Improved detection of renal pathologic features on multiphasic helical CT compared with IVU in patients presenting with microscopic hematuria
| Autor: | Frank Richter, Brian Gayle, Richard J. Macchia, Erich K. Lang, Gerhard Lechner, Richard A. Watson, Raju Thomas, Michael Marberger |
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| Rok vydání: | 2003 |
| Předmět: |
Adult
Male medicine.medical_specialty Urology media_common.quotation_subject Lupus nephritis Urination Medullary sponge kidney Kidney Kidney Calculi Medicine Humans Microscopic hematuria Upper urinary tract media_common Aged Hematuria Retrospective Studies business.industry Urography Middle Aged medicine.disease Helical ct Kidney Neoplasms Radiographic Image Enhancement Evaluation Studies as Topic Female Kidney Diseases Radiology Tomography business Tomography Spiral Computed Pyelogram |
| Zdroj: | Urology. 61(3) |
| ISSN: | 1527-9995 |
| Popis: | Objectives To examine the virtues of multiphasic helical computed tomography (CT) in the diagnosis of upper urinary tract lesions refractory to identification by intravenous urography (IVU). Methods A total of 86 patients (59 men and 27 women), 27 to 88 years old, with microscopic hematuria and negative IVU findings were examined with multiphasic helical CT consisting of a pre-enhancement, late arterial–early cortical–medullary, nephrographic, and excretory phase helical CT of the kidneys, using 3 to 5-mm collimation and 7.5-mm/s table feed. Results The multiphasic helical CT was conclusive in 84 lesions. Twenty-five cases of early papillary and medullary necrosis, 7 of 8 inflammatory lesions, 3 caliceal diverticula, 1 lupus nephritis, 26 small calculi, 2 medullary sponge kidney, 5 vascular anomalies, and 3 infarcts presented with characteristic manifestations on CT but lacked findings on IVU. Similarly 8 of 9 small malignant neoplasms, 2 small benign neoplasms, and 2 small cysts produced no detectable findings on IVU but were readily diagnosed on helical CT. Conclusions Characteristic findings, particularly on late arterial, early corticomedullary, parenchymal, and excretory phase helical CT make possible the diagnosis of early inflammatory disease, small masses and neoplastic lesions, and vascular abnormalities. Limited resolution (needed to identify small calculi) and the lack of ability to capture phases significantly reduce the diagnostic ability of IVU. |
| Databáze: | OpenAIRE |
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