Diagnosing urinary tract abnormalities: intravenous urography or CT urography?

El-Ghar, Mohamed Abou; Refaie, Huda; Sharaf, Doaa Elsayed; El-Diasty, Tarek

doi:10.2147/rmi.s35592

Cited by 6 publications

(4 citation statements)

References 31 publications

(40 reference statements)

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“…Hence, abdominal CT with contrast was chosen in this case to evaluate another anatomical abnormalities and complications. Computed tomography can detect duplicated urinary systems, especially in case of nonfunctioning moiety, anomaly with duplications such as ectopic ureter, and ureterocele [ 8 ]. In this case report, there was right kidney enlargement with duplicated collecting system and duplicated ureter obstruction (severe hydroureteronephrosis of right upper pole moiety) right kidney and ectopic insertion of the upper pole moiety between urethra and anterior vagina, no insertion to bladder, seemed to be dead end.…”

Section: Discussionmentioning

confidence: 99%

Unilateral duplicated collecting system and ureter with severe hydroureteronephrosis and ectopic ureter insertion of upper pole moiety: A case report

Chionardes¹,

Liemarto²,

Gunardi³

2022

Annals of Medicine &Amp; Surgery

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Introduction Incidence of duplicated urinary system is 0.7–4% of population, mostly are females and often diagnosed in childhood. Various symptoms meet difficulties to be diagnosed. Case presentation A 20-years-old woman admitted to hospital with fever, fatigue, nausea, loss of appetite, colic epigastric pain and right flank pain since 5 days before admission, normal pattern of urination with dribbling and recurrent urinary tract infection. Abdominal ultrasonography showed complicated cystic tumor upper pole of right kidney. Abdominal computed tomography with contrast showed enlargement right kidney with duplicated collecting system and duplicated ureter obstruction (severe hydroureteronephrosis right upper pole moiety) right kidney and ectopic ureter insertion of upper pole moiety between urethra and anterior vagina, no insertion to bladder, seemed to be dead end. Discussion Various symptoms of duplicated collecting system are asymptomatic, flank pain, abdominal pain, urinary incontinence, and recurrent UTI, often accompanied by abnormality of upper pole or lower pole or both. Abnormality of upper renal moiety usually has ectopic ureter as in Weigert-Meyer principle. Insertion into infrasphincter usually manifests as urinary dribbling or urinary incontinence or normal urination with few volume leakage or spotting incontinence, whereas suprasphincter usually manifests as recurrent UTI without incontinence. There are imaging modalities for diagnosing these anomalies, including USG and abdominal CT with contrast. Conclusion Understanding embryology, symptoms, imaging modality, and complications are necessary to consider this diagnosis for early detection. Ultrasonography and abdominal CT with contrast can be used to diagnose the urinary tract anomalies, especially duplicated urinary systems with ectopic ureter insertion.

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Section: Discussionmentioning

confidence: 99%

Unilateral duplicated collecting system and ureter with severe hydroureteronephrosis and ectopic ureter insertion of upper pole moiety: A case report

Chionardes¹,

Liemarto²,

Gunardi³

2022

Annals of Medicine &Amp; Surgery

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“…Despite the relatively higher patient radiation dose, CTU has displaced the conventional modality for diagnosing urinary tract abnormalities, the intravenous urography (IVU) [8,9]. Nowadays, the two most commonly used CTU protocols are the singleand the split-bolus, including a non-contrast phase and one or more phases after iodinated contrast medium injection [3,[10][11][12].…”

Section: Introductionmentioning

confidence: 99%

A retrospective survey to establish institutional diagnostic reference levels for CT urography examinations based on clinical indications: preliminary results

Efthymiou,

Metaxas,

Dimitroukas

et al. 2023

Biomed. Phys. Eng. Express

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Objective: To establish institutional diagnostic reference levels (IDRLs) based on clinical indications (CIs) for three- and four-phase computed tomography urography (CTU).Methods: Volumetric computed tomography dose index (CTDIvol), dose-length product (DLP), patients’ demographics, selected CIs like lithiasis, cancer, and other diseases, and protocols’ parameters were retrospectively recorded for 198 CTUs conducted on a Toshiba Aquilion Prime 80 scanner. Patients were categorised based on CIs and number of phases. These groups’ 75th percentiles of CTDIvol and DLP were proposed as IDRLs. The mean, median and IDRLs were compared with previously published values.Results: For the three-phase protocol, the CTDIvol (mGy) and DLP (mGy.cm) were 22.7/992 for the whole group, 23.4/992 for lithiasis, 22.8/1037 for cancer, and 21.2/981 for other diseases. The corresponding CTDIvol (mGy) and DLP (mGy.cm) values for the four-phase protocol were 28.6/1172, 30.6/1203, 27.3/1077, and 28.7/1252, respectively. A significant difference was found in CTDIvol and DLP between the two protocols, among the phases of three-phase (except cancer) and four-phase protocols (except DLP for other diseases), and in DLP between the second and third phases (except for cancer group). The results are comparable or lower than most studies published in the last decade.Conclusions: The CT technologist must be aware of the critical dose dependence on the scan length and the applied exposure parameters for each phase, according to the patient’s clinical background and the corresponding imaging anatomy, which must have been properly targeted by the competent radiologist. When clinically feasible, restricting the number of phases to three instead of four could remarkably reduce the patient’s radiation dose. CI-based IDRLs will serve as a baseline for comparison with CTU practice in other hospitals and could contribute to national DRL establishment. The awareness and knowledge of dose levels during CTU will prompt optimisation strategies in CT facilities.

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“…Consequently, renal and urinary tract developmental anatomic variants and their complication can be evaluated with imaging studies alone, which can differentiate the anatomical variants of the normal renal urinary tract from the pathologic changes visible on renal calyces, infundibulum and renal pelvis morphology [5] . CT urography is the ideal imaging technique for scanning the retroperitoneal organs, such as the kidney and has become the most useful diagnostic of urinary tract (UT) congenital abnormalities, including complex anomalies [ 5 , 6 ]. Renal ectopia, crossed ectopia, horseshoe kidney, and renal agenesis are all detected easily by computerized tomography urogram (CTU).…”

Section: Introductionmentioning

confidence: 99%

The importance of CT Urography in early diagnosis of anatomical variations in urogenital tract: case presentation

Dervishi

Hyseni²,

Musa

et al. 2022

Radiology Case Reports

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Diagnosing urinary tract abnormalities: intravenous urography or CT urography?

Cited by 6 publications

References 31 publications

Unilateral duplicated collecting system and ureter with severe hydroureteronephrosis and ectopic ureter insertion of upper pole moiety: A case report

Unilateral duplicated collecting system and ureter with severe hydroureteronephrosis and ectopic ureter insertion of upper pole moiety: A case report

A retrospective survey to establish institutional diagnostic reference levels for CT urography examinations based on clinical indications: preliminary results

The importance of CT Urography in early diagnosis of anatomical variations in urogenital tract: case presentation

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