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

Mcnicholas, M. M. J.; Raptopoulos, Vassilios; Schwartz, Rebecca K.; Sheiman, Robert G.; Ζορμπαλά, Αλεξάνδρα; Prassopoulos, Panos; Ernst, Randy D.; Pearlman, Justin D.

doi:10.2214/ajr.170.5.9574598

Cited by 152 publications

(90 citation statements)

References 12 publications

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“…Even fine anatomic details such as caliceal fornices could be visualized on diuretic-enhanced MS-CT urograms. McNicholas et al reported in their series a partial loss of caliceal detail at conventional window settings due to artefacts from dense contrast material [3]. Such a caliceal ¹pseudo-bluntingª, probably caused by too high papillary and forniceal concentration of contrast material, was not observed with use of low-dose furosemide in our series.…”

Section: Discussioncontrasting

confidence: 38%

“…In patients with normal or moderately impaired renal excretory function, the injection of only 10 mg of furosemide constantly achieved a rapid and uniform distribution of the radiopaque contrast material inside the entire upper urinary tract. In contrast to the conventional CTU technique used by McNicholas et al [3], no additional contrast material injection was necessary using the furosemide-enhanced method. In most of our patients, the ureters were completely visualized although an inconvenient compression device was not used.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…In contrast, urographic visualization of the urinary tract anatomy by means of contrast materialenhanced CT in the excretory phase could not really compete with intravenous pyelography (IVP), although several studies demonstrated a general feasibility of CT urography (CTU) [2,3]. In comparison with IVP, the conventional CTU examination technique still revealed a deficiency in the accurate delineation of pelvicaliceal details [3]. Furthermore, complete opacification of all ureteral segments seemed to be an inconsistent finding in Multi-slice CT Urography after diuretic injection: initial results previous CT urograms which necessitated the use of a compression device even in CT [3].…”

Section: Introductionmentioning

confidence: 99%

“…In comparison with IVP, the conventional CTU examination technique still revealed a deficiency in the accurate delineation of pelvicaliceal details [3]. Furthermore, complete opacification of all ureteral segments seemed to be an inconsistent finding in Multi-slice CT Urography after diuretic injection: initial results previous CT urograms which necessitated the use of a compression device even in CT [3]. In the present context, we assume that two aspects can help to improve the examination technique for CT urography: Firstly, it makes sense to utilize all the technical advantages of the new multi-slice technology [4] also for the performance of CTU.…”

Section: Introductionmentioning

confidence: 99%

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Multi-slice CT Urography after diuretic injection: initial results

Nolte-Ernsting¹,

Wildberger²,

Borchers³

et al. 2001

Fortschr Röntgenstr

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Schlüsselwörter: Urographie ± Computertomographie ± Multidetektor-Technologie ± Furosemid Purpose: To investigate the feasibility of CT urography (CTU) using a multi-slice (MS) scanner and to find out whether a lowdose diuretic injection is advantageous for the opacification of the urinary tract. Methods: MS-CTU was performed in 21 patients with urologic diseases. In 5/21 patients, 250 ml of physiologic saline Solution were injected. In 16/21 patients, 10 mg of furosemide were injected 3 ± 5 min before contrast material administration. A 4 2.5 mm collimation with a pitch of 1.25 and a tube curent of 100 ± 150 mA were used. Scan time was 12 ± 16 sec. 3 mm thin axial images with an overlap of 67 % were reconstructed. Multiplanar maximum intensity projection (MIP) images were postprocessed to obtain urographic views. Bone structures were eliminated using the volume-of-interest method. Results: Furosemide-enhanced MS-CTU achieved either near complete or complete opacification in 30/32 (94 %) ureters and in 32/32 (100 %) pelvicaliceal systems up to a serum creatinine of 150 mol/l. In our series, only one CTU scan per patient was needed to obtain a diagnostic urogram after 10 min of contrast material injection. Ureteral compression was not necessary. When physiologic saline solution was used instead of furosemide, the radiopacity inside the enhanced pelvicalices was 4 ± 5 times higher and more inhomogeneous. Diuretic-enhanced MS-CTU was more accurate in the depiction of pelvicaliceal details. In combination with furosemide, calculi were well identified inside the opacified urine and were safely differentiated from phleboliths. Postprocessing times of up to 20 minutes were problematic as were contrast-enhanced superimposing bowel loops on MIP images. Conclusion: Preliminary results demonstrate a good feasibility of furosemide-enhanced MS-CTU for obtaining detailed visualization of the entire upper urinary tract.

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Section: Discussioncontrasting

confidence: 38%

Section: Discussionmentioning

confidence: 99%