HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: 2253011515v1 225/3/783    most recent Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by McTavish, J. D. Articles by Silverman, S. G. Search for Related Content PubMed PubMed Citation Articles by McTavish, J. D. Articles by Silverman, S. G.

Multi–Detector Row CT Urography: Comparison of Strategies for Depicting the Normal Urinary Collecting System¹

¹ From the Department of Radiology, Division of Abdominal Imaging and Intervention, Brigham and Women’s Hospital, 75 Francis St, Boston, MA 02115 (J.D.M., M.J., K.H.Z., R.D.N., S.G.S.); Department of Diagnostic Radiology, Keio University School of Medicine, Tokyo, Japan (M.J.); and Department of Health Care Policy, Harvard Medical School, Boston, Mass (K.H.Z.). From the 2000 RSNA scientific assembly. Received September 14, 2001; revision requested November 12; final revision received April 26, 2002; accepted May 22. Address correspondence to S.G.S. (e-mail: sgsilverman@partners.org).

PURPOSE: To evaluate several protocols for depiction of the urinary collecting system with multi–detector row computed tomographic (CT) urography.

MATERIALS AND METHODS: Fifty-one patients with hematuria or a suspicious renal mass underwent CT urography, during which thinly collimated (1-mm) pyelographic phase scanning was performed 8–10 minutes after contrast medium administration. Patients were examined while prone only (n = 17) and while both prone and supine (n = 17) after a 250-mL infusion of normal saline. Each collecting system and ureter was divided into six segments that were assigned opacification scores. All acquisition techniques were compared, and the highest-scoring technique was compared with that in 17 patients who underwent conventional intravenous urography (IVU). Three reconstruction techniques (transverse, coronal, and maximal intensity projection) were also compared. Stratified analysis was performed with the paired two-tailed Student t test to compare opacification scores for both the acquisition techniques and display methods, both individually and in all possible combinations.

RESULTS: CT urography with supplemental saline administration, performed with the patient prone or supine, significantly improved mean opacification scores in the distal ureters (right, P = .004; left, P = .006). With this technique, CT urography produced a mean opacification score that was not significantly different from that with IVU in 11 of 12 segments and was significantly better than that with IVU in one of 12 segments (lower left ureter). Mean opacification scores obtained with transverse or coronal displays were equal to or higher than those obtained with maximum intensity projection reconstructions in all segments.

CONCLUSION: CT urography with a multi–detector row scanner and supplemental infusion of normal saline reliably displays the opacified urinary collecting system.

© RSNA, 2002

Index terms: Computed tomography (CT), image display and recording, 80.12111, 80.12112, 80.12114, 80.12117 • Computed tomography (CT), thin-section, 80.12118 • Genitourinary system, CT, 80.12111, 80.12112, 80.12114, 80.12117 • Urography, 80.1221

This article has been cited by other articles:

				S. Kawamoto, K. M. Horton, and E. K. Fishman Transitional Cell Neoplasm of the Upper Urinary Tract: Evaluation with MDCT Am. J. Roentgenol., August 1, 2008; 191(2): 416 - 422. [Abstract] [Full Text] [PDF]

				S. Kim, L. L. Wang, J. P. Heiken, C. L. Siegel, C. F. Hildebolt, and K. T. Bae Opacification of Urinary Bladder and Ureter at CT Urography: Effect of a Log-rolling Procedure and Postvoiding Residual Bladder Urine Volume Radiology, June 1, 2008; 247(3): 747 - 753. [Abstract] [Full Text] [PDF]

				L. C. Chow, S. W. Kwan, E. W. Olcott, and G. Sommer Split-Bolus MDCT Urography with Synchronous Nephrographic and Excretory Phase Enhancement Am. J. Roentgenol., August 1, 2007; 189(2): 314 - 322. [Abstract] [Full Text] [PDF]

				M. Jinzaki, A. Tanimoto, H. Shinmoto, Y. Horiguchi, K. Sato, S. Kuribayashi, and S. G. Silverman Detection of Bladder Tumors with Dynamic Contrast-Enhanced MDCT Am. J. Roentgenol., April 1, 2007; 188(4): 913 - 918. [Abstract] [Full Text] [PDF]

				S. G. Silverman, S. A. Akbar, K. J. Mortele, K. Tuncali, J. G. Bhagwat, and J. L. Seifter Multi-Detector Row CT Urography of Normal Urinary Collecting System: Furosemide versus Saline as Adjunct to Contrast Medium Radiology, September 1, 2006; 240(3): 749 - 755. [Abstract] [Full Text] [PDF]

				A S Lowe and C L Kay Recent developments in CT: a review of the clinical applications and advantages of multidetector computed tomography Imaging, June 1, 2006; 18(2): 62 - 67. [Abstract] [Full Text] [PDF]

				G. S. Sudakoff, D. P. Dunn, R. S. Hellman, M. A. Laguna, C. R. Wilson, R. W. Prost, D. C. Eastwood, and H. J. Lim Opacification of the Genitourinary Collecting System During MDCT Urography with Enhanced CT Digital Radiography: Nonsaline Versus Saline Bolus Am. J. Roentgenol., January 1, 2006; 186(1): 122 - 129. [Abstract] [Full Text] [PDF]

				S. Kawamoto, K. M. Horton, and E. K. Fishman Opacification of the Collecting System and Ureters on Excretory-Phase CT Using Oral Water as Contrast Medium Am. J. Roentgenol., January 1, 2006; 186(1): 136 - 140. [Full Text] [PDF]

				W. Liu, K. J. Mortele, and S. G. Silverman Incidental Extraurinary Findings at MDCT Urography in Patients with Hematuria: Prevalence and Impact on Imaging Costs Am. J. Roentgenol., October 1, 2005; 185(4): 1051 - 1056. [Abstract] [Full Text] [PDF]

				J Richenberg and P Thompson Haematuria Imaging, August 1, 2005; 17(1): 34 - 43. [Full Text] [PDF]

				E. M. Caoili, P. Inampudi, R. H. Cohan, and J. H. Ellis Optimization of Multi-Detector Row CT Urography: Effect of Compression, Saline Administration, and Prolongation of Acquisition Delay Radiology, April 1, 2005; 235(1): 116 - 123. [Abstract] [Full Text] [PDF]

				G. S. Sudakoff, M. Guralnick, P. Langenstroer, W. D. Foley, K. L. Cihlar, J. S. Shakespear, and W. A. See CT Urography of Urinary Diversions with Enhanced CT Digital Radiography: Preliminary Experience Am. J. Roentgenol., January 1, 2005; 184(1): 131 - 138. [Abstract] [Full Text] [PDF]

				M Noroozian, R H Cohan, E M Caoili, N C Cowan, and J H Ellis Multislice CT urography: state of the art Br. J. Radiol., December 1, 2004; 77(suppl_1): S74 - S86. [Abstract] [Full Text] [PDF]

				A. Kawashima, T. J. Vrtiska, A. J. LeRoy, R. P. Hartman, C. H. McCollough, and B. F. King Jr CT Urography RadioGraphics, October 1, 2004; 24(suppl_1): S35 - S54. [Abstract] [Full Text] [PDF]

				E. M. Caoili, R. H. Cohan, A. Kawashima, and A. J. LeRoy Invited Commentary * Authors' Response RadioGraphics, October 1, 2004; 24(suppl_1): S55 - S58. [Full Text] [PDF]

				R. D. Nawfel, P. F. Judy, A. R. Schleipman, and S. G. Silverman Patient Radiation Dose at CT Urography and Conventional Urography Radiology, July 1, 2004; 232(1): 126 - 132. [Abstract] [Full Text] [PDF]

				S. A. Joffe, S. Servaes, S. Okon, and M. Horowitz Multi-Detector Row CT Urography in the Evaluation of Hematuria RadioGraphics, November 1, 2003; 23(6): 1441 - 1455. [Abstract] [Full Text] [PDF]