The Value Of Multi-parameter Ultrasound Scoring Method In The Evaluation Of Fetal Hydronephrosis

Objective:To research the value of multi- parameter ultrasound scoring method in the evaluation of fetal hydronephrosis.To investigate the value of ultrasound scoring method compared with single diagnosis standard in distinguishing physiological and pathological hydronephrosis.To explore clinical significance of ultrasound scoring method in the diagnosis of fetal hydronephrosis.Materials and methods:The study was conducted in the Second People`s Hospital of Liaocheng from Oct.2010 to Dce.2012.Fifty-three cases of late pregnant women(≥28 weeks) with single fetus with hydronephrosis(PAPD≥10mm)were included.The parameters included pelvic anterior posterior diameter, pelvicaliceal morphology, renal parenchyma thickness and renal artery resistant index.Do the routine ultrasound examination of fetal and record all parameters.Re-examined every 3 weeks and recorded the changes in various parameters.The four parameters were graded from 0 to 3 score according to the severity.Added the scores of all parameters and obtained the total ultrasonic score of erch kidney.According to the results of the follow-up,the fetal hydronephrosis is divided into physiological ydronephrosis and pathological hydronephrosis.Pooled analysis of PAPD, pelvicaliceal morphology, renal parenchyma thickness,renal artery resistant index and total ultrasonic score of the two groups.Evaluated the value of each single diagnostic criteria and ultrasonic scoring method in distinguishing physiological and pathological hydronephrosis through the diagnosis rate.Results:pathological hydronephrosis of 66 kidneys with hydronephrosis.The higher the score,the higher the ratio of pathological hydronephrosis.When score was 1、2、3、4,allkidneys were physiological hydronephrosis.When score was 10、11、12,all kidneys were pathological hydronephrosis.When score was 5、6、7、8、9,the ratio of pathological hydronephrosis was 16.67%、25.00%、33.33%、50.00%、75.00%.The optimal cut-off value is score 7 and YI was 0.7913.That is,cases with scores≥7 was pathological hydronephr osis,whereas scores<7 as physiological hydronephrosis.Youden index of ultrasonic evalu ation method was higher than pelvic anterior posterior diameter(0.6261), pelvicaliceal morphology(0.6761),renal parenchyma thickness(0.7478) and renal artery resistant(0.6978).It followed that ultrasonic score was the bast approach for differential diagosis of fetal hydronephrosis.Conclusions:Compared with single diagnosis standard,the ultrasound scoring method has advent ages in the diagnosis of pathological and physiological hydronephrosis.It is the effe ctive method in distinguishing physiological and pathological hydronephrosis.The ultrasonic score provide correct treatment principle of fetal hydronephrosis.It has more compreh ensive, practical clinical value compared with the single diagnostic criteria.