Three-dimensional ultrasound (3D US) methods in the evaluation of calcular and non-calcular ureteric obstructive uropathy.

摘要

PURPOSE: To prospectively assess ureteric obstructive uropathy using three-dimensional ultrasound (3D US) methods when the etiology of ureteral obstruction was proved difficult to evaluate with two-dimensional ultrasound (2D US) and plain radiography. METHODS: The study had the local Ethics Committee approval. All patients gave informed consent. 318 patients: 219 men and 99 women (including 16 pregnant women) were selected within a 3-year period for 3D US based on clinical presentation, two dimensional ultrasound (2D US) results and preliminary plain radiography except for pregnant women. 3D US was performed on all patients. 301 patients had further excretory urogram before intervention decisions. RESULTS: The study showed a high accuracy of detection of different levels of ureteric calcular obstruction; 99.1% in men and 96.7% in women. 3D XI technology proved more efficient in stone count (88.9%) than sectional planes and rendering method altogether (55.6%). The success rate of identifying obstructiveuropathy due to inflammatory variants showed a perfect diagnostic value of 100%. Similar percentages could be obtained in cases secondary to neoplastic infiltration or permeation of the ureters. Cases compared with excretory urography revealed close correlation with 3D US and superiority of the latter when renal function physiologically altered in some cases of calcular obstructive uropathy. CONCLUSIONS: The 3D US methods in case of obstructive uropathy have proved to be useful as an easy, mobile and non-invasive diagnostic tool, improving 2D US diagnostic utility.