Advertisement

European Radiology

, Volume 16, Issue 8, pp 1667–1674 | Cite as

MDCT urography: retrospective determination of optimal delay time after intravenous contrast administration

  • Thomas MeindlEmail author
  • Eva Coppenrath
  • Rami Kahlil
  • Ulrike L. Müller-Lisse
  • Maximilian F. Reiser
  • Ullrich G. Müller-Lisse
Urogenital

Abstract

The optimal delay time after intravenous (i.v.) administration of contrast medium (CM) for opacifcation of the upper urinary tract (UUT) for multidetector computed tomography urography (MDCTU) was investigated. UUT opacification was retrospectively evaluated in 36 four-row MDCTU examinations. Single- (n=10) or dual-phase (n=26) MDCTU was performed with at least 5-min delay after i.v. CM. UUT was divided into four sections: intrarenal collecting system (IRCS), proximal, middle and distal ureter. Two independent readers rated UUT opacification: 1, none; 2, partial; 3, complete. Numbers and percentages of scores, and the 5%, 25%, 50%, 75% and 95% percentiles of delay time were calculated for each UUT section. After removing diseased segments, 344 segments were analysed. IRCS, proximal and middle ureter were completely opacified in 94% (81/86), 93% (80/86) and 77% (66/86) of cases, respectively. Median delay time was 15 min for complete opacification. The distal ureter was completely opacified in 37% (32/86) of cases and not opacified in 26% (22/86). Median delay time for complete opacification was 11 min with 25% and 75% percentiles of 10 and 16 min, respectively. At MDCTU, opacification of the IRCS, proximal and middle ureter was hardly sensitive to delay time. Delay times between 10 and 16 min were favourable in the distal ureter.

Keywords

Computed tomography Urography Kidney Ureter Genitourinary system 

Notes

Acknowledgements

The authors acknowledge the assistance in statistic data analysis of M. Schmidt, MD, (Institute for Medical Information, Biometry, and Epidemiology, University Munich, Germany).

References

  1. 1.
    Choe KA, Smith RC, Rosenfield AT (1995) Acute flank pain: comparison of non-contrast-enhanced CT and intravenous urography. Radiology 194:789–794PubMedGoogle Scholar
  2. 2.
    Freed KS, Sheafor DH, Hertzberg BS (2000) Nonenhanced helical CT and US in the emergency evaluation of patients with renal colic: prospective comparison. Radiology 217:792–797PubMedGoogle Scholar
  3. 3.
    Smith RC, Verga M, McCarthy S, Rosenfield AT (1996) Diagnosis of acute flank pain: value of unenhanced helical CT. AJR Am J Roentgenol 166:97–101PubMedGoogle Scholar
  4. 4.
    Caoili EM, Cohan RH, Korobkin M, Platt JF, Francis IR, Faerber GJ, Montie JE, Ellis JH (2002) Urinary tract abnormalities: initial experience with multi-detector row CT urography. Radiology 222:353–360PubMedCrossRefGoogle Scholar
  5. 5.
    Lang EK, Macchia RJ, Thomas R, Watson RA, Marberger M, Lechner G, Gayle B, Richter F (2003) Improved detection of renal pathologic features on multiphasic helical CT compared with IVU in patients presenting with microscopic hematuria. Urology 61:528–530CrossRefPubMedGoogle Scholar
  6. 6.
    Foley WD (2003) Renal MDCT. Eur Radiol 45:S73–S75CrossRefGoogle Scholar
  7. 7.
    Warshauer DM, McCarthy SM, Street L (1988) Detection of renal masses: sensitivities and specifities of excretory urography/linear tomography, US and CT. Radiology 169:363–365PubMedGoogle Scholar
  8. 8.
    Kawashima A, Sandler CM, Ernst RD, Goldman SM, Ravel B, Fishman EK (1997) Renal inflammatory disease: the current role of CT. Crit Rev Diagn Imaging 38:369–415PubMedGoogle Scholar
  9. 9.
    Herschorn S, Radomski SB, Shoskes DA, Mahoney J, Hirshberg E, Klotz L (1991) Evaluation and treatment of blunt renal trauma. J Urol 146:274–276PubMedGoogle Scholar
  10. 10.
    Schreyer HH, Uggowitzer MM, Ruppert-Kohlmayr A (2002) Helical CT of the urinary organs. Eur Radiol 12:575–591PubMedGoogle Scholar
  11. 11.
    McTavish JD, Jinzaki M, Zou KH, Nawfel RD, Silverman SG (2002) Multi-detector row CT urography: comparison of strategies for depicting the normal urinary collecting system. Radiology 225:783–790PubMedCrossRefGoogle Scholar
  12. 12.
    Nolte-Ernsting CCA, Wildberger JE, Borchers H, Schmitz-Rode T, Guenther RW (2001) Multi-slice CT urography after diuretic injection:initial results. Fortschr Roentgenstr 173:176–180CrossRefGoogle Scholar
  13. 13.
    Chow LC, Sommer FG (2001) Multidetector CT urography with abdominal compression and three-dimensional reconstruction. AJR Am J Roentgenol 177:849–855PubMedGoogle Scholar
  14. 14.
    Caoili EM, Inampudi P, Cohan RH, Ellis JH (2005) Optimization of multi-detector row CT urography: effect of compression, saline administration and prolongation of acquisition delay. Radiology 235:116–123PubMedCrossRefGoogle Scholar
  15. 15.
    Glantz SA (1997) Primer of Biostatistics. McGraw-Hill, New York St. Louis San FranciscoGoogle Scholar
  16. 16.
    Dyer RB, Chen MY, Zagoria RJ (2001) Intravenous urography: technique and interpretation. Radiographics 21:799–824PubMedGoogle Scholar
  17. 17.
    Nawfel RD, Judy PF, Schleipman AR, Silverman SG (2004) Patient radiation dose at CT urography and conventional urography. Radiology 232:126–132PubMedCrossRefGoogle Scholar
  18. 18.
    Caoili EM, Cohan RH, Korobkin M (2001) Effectiveness of abdominal compression during renal helical CT. Acad Radiol 8:1100–1106CrossRefPubMedGoogle Scholar
  19. 19.
    Heneghan JP, Kim DH, Leder RA (2001) Compression CT urography: a comparison with IVU in the opacification of the collecting system and ureters. J Comput Assist Tomogr 25:343–347CrossRefPubMedGoogle Scholar
  20. 20.
    Inampudi P, Caoili EM, Cohan RH, Ellis JH, Korobkin M, Platt JF (2003) Effect of compression, saline administration, and prolonging acquisition delay on images obtained during multidetector CT urography. AJR Am J Roentgenol 180 (Suppl):71PubMedGoogle Scholar
  21. 21.
    Mc Nicholas MM, Raptopoulos VD, Schwartz RK (1998) Excretory phase CT urography for opacification of the urinary collecting system. AJR Am J Roentgenol 170:1261–1267PubMedGoogle Scholar
  22. 22.
    Schumpert T, Coll DM, Papanicolaou N, Smith RC (2001) CT urography in renal donors: to compress or not to compress? AJR Am J Roentgenol 176 (Suppl):93Google Scholar
  23. 23.
    Raptopoulos V, McNamara A (2005) Improved pelvicalyceal visualization with multidetector computed tomography urography; comparison with helical computed tomography. Eur Radiol 15:1834–1840CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • Thomas Meindl
    • 1
    Email author
  • Eva Coppenrath
    • 1
  • Rami Kahlil
    • 1
  • Ulrike L. Müller-Lisse
    • 2
  • Maximilian F. Reiser
    • 1
  • Ullrich G. Müller-Lisse
    • 1
  1. 1.Institute for Clinical RadiologyUniversity MunichMunichGermany
  2. 2.Department of UrologyUniversity MunichMunichGermany

Personalised recommendations