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[IVU: a test of the past without future?]
J P Laissy1, E Abecidan, P Karila-Cohen
1Services de Radiologie et d'Urologie, Hôpital Bichat, 46, rue Henri Huchard, 75018 Paris. jean-pierre.laissy@bch.ap-hop-paris.fr
Summary
Intravenous urography (IVU) is largely replaced by CT and ultrasound for renal imaging. IVU remains an expert examination for specific urinary tract assessments when advanced imaging is unavailable or contraindicated.
Area of Science:
- Radiology
- Medical Imaging
- Urology
Background:
- Intravenous urography (IVU) was historically the gold standard for renal parenchyma and urinary tract investigation.
- Ultrasound and computed tomography (CT) have largely superseded IVU due to advancements in imaging technology.
Purpose of the Study:
- To evaluate the current role and limitations of IVU in diagnosing renal colic and other urinary tract conditions.
- To compare the efficacy and indications of IVU against newer imaging modalities like CT and ultrasound.
Main Methods:
- Review of current literature and clinical practice regarding IVU, CT, and ultrasound for renal and urinary tract imaging.
- Analysis of specific clinical scenarios where IVU might still offer advantages or be necessary.
Main Results:
- CT offers superior contrast resolution, broader coverage for differential diagnoses, and greater speed and efficacy compared to IVU.
- IVU retains a role in specific cases of renal colic, particularly when CT is unavailable or contraindicated (e.g., pregnancy), or for detailed urinary tract visualization (hematuria, tumors, malformations).
- IVU can provide a gross assessment of renal function in trauma patients unsuitable for CT, but may miss subtle findings like papillary necrosis.
Conclusions:
- IVU is now considered an expert examination with a limited future, largely replaced by CT urography.
- While CT is generally preferred, IVU remains valuable for specific indications where advanced imaging is limited or when detailed urinary tract assessment is crucial.