Comparison of USG KUB Findings with MR Urography (fluid static) in Patients with Obstructive Uropathy- A Cross Sectional Study

Abstract

Introduction– Obstructive uropathy is one of the most urgent clinical entities that has to be diagnosed and treated on time. Ultrasonography [USG] is cheap and easily accessible for determining the cause of obstructive uropathy. Magnetic Resonance Urography [MRU] has the potential to provide an excellent noninvasive examination of a wide range of urinary tract disorders, congenital anomalies and neoplasms without contrast administration. Aims- To assess the role of USG in obstructive uropathy patients and compare its finding with MRU static fluid. Design- Cross sectional study Materials and methods- This study was conducted on all patients referred to the Radio-Diagnosis department with any clinically suspicious obstructive uropathy symptoms. They underwent USG KUB and those with confirmed obstructive uropathy, underwent static fluid MR urography. Results- The study was conducted in 74 patients; 59.4% patients were males. Hydroureteronephrosis was the most common finding. MRU was superior to USG for diagnosis of stricture ureter and calculus in patients with obstructive uropathy. USG and MRI for diagnosis of VUJ, vesical, renal and pelvis calculus showed perfect agreement (κ=1; p=0.01); moderate for ureteric calculus (0.60-0.79; p less than 0.05) and minimal for ureteric stricture (0.21-0.39; p less than 0.05). MRU was superior in detailing PUJ obstruction as partial and complete. Conclusions- Ultrasound as an initial investigation helped in finding the level and severity of urinary obstruction. However, MRU performed better, in whom ultrasound showed inadequate results. In case of malignant obstruction, it gave precise soft tissue details. MRU appears as a better tool in diagnosing both extrinsic and intrinsic causes of obstructive uropathy.