Literature DB >> 16954923

Improved visualization of the urinary tract in multidetector CT urography (MDCTU): analysis of individual acquisition delay and opacification using furosemide and low-dose test images.

Joern Kemper1, Marc Regier, Alexander Stork, Gerhard Adam, Claus Nolte-Ernsting.   

Abstract

PURPOSE: To retrospectively analyze the reliability of opacification and image quality of a modified MDCTU examination protocol using furosemide and an individual acquisition delay by low-dose test images
MATERIALS AND METHODS: Excretory phase images obtained from 4-row and 16-row MSCTU examinations in 103 patients (69 men, 34 women) were independently reviewed by two radiologists. MDCTUs were performed by using a low-dose furosemide iv injection. No fixed delay for urographic image acquisition was applied. Urographic timing was individually adjusted by performing low-dose test images of the distal ureters to display their current opacification. Image analysis included grading of opacification and image quality of the segmented collecting system. Average urographic delay was calculated. Stratified comparisons of mean scores were assessed. Interobserver kappa values were calculated.
RESULTS: Calculated median scan delay for patients with normal creatine levels (n = 92) was 420 sec (mean 453 sec; SD, 121 sec). The median number of acquired test images was 2 (range 1-6 images). The analysis of opacification demonstrated that 97% of the ICS, 89% of the proximal, 86% of the middle, and 81% of the distal ureter segments showed opacification greater than 90%. 7.8% of the distal ureteral segments could not be visualized. Statistics did not show significant differences of opacification between proximal, middle, and distal ureteral segments (P > 0.05). Overall image quality of MSCTU showed to be high when latest test images indicated homogeneous bilateral contrasted ureters (Pearson correlation coefficient r= 0.81). Interobserver kappa values were 0.8 and 0.78.
CONCLUSION: Furosemide and scan delay timing by means of test images for MDCTU proved to be a reliable procedure to reach improved opacification of the upper urinary tract. It features the individual adaption of MDCTU to the excretory rate of the kidneys.

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Year:  2006        PMID: 16954923     DOI: 10.1097/01.rct.0000224631.25198.ed

Source DB:  PubMed          Journal:  J Comput Assist Tomogr        ISSN: 0363-8715            Impact factor:   1.826


  7 in total

1.  Delineation of upper urinary tract segments at MDCT urography in patients with extra-urinary mass lesions: retrospective comparison of standard and low-dose protocols for the excretory phase of imaging.

Authors:  Ulrike L Mueller-Lisse; Eva M Coppenrath; Thomas Meindl; Christoph Degenhart; Michael K Scherr; Christian G Stief; Maximilian F Reiser; Ullrich G Mueller-Lisse
Journal:  Eur Radiol       Date:  2010-08-30       Impact factor: 5.315

Review 2.  [Multi-detector computed tomography in non-traumatic urologic emergencies].

Authors:  M K Scherr
Journal:  Radiologe       Date:  2009-06       Impact factor: 0.635

3.  Multidetector-row computed tomography (MDCT) in patients with a history of previous urothelial cancer or painless macroscopic haematuria.

Authors:  Ullrich G Mueller-Lisse; Ulrike L Mueller-Lisse; Josef Hinterberger; Peter Schneede; Thomas Meindl; Maximilian F Reiser
Journal:  Eur Radiol       Date:  2007-04-03       Impact factor: 5.315

4.  CT urography: definition, indications and techniques. A guideline for clinical practice.

Authors:  Aart J Van Der Molen; Nigel C Cowan; Ullrich G Mueller-Lisse; Claus C A Nolte-Ernsting; Satoru Takahashi; Richard H Cohan
Journal:  Eur Radiol       Date:  2007-11-01       Impact factor: 5.315

5.  Integration of CT urography improves diagnostic confidence of 68Ga-PSMA-11 PET/CT in prostate cancer patients.

Authors:  Leon Will; Frederik L Giesel; Martin T Freitag; Anne K Berger; Walter Mier; Klaus Kopka; Stefan A Koerber; Hendrik Rathke; Christophe Kremer; Clemens Kratochwil; Hans-Ulrich Kauczor; Uwe Haberkorn; Tim F Weber
Journal:  Cancer Imaging       Date:  2017-12-20       Impact factor: 3.909

6.  Diagnostic value of 64-slice spiral computed tomography imaging of the urinary tract during the excretory phase for urinary tract obstruction.

Authors:  De-Li Zhao; Guang-Sheng Jia; Peng Chen; Xin-Ding Liu; Sheng-Jie Shu; Zai-Sheng Ling; Ting-Ting Fan; Xiu-Fen Shen; Jin-Ling Zhang
Journal:  Exp Ther Med       Date:  2017-09-21       Impact factor: 2.447

7.  Influence of diuretic (furosemide) on contrast medium distribution in computed tomography urography of high-grade hydronephrosis in children.

Authors:  Przemysław Bombiński; Michał Brzewski; Stanislaw Warchol; Agnieszka Biejat; Marcin Banasiuk; Marek Gołębiowski
Journal:  Cent European J Urol       Date:  2018-12-27
  7 in total

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