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MDCT urography: experience with a bi-phasic excretory phase examination protocol.

Thomas Meindl1, Eva Coppenrath, Christoph Degenhart

  • 1Department of Clinical Radiology, University Munich, Ziemssenstr 1, 80336, Munich, Germany. thomas.meindl@med.uni-muenchen.de

European Radiology
|April 13, 2007
PubMed
Summary

Multidetector computed tomographic urography (MDCTU) using two excretory phases (EPs) significantly improves visualization of the middle and distal ureter. Single EPs reliably opacify the intrarenal collecting system and proximal ureter.

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Area of Science:

  • Radiology
  • Medical Imaging
  • Urology

Background:

  • Multidetector computed tomographic urography (MDCTU) is a key imaging modality for the upper urinary tract (UUT).
  • Assessing the optimal timing for excretory phase (EP) imaging in MDCTU is crucial for diagnostic accuracy.

Purpose of the Study:

  • To evaluate the benefit of bi-phasic MDCTU for visualizing early and late excretory phase (EP) upper urinary tract (UUT) opacification.
  • To compare the diagnostic yield of single versus combined EPs for UUT opacification.

Main Methods:

  • Retrospective evaluation of 45 bi-phasic four-row MDCTU examinations.
  • UUT divided into intrarenal collecting system (IRCS), proximal, middle, and distal ureter.
  • Two independent readers assessed opacification (none, partial, complete) for each EP and combined EPs.

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Main Results:

  • Intrarenal collecting system and proximal ureter showed >95% opacification in each EP.
  • Distal ureter opacification improved from 65% in early EP to 78% in late EP.
  • Combining two EPs reduced non-opacified distal segments to 9% (P < 0.03).

Conclusions:

  • Bi-phasic MDCTU substantially improves opacification of the middle and distal ureter.
  • A single EP reliably opacifies the IRCS and proximal ureter.
  • Utilizing both early and late EPs enhances diagnostic confidence in MDCTU urography.