PELVIURETERIC JUNCTION (P.U.J.) OBSTRUCTION, ITS EVALUATION BY SONOGRAPHY (USG), USING PELVIS / CORTEX RATIO.

Abstract

Objectives- Aim of this study was to document pelvis/cortex ratio, (P/C ratio) in children presenting with antenatally detected hydronephrosis and determine if it could be used as a sonographic marker of PUJ obstruction. Material and Methods- All children presenting with unilateral hydronephrosis (PUJ) between January 2009-March 2015 were included. Ultrasound was performed by the same radiologist and P/C ratio was determined by dividing maximum anteroposterior pelvic diameter with maximum cortical thickness. Results- Among a total of 111 children 87 (78%) improved on conservative management ,while 24(22%) required surgery (pyeloplasty). The mean (+-SD) P/C ratio was 2.7+-2.18 in those improved on conservative management , while 13.5+-1.48 in those who required surgery (p<0.01). All (22/22) children with P/C ratio of 12 or above required pyeloplasty, while 2/5 with P/C ratio 8-12 and none (0/84) with P/C ratio less than 8 required pyeloplasty (p<0.01). Conclusion- P/C ratio could be used as a marker of PUJ obstruction in children with hydronephrosis.