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Published online before print February 16, 2005, 10.1148/radiol.2351031085
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(Radiology 2005;235:116-123.)
© RSNA, 2005

Genitourinary Imaging

Optimization of Multi–Detector Row CT Urography: Effect of Compression, Saline Administration, and Prolongation of Acquisition Delay1

Elaine M. Caoili, MD, Prasuna Inampudi, MD, Richard H. Cohan, MD and James H. Ellis, MD

1 From the Department of Radiology, University of Michigan Medical Center, 1500 E Medical Center Dr, Taubman Center B1 132D, Ann Arbor, MI 48109-9723. Received July 10, 2003; revision requested September 25; revision received August 19, 2004; accepted October 11. Supported by the Radiological Society of North America Research and Education Foundation. Address correspondence to E.M.C. (e-mail: caoili@umich.edu).

PURPOSE: To retrospectively compare the effects of abdominal compression, intravenous saline hydration, and two imaging delays on both distention and opacification of the intrarenal collecting system and ureter during multi–detector row computed tomographic (CT) urography.

MATERIALS AND METHODS: Institutional review board approval for reviewing images and medical records of the patients was obtained; informed patient consent was not required. Excretory phase images obtained from multi–detector row CT urography in 85 patients (57 men, 28 women) were reviewed. Examinations were performed by using one of four techniques: abdominal compression and intravenous hydration with 250 mL of normal saline, compression only, intravenous hydration with saline only, and neither compression nor saline hydration. Excretory phase imaging was performed at 300 and 450 seconds for each patient. Two reviewers measured urinary tract distention on transverse images and graded opacification and image quality on volume-rendered images. Effects were compared by using statistical mixed models with repeated-measures analysis of variance.

RESULTS: Saline hydration significantly improved opacification (P = .02) and overall image quality (P < .001) of the intrarenal collecting system and proximal ureter. Delayed excretory phase image acquisition of 450 seconds significantly increased distention of the intrarenal collecting system and proximal ureter (P < .001). No significant effects involving the lower segment of the ureter were seen with any technique; however, there were fewer nonvisualized distal ureteral segments with the longer imaging delay.

CONCLUSION: Compression does not significantly improve distention or opacification of the urinary tract. Saline hydration is effective in improving opacification of the proximal urinary tract. Longer imaging delays improve distention of the proximal urinary tract and may aid in visualization of the lower segment of the ureter.

© RSNA, 2005




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