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Urinary Tract Abnormalities: Initial Experience with Multi–Detector Row CT Urography¹

¹ From the Department of Radiology (E.M.C., R.H.C., M.K., J.F.P., I.R.F., J.H.E.) and Department of Surgery, Urology Surgery Section (G.J.F., J.E.M.), University of Michigan Medical Center, 1500 E Medical Center Dr, Ann Arbor, MI 48109-9723. Received March 26, 2001; revision requested April 23; revision received June 22; accepted July 25. Address correspondence to E.M.C. (e-mail: caoili@umich.edu).

PURPOSE: To evaluate multi-detector row computed tomographic (CT) urography for detection of urinary tract abnormalities.

MATERIALS AND METHODS: Sixty-five patients referred from the urology service, in whom urinary tract abnormalities were strongly suspected, underwent multi-detector row CT urography. The technique included unenhanced, nephrographic, compression, and excretory-phase images through the abdomen and pelvis. Transverse images and three-dimensional reformations were reviewed by one of two radiologists. Findings were retrospectively compared with results of urinalysis, cystoscopy and/or ureteroscopy, and/or surgery.

RESULTS: Multi-detector row CT urography depicted many clinically diagnosed urinary tract abnormalities, including 15 of 16 uroepithelial malignancies, five congenital anomalies, five urinary tract calculi, and 18 calyceal and/or papillary, 30 renal pelvic and/or ureteral, and 25 bladder abnormalities. All abnormalities were detected on transverse images. These abnormalities included diffuse urothelial wall thickening in four patients (three of whom had transitional cell carcinoma), a renal abscess, a colovesical fistula, and incidentally detected extrarenal disease (a liver mass, hepatic metastases, lymph node metastases, an aortic dissection, and a pheochromocytoma; each of these findings was seen in one patient).

CONCLUSION: Multi-detector row CT urography is a useful method for detecting urinary tract abnormalities.

Index terms: Bladder, CT, 83.1211 • Computed tomography (CT), technology, 80.1211 • Kidney, abnormalities, 81.14 • Kidney, CT, 81.12115 • Ureter, CT, 82.12115 • Urography, 80.1211

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