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Multi–Detector Row CT Urography of Normal Urinary Collecting System: Furosemide versus Saline as Adjunct to Contrast Medium¹

¹ From the Division of Abdominal Imaging and Intervention, Department of Radiology (S.G.S., S.A.A., K.J.M., K.T., J.G.B.) and Renal Division, Department of Medicine (J.L.S.), Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115. Received February 14, 2005; revision requested April 13; revision received August 4; accepted September 1; final version accepted December 21. Address correspondence to S.G.S. (e-mail: sgsilverman{at}partners.org).

View larger version (70K): [in a new window]   Figure 1a: Curved planar reformatted multi–detector row CT urographic images of collecting system and ureters on (a) right and (b) left side in patient who received 10 mg of intravenous furosemide. All urinary segments were assigned opacification scores of 3.

View larger version (65K): [in a new window]   Figure 1b: Curved planar reformatted multi–detector row CT urographic images of collecting system and ureters on (a) right and (b) left side in patient who received 10 mg of intravenous furosemide. All urinary segments were assigned opacification scores of 3.

View larger version (19K): [in a new window]   Figure 2: Bar graph shows effects of supplemental intravenous saline (white bars), furosemide (black bars), and both (gray bars) at multi–detector row CT urography on mean opacification scores in right-sided urinary collecting system. For the right middle ureteral segment, when the examination was performed with furosemide, the opacification score (2.60) was significantly higher than when it was performed with saline (2.20, P = .008). Mean opacification score for the right distal segment when the examination was performed with furosemide (2.56) was significantly higher than the score for the same segment when performed with saline (1.37, P < .001). IRCS = intrarenal collecting system.

View larger version (20K): [in a new window]   Figure 3: Bar graph shows effects of supplemental intravenous saline (white bars), furosemide (black bars), and both (gray bars) at multi–detector row CT urography on mean opacification scores in left-sided urinary collecting system. In the left middle ureteral segment, when the examination was performed with furosemide, the opacification score (2.71) was significantly higher than when it was performed with saline (2.26, P = .004). Mean opacification score for left distal ureteral segment when the examination was performed with furosemide (2.71) was significantly higher than when performed with saline (1.72, P < .001). IRCS = intrarenal collecting system.

View larger version (10K): [in a new window]   Figure 4: Bar graph shows that mean maximum ureteral widths on right side were higher when multi–detector row CT urography was performed with furosemide (black bars) than when performed with saline (white bars) or both (gray bars). Mean maximum width of right middle ureter when CT was performed with furosemide (6.08 mm) was significantly higher than when performed with saline (5.30 mm, P = .04). Mean maximum width of right distal ureter when CT was performed with furosemide (4.53 mm) was also significantly higher than when performed with saline (3.84 mm, P = .01).

View larger version (10K): [in a new window]   Figure 5: Bar graph shows that mean maximum ureteral widths on left side were higher when multi–detector row CT urography was performed with furosemide (black bars) than when performed with saline (white bars) or both (gray bars). Mean maximum width of left middle ureter when CT was performed with furosemide (5.96 mm) was significantly higher than when performed with saline (4.87 mm, P = .01). Mean maximum width of left distal ureter when CT was performed with furosemide (4.61 mm) was also significantly higher than when performed with saline (3.93 mm, P = .01).