池上 雅久¹, 永野 哲郎¹, 栗田 孝¹, 西岡 伯², 秋山 隆弘², 能勢 和宏³, 片岡 喜代徳³

Masahisa IKEGAMI¹, Tetsuro NAGANO¹, Takashi KURITA¹, Tukasa NISHIOKA², Takahiro AKIYAMA², Kazuhiro NOSE³, Kiyonori KATAOKA³

¹近畿大学医学部泌尿器学教室, ²近畿大学堺病院, ³泉大津市立病院泌尿器科

¹Department of Urology, Kinki University School of Medicine, 377-2 Onohigashi, Osakasayama-shi, Osaka 589-8511, Japan, ²Department of Urology, Kinki University Sakai Hospital, 2-7-1 Harayama, Sakai-shi, Osaka-fu 590-0132, Japan, ³Department of Urology, Izumiotsu Municipal Hospital, 16-1 Shimojo-machi, Izumiotsu-shi, Osaka-fu 595-0000, Japan

キーワード : Color flow imaging, Hydronephrosis, Power mode, Renal blood flow

Purpose We investigated the renal hemodynamics of patients with hydronephrosis by using color flow imaging to investigate the relation between severity of hydronephrosis and presence or absence of colic pain.
Method A group of 38 patients with hydronephrosis (42 kidneys, consisting of 18 right and 24 left kidneys) and a control group of 11 healthy subjects (6 right and 5 left kidneys) were enrolled in the study. Severity of hydronephrosis was calculated using the hydronephrosis index (HI). The control group was designated as group A; those with kidney pain and an HI of less than 0.7, as group B; those with no pain and an HI of less than 0.7, as group C; those with pain and an HI of 0.7 or more, as group D; and those with no pain and an HI of 0.7 or more, as group E. Color flow imaging equipment (SSD-2000, Aloka Inc.) and a 5.5 MHz probe were used. The resistive index (RI) (Vmax-Vmin)/Vmax) was used as a measure of vascular resistance of the segmental and the interlobar arteries.
Results The results showed that RI increased in those arteries in mildly hydronephrotic kidneys when patients had pain (HI less than 0.7). Pain was therefore a factor accounting for increase in RI in those arteries. RI increased significantly regardless of the presence or absence of pain in groups with an HI of 0.7 or more. Vascular pressure caused by hydronephrosis increased RI and reduced peripheral blood flow.