Korean J Radiol.  2004 Mar;5(1):1-10. 10.3348/kjr.2004.5.1.1.

Multidetector CT Urography in Imaging of the Urinary Tract in Patients with Hematuria

• Maher MM
• Kalra MK
• Rizzo S
• Mueller PR
• Saini S

• KMID: 1066239
• DOI: http://doi.org/10.3348/kjr.2004.5.1.1

Abstract

This review article comprehensively discusses multidetector CT urography protocols and their role in imaging of the urinary tract in patients with hematuria.

Keyword

Multidetector CT; Urography

MeSH Terms

Hematuria/etiology/*radiography
Human
Incidental Findings
Sensitivity and Specificity
Tomography, X-Ray Computed/*methods/standards
Urinary Tract/abnormalities
Urography/methods/standards
Urologic Diseases/complications/congenital/radiography

Figure

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  Fig. 1 A proposed algorithm for imaging of patients with hematuria.

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  Fig. 2 Multidetector CT urography in a 36 year-old woman with hematuria. Nephropyelographic phase axial multidetector CT urography image (A) shows an obstructed upper pole moiety which is elegantly confirmed on a coronal multidetector CT urography image (B).

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  Fig. 3 Multidetector CT urography examination of a 65-year-old lady with left renal caliceal diverticulum and nodular calcification. Supine (A) and prone images (B) show change in position of this nodular calcific density (arrows) suggestive of calculus.

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  Fig. 4 Unenhanced multidetector CT urography in a 46-year-old man with hematuria and colicky pain in left flank demonstrates left mid-ureteral calculus (A) with "tissue-rim sign" (arrow) and proximal hydronephrosis (B) with minimal perinephric fat stranding (arrows).

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  Fig. 5 Multidetector CT urography study in a 52-year-old lady hematuria demonstrating renal cell carcinoma. Unenhanced image (A) demonstrates right renal mass with calcification. Contrast-enhanced images demonstrate a hypervascular enhancing mass (B).

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  Fig. 6 Multidetector CT urography image of a 53-year-old man with hematuria secondary to a transitional cell carcinoma of left ureter shows thickened, enhancing ureteric wall (arrow) with periureteric fat stranding suggestive of urothelial lesion with extramural spread of the disease (A and B). Proximal hydronephrosis with hydroureter is noted (C).

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  Fig. 7 A 42-year-old man underwent multidetector CT urography examination for hematuria. An eccentric filling defect (arrow) in the distal left ureter was reported as suspicious for urothelial neoplasm on axial post-contrast (A), coronal (B) and sagittal (C) maximum intensity projection images. Retrograde pyelography did not reveal any intraluminal abnormality. In retrospect, the "filling defect" was thought to be due to vascular impression.

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  Fig. 8 Multidetector CT urography evaluation of a 71-year-old lady with macroscopic hematuria secondary to transitional cell carcinoma of urinary bladder. A large polypoidal mass is seen arising from the right lateral wall with subtle perivesical fat stranding (arrows) suggestive of extramural spread.

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  Fig. 9 Multidetector CT urography study in a 75-year-old man with uncontrolled diabetes mellitus, left flank pain, hematuria and fever. A large staghorn calculus (arrow) with hypodense, non-enhancing parenchymal mass is seen in the left kidney suggestive of xanthogranulomatous pyelonephritis.

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