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Multi–Detector Row CT Urography in the Evaluation of Hematuria¹

¹ From the Department of Radiology, Beth Israel Medical Center, 1st Ave at 16th St, New York, NY 10003. Presented as an education exhibit at the 2002 RSNA scientific assembly. Received March 28, 2003; revision requested April 15; revision received May 21; accepted May 27. Address correspondence to S.A.J. (e-mail: sjoffe@bethisraelny.org).

Hematuria can be well evaluated with a comprehensive contrast material–enhanced multi–detector row computed tomography (CT) protocol that combines unenhanced, nephrographic-phase, and excretory-phase imaging. Unenhanced images are obtained from the kidneys to the bladder and allow optimal detection of renal calculi, a common cause of hematuria. Renal parenchymal abnormalities, particularly masses, are best visualized on nephrographic-phase images, which also provide excellent evaluation of the other abdominal organs. Thin-section delayed images obtained from the kidneys to the bladder demonstrate the urinary tract distended with contrast material and are useful in detecting urothelial disease. Intravenous urography, ultrasonography, CT, retrograde ureterography and pyelography, cystoscopy, and ureteroscopy can all be used to evaluate patients with hematuria. In the past, a combination of several of these examinations was necessary to fully evaluate these patients. Now, however, this CT protocol may permit evaluation of hematuria patients with a single comprehensive examination, although more experience and data are needed to determine its efficacy in this setting.

© RSNA, 2003

Index Terms: Computed tomography (CT), multi–detector row, 80.1211 • Genitourinary system, CT, 80.1211 • Urography, technology, 80.1221

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