OPPORTUNITIES OF DOPPLEROGRAPHY IN ASSESSING RENAL BLOOD FLOW IN OBSTRUCTIVE UROPATHIES IN CHILDREN
Abstract
The use of dopplerography in children makes it possible to visualize not only the vessels of the kidneys to the cortical layer of the parenchyma, but also to quantify the renal blood flow in dynamics. The aim of the study was to study the diagnostic significance of dynamic Dopplerography of intrarenal blood flow and the state of the parenchyma in children with obstructive uropathy. Material and research methods. The study involved 128 patients with obstructive uropathy of various origins (vesicoureteral reflux, hydronephrosis, megaureter, urolithiasis) aged 3 months to 17 years, who were divided into 3 groups. The control group consisted of 56 practically healthy children of the same age who had never had a pathology of the urinary system. All children underwent a general clinical examination, ultrasound examination of the kidneys and their vessels and the bladder, excretory urography and voiding cyst-obstructive uropathy-reterography. All ultrasound examinations were performed using Aloka-SSD-3500 SV devices using convex (6.0-8.0 MHz) and linear (9.0-14.0 MHz) transducers. Results. As a result of the conducted studies, no deviations from the Dopplerographic parameters were revealed in patients of group I. In patients of group II, a significant increase in the resistance index in the interlobar and segmental arteries and the normalization of its values after treatment were established, which suggests a functionally adaptive nature of the changes. The absence of positive dynamics in Doppler sonography in children of group III after treatment and the severity of their changes suggest the presence of morphological disorders. Conclusions. A comprehensive ultrasound examination of the kidneys using Doppler sonography makes it possible to assess the state of renal blood flow in children and adolescents with obstructive uropathy. The possibility of dynamic monitoring of the state of the vascular bed during conservative treatment, after surgical interventions makes the ultrasound method in demand in urology and surgery.
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