Document Detail


Improved detection of renal pathologic features on multiphasic helical CT compared with IVU in patients presenting with microscopic hematuria.
MedLine Citation:
PMID:  12639640     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Erich K Lang; Richard J Macchia; Raju Thomas; Richard A Watson; Michael Marberger; Gerhard Lechner; Brian Gayle; Frank Richter
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Urology     Volume:  61     ISSN:  1527-9995     ISO Abbreviation:  Urology     Publication Date:  2003 Mar 
Date Detail:
Created Date:  2003-03-17     Completed Date:  2003-06-25     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0366151     Medline TA:  Urology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  528-32     Citation Subset:  IM    
Affiliation:
Department of Radiology, Tulane University Health Sciences Center, New Orleans, Louisiana70112-2699, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Evaluation Studies as Topic
Female
Hematuria / radiography*
Humans
Kidney / radiography*
Kidney Calculi / radiography
Kidney Diseases / radiography*
Kidney Neoplasms / radiography
Male
Middle Aged
Radiographic Image Enhancement
Retrospective Studies
Tomography, Spiral Computed / methods*
Urination
Urography / methods*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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