Clinical utility of ureteral jets: Disparate opinions

Background and Purpose: Many renal/bladder ultrasound scans at our institution include evaluation of ureteral jets, often regardless of the indication for the study. Such jets often are absent in normal volunteers. Because these jets are of unclear clinical significance, we sought to determine if urologists and radiologists nationally agree on the clinical utility of ureteral jets. Materials and Methods: A three-item survey was mailed electronically to a randomly selected group of urologists and radiologists asking about the physician's practice pattern and opinion of the clinical relevance of ureteral jets by percentage and on the Likert scale. Using the unpaired Student's β-test, the responses of the groups were compared. Results: Responses were available from 177 physicians. Statistically significant differences were noted between urologists and radiologists for all three questions. Radiologists reported that 50% of ultrasonograms evaluate ureteral jets, compared with 29% for urologists (P < 0.01). Whereas radiologists "somewhat agreed" (2.01) that ureteral jets were clinically relevant, urologists were "indifferent" (2.77) to their clinical relevance (P < 0.01). The two groups also differed on the question of whether a routine ultrasound study should include evaluation of ureteral jets. Conclusions: Urologists and radiologists disagreed on both the necessity for evaluating ureteral jets and their clinical relevance. On the basis of jet frequency and a review of the literature, accurate evaluation of jets requires a minimum of 10 minutes. The cost of this time should be considered in light of the requesting physician's opinion of the clinical relevance of the results. Until further evidence supports their value, evaluation of jets should be excluded from routine renal/bladder sonography.