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Multidetektor-CT bei nichttraumatischen urologischen Notfällen

Multi-detector computed tomography in non-traumatic urologic emergencies

Zusammenfassung

Durch den Einsatz moderner Multidetektor-Computertomographen (MDCT) mit schnellen Gantryrotationszeiten sind heute große Scanvolumina in hoher zeitlicher und mit hoher räumlicher Auflösung möglich. Die schnelle Bilddatenakquisition und -verarbeitung ermöglichen Mehrphasenprotokolle mit mehreren kurz aufeinander folgenden Scanserien innerhalb jeweils eines Atemanhalts und eine akzeptable Bildqualität bei unkooperativen Patienten. Diese führen zu dünnschichtigen Rohdaten mit isotropen Voxel im Submillimeterbereich, die mit verschiedenen Nachrekonstruktionsverfahren optimal visualisiert werden können.

Die urologische Notfalldiagnostik profitiert hier von der hervorragenden Darstellbarkeit akuter Gefäßpathologien in der arteriellen und venösen Vaskularisation der Nieren. Die renale Parenchymdarstellung und die präzise Abbildung der ableitenden Harnwege im nichttraumatischen Zusammenhang ermöglichen eine Darstellung inflammatorischer Prozesse und die Differenzierung verschiedener obstruierender oder posttherapeutischer Pathologien der ableitenden Harnwege und des kleinen Beckens. Die gewonnenen Befunde dienen der Therapieentscheidung und der Planung operativer und interventioneller Eingriffe.

Abstract

Today’s modern multi-detector computer tomography (MDCT) with its fast gantry rotation enables scanning of large body volumes with high temporal and spatial resolution. The fast acquisition of data and subsequent data reconstruction enables multiphase protocols with short time gaps between consecutive scan series so that large numbers of scans within one respiratory pause are possible and even in cases of non-cooperative patients acceptable quality of image data is provided. The acquired thin-slice raw data with isotropic submillimeter voxels can be visualized with different reconstruction algorithms.

The aadvantages of imaging for diagnostics in urologic emergencies are the excellent visualization of acute arterial and venous pathologies, detailed assessment of renal parenchyma and the precise depiction of the urinary tract. In non-trauma settings this enables detailed visualization of inflammatory diseases and differentiation of obstructive or post-therapeutic pathologies along the upper and lower urinary tract. Based on these MDCT findings adequate therapy planning and planning of interventional or surgical procedures can be carried out.

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Correspondence to M.K. Scherr.

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Scherr, M. Multidetektor-CT bei nichttraumatischen urologischen Notfällen. Radiologe 49, 516–522 (2009). https://doi.org/10.1007/s00117-008-1810-y

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Schlüsselwörter

  • Multidetektor-CT (MDCT)
  • Notfall
  • Urologie
  • Nephritis
  • Urolithiasis

Keywords

  • Multi-detector computed tomography (MDCT)
  • Emergency
  • Urology
  • Nephritis
  • Urolithiasis