Kidney, Ureter, Adrenal Gland

Abstract

Today, multidetector computer tomography (MDCT), with its fast gantry rotation, enables large body volumes to be scanned with high temporal and spatial resolution. The fast rates of data acquisition and reconstruction result in multiphase protocols with short time intervals between consecutive scan series following the administration of a single bolus of intravenous contrast material (CM). Large scans obtained within a single breath-hold are possible and even the image data of non-cooperative or emergency patients are of acceptable quality. The acquired thin-slice raw data with isotropic sub-millimeter voxels can be visualized using different reconstruction algorithms and reformatted in all three spatial planes. The advantages of MDCT in the imaging of urologic emergencies are the excellent visualization of acute arterial and venous pathologies, detailed assessment of adrenal and renal parenchyma, and the precise depiction of the urinary tract (Foley WD (2002) Special focus session: multidetector CT: abdominal visceral imaging. Radiographics 22:701–719). Thus, in trauma and non-trauma settings a highly informative visualization of parenchymal patterns, bleeding, inflammatory disease is provided, allowing the differentiation of obstructive, post-traumatic, or post-therapeutic pathologies along the upper and lower urinary tract and including the adjacent retroperitoneal structures. Based on these MDCT findings, adequate decision-making in acute trauma, therapy planning, and interventional or surgical procedure planning can be carried out.