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The large number of very thin section images allows for isotropic presentation of the axially acquired data set in any chosen plane. Most CTU protocols are triphasic examinations that include noncontrast, enhanced, and delayed images.
University of Sydney Library. Related resource Table of contents only at http: Urothelial carcinoma, most commonly transitional cell carcinoma,most commonly affects males older than When hematuria is the indication for imaging, particularly in the setting of gross atlxs, intraluminal blood clots within the bladder usually can be differentiated from urothelial tumors.
It should be noted, however, that the most reliable method to diagnose a suspected ureteral tear is a retrograde pyelogram. CT urography of urinary diversions with enhanced CT digital radiography: Papillary necrosis is associated with analgesic overuse, sickle cell anemia, diabetes, pyelonephritis, renal obstruction, and renal vein thrombosis.
What is the current role of CT urography and MR urography in the evaluation of the urinary tract? As an alternative to the triphasic single bolus CTU technique, the split contrast bolus technique has been designed whereby the contrast is given as 2 boluses before a single enhanced-scan is acquired. Ab within the bladder appear similar to those in the upper tract and are easily seen on noncontrast images.
Diverticula of the bladder are fairly common and appear as focal outpouchings of urograph bladder wall contiguous with the lumen. Traumatic injury to the ureter is most frequently iatrogenic, but it may result from blunt or penetrating traumatic injuries.
Fibroepithelial polyps are benign mesodermal tumors of the ureter composed of a fibrovascular core lined by normal urothelium. The final chapter illustrates artifacts and diagnostic pitfalls. Accumulating data, however, indicates that CTU is reliable in detecting bladder cancer.
Urinary bladder rupture may be seen in cases of pelvic trauma, although the recommended imaging method to detect a urinary bladder rupture is a cystogram, using direct instillation of contrast into the bladder and imaging with either conventional radiography or CT. Physical Description xviii, p.
CT Urography: An Atlas – Google Books
Case 56 Obstructing calculi at the distal ureter. A detailed description of the radiographic features of each lesion is beyond the scope of this review. These diversions may be imaged on CTU. Imaging of the upper urinary tract has traditionally been the purview of intravenous IV urography, but over the last decade, computed tomography urography CTU has become the modality of choice in imaging the urinary tract.
Hematuria following traumatic injury may be an initial clinical clue. Check copyright status Cite this Title CT urography: Multiple small contrast-containing outpouchings are evident on excretory images. CT urography is well suited to detect such complications. Review of technique and spectrum of diseases. Less commonly encountered masses include renal lymphoma primary or secondaryfat-poor angiomyolipoma, multilocular cystic nephroma, oncocytoma, and metastatic disease.
Indications for CTU continue to evolve. Conditions commonly referred for CTU include urinary calculus disease, hematuria, flank and abdominal pain, suspected renal or urothelial neoplasm, a variety of inflammatory conditions, and congenital anomalies of the kidneys and ureters. Various growth patterns have been described, including predominantly pedunculated or intraluminal growth and sessile with mural invasion.
Many surgical techniques are available for urinary diversion following cystectomy and are created by fashioning a section of bowel into a conduit or reservoir to which the ureters can be anastomosed. Lists What are lists?
Infiltrating urothelial carcinoma tends to invade the renal sinus fat and renal parenchyma as a soft tissue neoplasm of decreased attenuation compared to that of the normal kidney, usually without a significant change in the renal contour Figure 8.
CT urography: Review of technique and spectrum of diseases
A variety of benign and malignant renal masses are well depicted by CTU, particularly during the nephrographic phase. While diagnostic unenhanced and nephrographic acquisitions are relatively easy to obtain, optimal opacification and distention of the ureters during the excretory phase can be more problematic. Each case is presented on a two-page spread, with images and succinct discussion of the entity and how CT urography was used to diagnose it.
Normal postoperative anatomy after. Classically, the ureterocele of the upper pole ureter results in obstruction, while abnormal insertion of the lower pole ureter results in vesicoureteral reflux Weigert-Meyer rule.
Suboptimal distention of the ureters and intermittent peristaltic waves may result in limited visualization of one or more segments.
Radiation dose As 3 CT scans of the abdomen and pelvis are performed in the examination, radiation dose to the patient is of concern. Furthermore, CTU is used to diagnose fistulae between the lower ureter or bladder and adjacent intestinal tract or vagina. Account Options Sign in.