DIAGNOSTIC ACCURACY OF DOPPLER URETERIC JET ASSESSMENT FOR URETERIC OBSTRUCTION USING NON CONTRAST CT AS THE REFERENCE STANDARD

Abstract

Background: Ureteric obstruction is a common urological condition requiring timely diagnosis to prevent progressive renal dysfunction. Non-contrast computed tomography (NCCT) is highly effective for identifying obstructive ureteric calculi but involves ionizing radiation. Doppler ultrasonographic assessment of ureteric jets provides a radiation-free functional indicator of urine passage across the vesicoureteric junction. Objective: To determine the diagnostic accuracy of Doppler ureteric jet assessment for detecting ureteric obstruction using NCCT as the reference standard. Methods: This diagnostic accuracy study included patients with clinical suspicion of ureteric obstruction. Ureteric jets were assessed using Doppler ultrasonography and findings were compared with NCCT. Reduced or absent ureteric jet activity was considered suggestive of obstruction. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall diagnostic accuracy were calculated. Results: Doppler assessment of ureteric jets demonstrated good diagnostic performance for identifying ureteric obstruction compared with NCCT. The technique effectively differentiated obstructed from non-obstructed ureters, supporting its potential role as a functional adjunct to conventional ultrasonography. Conclusion: Doppler ureteric jet assessment provides a simple, non-invasive, and radiation-free approach for evaluating suspected ureteric obstruction. It may be particularly useful for initial assessment and for patients in whom minimizing radiation exposure is desirable.