We evaluated 44 patients aged 2 to 17 ys, presented with
unilateral SFU grade III and IV hydronephrosis suspicious of obstruction. All underwent reference test (RS) and index tests (US and CDUS). Hydronephrotic units were reclassified according to the alternative grading system (AGS) proposed by Onen at al . Obstruction was defined as differential renal function < 40%.