B. Talner
    • 1
  • William Scheible
    • 2
  • Paul H. Ellenbogen
    • 5
  • Clyde H. Beck
    • 3
  • Barbara B. Gosink
    • 4
  1. 1.Department of RadiologyUniversity of CaliforniaSan DiegoUSA
  2. 2.Division of UltrasoundUniversity of CaliforniaSan DiegoUSA
  3. 3.Division of NephrologyUniversity of CaliforniaSan DiegoUSA
  4. 4.Veterans Administration HospitalSan DiegoUSA
  5. 5.Department of RadiologyPresbyterian Hospital of DallasDallasUSA

Personalised recommendations