Effect of Splenomegaly on RI Values of Extrınsıcally Compressed Left Kıdney
Year 2019,
Volume: 8 Issue: 2, 46 - 51, 01.05.2019
Kadihan Yalçın Şafak
Güven Yılmaz
Abstract
INTRODUCTION: To evaluate the effect of splenomegaly on resistiveindex RI values and sphericity indices long axis / short axis of extrinsically compressed left kidney by using renal gray scale and Doppler ultrasonography USG . METHODS: 57 patients with splenomegaly with measurement of greater than 130 mm diameter in abdominal USG were studied. Patients right kidneys were accepted as control group. The bipolar lengths and transverse diameters of both kidneys in each patients were measured. Three Doppler waveform tracings were obtained from each kidney by sampling the interlobar arteries in the superior, middle, and inferior portions of the kidney. The difference of mean RI values and sphericity indices between two kidneys were compared.RESULTS: The average spleen diameter of the patients was 165.21 ± 29.45 mm. The mean RI of the compressed left kidney and contralateral right kidney were 0.61 ± 0.04 and 0.59 ± 0.04 respectively. The mean RI value of the left kidney is statistically higher than right kidney p: 0.001; p > 0.01 . The mean sphericity indices value of the left kidney is statistically higher than right kidney p: 0.001; p < 0.01 .DISCUSSION AND CONCLUSION: The compression on left kidney due to splenomegaly can increase the RI and sphericity indices values of the left kidney.
References
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- 2. Boddi M. Cecioni I. Poggesi L. Fiorentino F. Olianti K. Berardino S. et al. “Renal resistive index early detects chronic tubulointerstitial nephropathy in normo- and hypertensive patients,” American Journal of Nephrology.2006; 26:16-21.
- 3. Mostbeck G.H., Kain R., Mallek R., Derfler K., Walter R., Havelec L. “Duplex Doppler sonography in renal parenchymal disease. Histopathologic correlation,” Journal of Ultrasound in Medicine.1991; 10: 189-194.
- 4. Kawai T, Kamide K, Onishi M, Yamamoto-Hanasaki H, Baba Y, Hongyo K. “Usefulness of the resistiv index in renal Doppler ultrasonography as an indicator of vascular damage in patients with risks of atherosclerosis,” Nephrology Dialysis Transplantation. 2011; 26: 3256- 3262.
- 5. Perlmutter GS. Ultrasound measurements of the spleen. In: Goldberg BB, Kurtz AB, editors. Atlas of ultrasound measurements. first ed. Chicago: Yearbook Medical Publishers. 1990; 126-38.
- 6. Mackintosh CE, Kreel L. Splenomegaly and renal displacement. Gut. 1967; 8: 291-295.
- 7. Pozniak MA, Kelcz F &Stratta RJ. Extraneous Factors Affecting Resistive Index. Invest Radiol. 1988; 23: 899-901.
- 8. Selim S, Güzliz Y, Gökhan P. Effect of Splenomegaly on Renal Resistive Index: Doppler Ultrasonograghy Study. Nephro-Urology Monthly. 2010;2: 368-372.
- 9. Tublin ME, Bude RO, Platt JF. Theresistiveindex in renal Doppler sonography: where do we stand? AJRAm J Roentgenol.2003;180:885-892.
- 10. Veglio F, Provera E, Pinna G, Frascisco M, Rabbia F, Melchio R et al. Renalresistiveindexaftercaptopril test byecho-Doppler in essentialhypertension. Am J Hypertens. 1992; 5: 431-436.
- 11. Shokeir AA, Abdulmaaboud M. Prospective comparison of nonenhanced helical computerized tomography and Doppler ultrasonography for the diagnosis of renal colic. J Urol. 2001; 165: 1082-1084.
- 12. Mitchell E. Tublin, Ronald O. Bude, Joel F. Platt. The Resistive Index in Renal Doppler Sonography: Where Do We Stand? AJR. 2003;180: 885-892.
- 13. Mastorakou I, Lindsell DR, Piepoli M, Adamopoulos S, Ledingham JG. Pulsatility and resistance indices in intrarenal arteries of normal adults. Abdom Imaging. 1994;19:369–373.
- 14. Boddi, M.,Sacchi, S., Lammel, R.M., Mohseni, R., Serneri, G.G. Age-related and vasomotor stimuli-induced changes in renal vascular resistance detected by Doppler ultrasound. Am J Hypertens. 1996;9: 461-466.
- 15. Sauvain JL, Bourscheid D, Pierrat V, Cuenin E, Chavanne C, Rocq B, et al. Duplex Dopplerultrasonography of intrarenal arteries. Normal and pathological aspects. Ann Radiol (Paris). 1991;34:237-247.
- 16. Mastorakou I, Lindsell DR, Piepoli M, Adamopoulos S, Ledingham JG. Pulsatility and resistance indices in intrarenal arteries of normal adults. Abdominal Imaging.1994;19: 369-373.
- 17. Keogan MT, Kliewer MA, Hertzberg BS, DeLong DM, Tupler RH, Carroll BA. Renalresistive indexes: variability in Doppler US measurement in a healthy population. Radiology. 1996; 199: 165-169.
- 18. Platt JF, Rubin JM, Ellis JH, DiPietro MA. Duplex Doppler US of the kidney: Differentiation of obstructive from nondestructive dilatation. Radiology. 1989; 171: 515-517.
- 19. Thomas Benter, Lothar Klühs, Ulf Teichgräber. Sonography of the Spleen. Journal of Ultrasound in Medicine. 2011;30:1281-1293.
- 20. Kaiser, Larry R. PavanAtluri, Giorgos C Karakousis, Paige M Porrett. The surgical review: an integrated basic and clinical science study guide. Hagerstwon, MD: Lippincott Williams &Wilkins. 2006; 641-643.
- 21. Langer R. Unusual renal displacement due to extreme splenomegaly. Rontgenblatter. 1985; 38:121-3.
- 22. Sandler CM, Conley SB, Fogel SR, Brewer ED. Splenic compression of the left kidney simulating pathologic unilateral renal enlargement. J Comput Assist Tomogr.1980; 4:248-50.
- 23. Olutola PO, Daneman A, Martin DJ, Alton DJ. Unusual renal distortion and displacement due to the spleen.Pediatr Radiol. 1982;12:185-189.
- 24. Miriam Hadj-Moussa, James A Brown. Reversible renal insufficiency secondary to extrinsic splenic compression of the kidney in a patient with chronic lymphocyticleukemia. Scientific World Journal. 2010; 4:796-798.
- 25. Andley Manoj, Pusuluri Rahul, Goel Rajat, Kumar Ashok, Kumar Ajay. Left-side unilateral hematuria: an unusual association with tropical splenomegaly--a case report and review of literature. IntSurg. 2008; 93: 116-118.
Splenomegalinin Neden Olduğu Kompresyonun Sol Böbrek Rİ Değerlerine Etkisinin Doppler USG ile Değerlendirilmesi
Year 2019,
Volume: 8 Issue: 2, 46 - 51, 01.05.2019
Kadihan Yalçın Şafak
Güven Yılmaz
Abstract
GİRİŞ ve AMAÇ: Gri skala ve Doppler USG USG tekniklerini kullanarak splenomegali nedeniyle kompresyona maruz kalan sol böbreğin rezidiv indeks Rİ ve sferisite indeksi uzun eksen / kısa eksen değerlerinde meydana gelebilecek değişiklikleri belirlemektir.YÖNTEM ve GEREÇLER: Abdominal USG incelemeleri sırasında splenomegali saptanan 57 31 erkek, 26 kadın; ortalama yaş 42.46 ± 13.28 hasta çalışmaya dahil edildi. Tüm olguların sağ böbreği kontrol grubu olarak kabul edildi. Dalak longitudinal aksta görüntülendi ve üst polden alt pole doğru kranio - kaudal uzunluğu ölçüldü. Her olgunun böbrek transvers ve longitudinal uzunlukları ölçüldü. Tüm olguların sferisite indeksi değerleri hesaplandı. Her bir böbreğin üst, orta ve alt kesimlerinden üçer kez doppler örnekleri alınıp ortalaması hesaplandı. Olguların her iki böbrekleri arasındaki RI ve sferisite indeksi değerleri arasındaki fark karşılaştırıldı. BULGULAR: Olguların ortalama dalak boyutları 165.21 ± 29.45 mm idi. Kompresyona maruz kalan sol böbrek ve kontrol grubunu oluşturan sağ böbrek ortalama Rİ değerleri sırasıyla 0.61 ± 0.04 ve 0.59 ± 0.04 bulundu. Ortalama sol böbrek Rİ değerleri istatistiksel olarak sağ böbrek Rİ değerlerinden yüksek saptandı p: 0.001; p > 0.01 . Ortalama sol böbrek sferisite indeksi değeleri istatistiksel olarak sağ böbrek sferisite indeksi değerlerinden yüksek bulundu p: 0.001;p
References
- 1. Rawashdeh YF, Djurhuus JC, Mortensen J, Horlyck A, Frokiaer J. The Intrarenal Resistive Index as Pathophysiologycal Marker of Obstructive Uropaty. J Urol.2001; 165:1397-1404.
- 2. Boddi M. Cecioni I. Poggesi L. Fiorentino F. Olianti K. Berardino S. et al. “Renal resistive index early detects chronic tubulointerstitial nephropathy in normo- and hypertensive patients,” American Journal of Nephrology.2006; 26:16-21.
- 3. Mostbeck G.H., Kain R., Mallek R., Derfler K., Walter R., Havelec L. “Duplex Doppler sonography in renal parenchymal disease. Histopathologic correlation,” Journal of Ultrasound in Medicine.1991; 10: 189-194.
- 4. Kawai T, Kamide K, Onishi M, Yamamoto-Hanasaki H, Baba Y, Hongyo K. “Usefulness of the resistiv index in renal Doppler ultrasonography as an indicator of vascular damage in patients with risks of atherosclerosis,” Nephrology Dialysis Transplantation. 2011; 26: 3256- 3262.
- 5. Perlmutter GS. Ultrasound measurements of the spleen. In: Goldberg BB, Kurtz AB, editors. Atlas of ultrasound measurements. first ed. Chicago: Yearbook Medical Publishers. 1990; 126-38.
- 6. Mackintosh CE, Kreel L. Splenomegaly and renal displacement. Gut. 1967; 8: 291-295.
- 7. Pozniak MA, Kelcz F &Stratta RJ. Extraneous Factors Affecting Resistive Index. Invest Radiol. 1988; 23: 899-901.
- 8. Selim S, Güzliz Y, Gökhan P. Effect of Splenomegaly on Renal Resistive Index: Doppler Ultrasonograghy Study. Nephro-Urology Monthly. 2010;2: 368-372.
- 9. Tublin ME, Bude RO, Platt JF. Theresistiveindex in renal Doppler sonography: where do we stand? AJRAm J Roentgenol.2003;180:885-892.
- 10. Veglio F, Provera E, Pinna G, Frascisco M, Rabbia F, Melchio R et al. Renalresistiveindexaftercaptopril test byecho-Doppler in essentialhypertension. Am J Hypertens. 1992; 5: 431-436.
- 11. Shokeir AA, Abdulmaaboud M. Prospective comparison of nonenhanced helical computerized tomography and Doppler ultrasonography for the diagnosis of renal colic. J Urol. 2001; 165: 1082-1084.
- 12. Mitchell E. Tublin, Ronald O. Bude, Joel F. Platt. The Resistive Index in Renal Doppler Sonography: Where Do We Stand? AJR. 2003;180: 885-892.
- 13. Mastorakou I, Lindsell DR, Piepoli M, Adamopoulos S, Ledingham JG. Pulsatility and resistance indices in intrarenal arteries of normal adults. Abdom Imaging. 1994;19:369–373.
- 14. Boddi, M.,Sacchi, S., Lammel, R.M., Mohseni, R., Serneri, G.G. Age-related and vasomotor stimuli-induced changes in renal vascular resistance detected by Doppler ultrasound. Am J Hypertens. 1996;9: 461-466.
- 15. Sauvain JL, Bourscheid D, Pierrat V, Cuenin E, Chavanne C, Rocq B, et al. Duplex Dopplerultrasonography of intrarenal arteries. Normal and pathological aspects. Ann Radiol (Paris). 1991;34:237-247.
- 16. Mastorakou I, Lindsell DR, Piepoli M, Adamopoulos S, Ledingham JG. Pulsatility and resistance indices in intrarenal arteries of normal adults. Abdominal Imaging.1994;19: 369-373.
- 17. Keogan MT, Kliewer MA, Hertzberg BS, DeLong DM, Tupler RH, Carroll BA. Renalresistive indexes: variability in Doppler US measurement in a healthy population. Radiology. 1996; 199: 165-169.
- 18. Platt JF, Rubin JM, Ellis JH, DiPietro MA. Duplex Doppler US of the kidney: Differentiation of obstructive from nondestructive dilatation. Radiology. 1989; 171: 515-517.
- 19. Thomas Benter, Lothar Klühs, Ulf Teichgräber. Sonography of the Spleen. Journal of Ultrasound in Medicine. 2011;30:1281-1293.
- 20. Kaiser, Larry R. PavanAtluri, Giorgos C Karakousis, Paige M Porrett. The surgical review: an integrated basic and clinical science study guide. Hagerstwon, MD: Lippincott Williams &Wilkins. 2006; 641-643.
- 21. Langer R. Unusual renal displacement due to extreme splenomegaly. Rontgenblatter. 1985; 38:121-3.
- 22. Sandler CM, Conley SB, Fogel SR, Brewer ED. Splenic compression of the left kidney simulating pathologic unilateral renal enlargement. J Comput Assist Tomogr.1980; 4:248-50.
- 23. Olutola PO, Daneman A, Martin DJ, Alton DJ. Unusual renal distortion and displacement due to the spleen.Pediatr Radiol. 1982;12:185-189.
- 24. Miriam Hadj-Moussa, James A Brown. Reversible renal insufficiency secondary to extrinsic splenic compression of the kidney in a patient with chronic lymphocyticleukemia. Scientific World Journal. 2010; 4:796-798.
- 25. Andley Manoj, Pusuluri Rahul, Goel Rajat, Kumar Ashok, Kumar Ajay. Left-side unilateral hematuria: an unusual association with tropical splenomegaly--a case report and review of literature. IntSurg. 2008; 93: 116-118.