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At least 37 records · Page 2Linked to original sources
PubMed1996

The value of MR urography that uses HASTE sequences to reveal urinary tract disorders.

OBJECTIVE: Breath-hold MR urography using half-Fourier acquisition single-shot turbo spin-echo (HASTE) sequences was evaluated as a noninvasive alternative to excretory urography in healthy volunteers and in patients with disorders of the urinary tract. SUBJECTS AND METHODS: Twenty healthy volunteers and 45 patients with disorders of the urinary tract underwent HASTE MR urography on a 1.5-T MR imaging unit. Imaging time was 2 sec for single-thick-slice (20- to 60-mm slice thickness) technique and 10-18 sec for multislice technique. In the latter, images were postprocessed with maximum-intensity-projection technique and visualized in an arbitrary plane. Obstruction and its level were determined solely by excretory urography in eight patients, by excretory urography with other imaging techniques (CT, retrograde pyelography, or sonography) in 27 patients, and by sonography alone in the 20 normal volunteers, seven pregnant women, and three patients who were allergic to iodinated contrast media. We evaluated whether HASTE MR urograms showed obstruction, showed the level of obstruction, and showed the cause of obstruction. RESULTS: In all 20 healthy volunteers and all 45 patients, the upper, middle, and lower group of renal calices and the pelvis were clearly revealed by HASTE MR urography. In patients whose urinary tracts were seen on excretory urography (n = 31), the accuracy of HASTE MR urography in revealing urinary tract dilatation and level of obstruction completely correlated with that of excretory urography, although functional information about the obstructed collecting system was not obtained. However, MR urography revealed nonfunctioning urinary tracts that were invisible on excretory urography (n = 6). In patients with extrinsic obstruction (n = 27), MR urography also revealed the obstructing lesions. Small stones within the ureter were more clearly seen on single-shot or source images. With HASTE MR urography, hydronephrosis in pregnant women (n = 7) was clearly shown. CONCLUSION: HASTE MR urography can be used as an alternative to excretory urography to obtain high-quality images of the dilated urinary tract and adjacent abnormalities. HASTE MR urography allows rapid acquisition of images, thus overcoming the drawbacks of earlier MR urography techniques.

Adolescent↗
PubMed1998

Excretory phase CT urography for opacification of the urinary collecting system.

OBJECTIVE: The purpose of our study was threefold: to evaluate the ability of excretory phase CT urography to opacify the urinary collecting system by comparing opacification seen on CT with the opacification seen on a series of unmatched IV urography examinations; to determine the optimal CT urography technique for ureteral filling by comparing studies of patients who were imaged supine, prone, and with abdominal compression; and to assess the possible value that reformatted planar images might add to axial excretory phase images. SUBJECTS AND METHODS: Seventy patients with hematuria were imaged in one of four ways. Twenty-five patients underwent contrast-enhanced excretory phase helical CT of the kidneys, ureters, and bladder. All patients were imaged in a supine position. Ten other patients underwent a similar CT protocol in which we used abdominal compression. Ten further patients underwent excretory phase CT while in a prone position. A final 25 patients underwent IV urography. Each patient's collecting system was arbitrarily divided into 10 parts (both right and left sides of calices; pelvis; upper, mid, and lower ureters) for scoring of images on a five-point scale for opacification by contrast material. Opacification scores for the four groups of patients were then compared. For patients who underwent CT, reformatted images of the collecting systems were generated and evaluated for their potential to add value to the conventional axial images. RESULTS: We found no significant difference in the ability of CT urography and IV urography to yield opacification of the calices, pelvis, and upper or mid ureters. Opacification of the distal ureter was less well seen on supine CT urography than on IV urography. Prone and compression CT urography resulted in better opacification of the collecting system than the supine noncompression technique. Opacification of the distal ureter was best seen with compression CT and was as good as that seen with IV urography. Reformatted CT urography was judged to be of probable or definite additional value to the axial images in 44% of cases. In each case, we saw a pathologic finding whose relationship to the kidney and collecting system was not as easy to appreciate on the axial CT scans. CONCLUSION: CT urography with abdominal compression results in reliable opacification of the collecting system that is comparable with opacification seen on IV urography. In patients with abnormalities, reformatted images were a useful adjunct to axial images. CT urography has potential as an imaging tool for the urothelium.

Abdomen↗
PubMed2007

The role of computerized tomographic urography in the initial evaluation of hematuria.

PURPOSE: We determined the usefulness of computerized tomographic urography for the initial evaluation of patients with hematuria as an alternative to excretory urography. MATERIALS AND METHODS: A total of 259 patients (140 men and 119 women), age range 20 to 100 (mean 59.4) years, underwent computerized tomographic urography for the evaluation of hematuria and were available for followup. A cohort of 253 patients (153 men, 100 women), age range 21 to 92 (mean 57.6) years, underwent conventional excretory urography and were evaluated for comparison. RESULTS: A source of hematuria was identified in 107 patients (41.3%) in the computerized tomographic urography cohort and in 103 patients (40.7%) in the excretory urography cohort. Computerized tomographic urography alone identified a source of hematuria in 25.5% of these patients with the most commonly diagnosed lesions being renal calculi (18.9%), ureteral calculi (2.7%) and renal pelvic masses (2.3%) in the upper tract (0.94 sensitivity), and bladder masses (8.1%), prostatic abnormalities (5.4%) and inflammatory disorders (3.5%) in the lower tract (0.40 sensitivity, 0.99 specificity). The overall detection rate (19.5%), most commonly diagnosed lesions, and lower urinary tract sensitivity and specificity were similar in the excretory urography cohort. However, excretory urography exhibited a markedly lower sensitivity in detecting upper tract lesions (0.50). CONCLUSIONS: Computerized tomographic urography exhibited a significantly higher sensitivity than conventional excretory urography in detecting upper tract pathology (94.1% vs 50%). However, sensitivity for detecting lower tract lesions was low (40% or less), suggesting that computerized tomographic urography offers a comprehensive alternative to excretory urography but does not obviate the need for adjunctive cystourethroscopy for accurate evaluation of the lower urinary tract.

Female↗