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Imaging Studies III: Computed Tomography

Imaging Studies III: Computed Tomography

DefinitionComputed Tomography (CT) of the genitourinary (GU) tract is a non-invasive imaging modality that utilizes X-rays and computer processing to generate detailed cross-sectional images of the urinary system, encompassing the kidneys, ureters, bladder, and adjacent structures such as the adrenal glands.PurposeCT scans of the GU tract serve several diagnostic and therapeutic purposes, including:Diagnosis of Urinary Tract Diseases: Detects kidney stones, tumors, cysts, and congenital...

Imaging Studies V: Intravenous Urography and Retrograde Pyelography

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IntroductionIntravenous Urography (IVU) and Retrograde Pyelography (RP) are important diagnostic imaging techniques used to evaluate the urinary system. These methods help identify structural abnormalities, obstructions, and functional issues in the kidneys, ureters, and bladder. Both procedures use iodine-based contrast media to enhance the visibility of urinary tract structures on X-ray images, though they differ in their methods and indications.1. Intravenous Urography (IVU)Intravenous...

Imaging Studies II: Ultrasonography

Imaging Studies II: Ultrasonography

IntroductionUltrasonography, or renal ultrasound, is a noninvasive medical imaging technique that uses high-frequency sound waves to visualize the kidneys, ureters, bladder, and surrounding tissues.Indications for Urinary System UltrasonographyUrinary system ultrasonography is indicated in various clinical scenarios, such as:Kidney Stones (Urolithiasis): To detect and monitor the size and presence of kidney or urinary tract stones.Hydronephrosis: To assess the dilation of the renal pelvis and...

Imaging Studies VI: Voiding Cystourethrography and Cystography

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Voiding Cystourethrography (VCUG) and Cystography are specialized radiographic procedures used to examine the structure and function of the bladder and urethra.Voiding Cystourethrography (VCUG)A Voiding Cystourethrogram (VCUG) is a diagnostic imaging procedure that assesses the anatomy and function of the lower urinary tract. It focuses on the bladder, bladder neck, and urethra, helping detect abnormalities such as vesicoureteral reflux (VUR)—the backward or reverse flow of urine into the...

Imaging Studies IV: Magnetic Resonance Imaging

Imaging Studies IV: Magnetic Resonance Imaging

Introduction:Magnetic Resonance Imaging, or MRI, can include a specialized imaging technique of the urinary system known as Magnetic Resonance Urography (MRU). This radiation-free technique uses strong magnetic fields and radio waves to produce detailed images with the help of a computer. MRU is particularly effective for visualizing fluid-filled structures like the kidneys, ureters, and bladder.Applications of MRI in the Genitourinary SystemKidneys and Ureters: MRI detects tumors, cysts,...

Imaging Studies I: Kidney, Ureter, and Bladder Studies

Imaging Studies I: Kidney, Ureter, and Bladder Studies

Kidney, Ureter, and Bladder (KUB) StudiesKidney, Ureter, and Bladder (KUB) studies are standard diagnostic imaging procedures used to assess the anatomy of the urinary system. They are commonly utilized for patients experiencing abdominal pain or urinary symptoms. By using a simple X-ray of the abdomen, KUB studies can reveal structural and pathological abnormalities within the kidneys, ureters, and bladder. These studies are particularly valuable in diagnosing kidney stones, urinary...

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Point-of-Care Kidney and Genitourinary Ultrasound in Adults: Image Acquisition

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Genitourinary imaging with noncontrast computerized tomography--are we missing duplex ureters?

Brian H Eisner¹, Mehrine Shaikh, Raul N Uppot

¹Kidney Stone Center, Department of Urology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA. beisner@partners.org

The Journal of Urology

|February 26, 2008

Summary

Noncontrast computerized tomography (CT) often misses ureteral duplication, a congenital anomaly. Contrast-enhanced CT scans are more accurate for diagnosing these urinary tract abnormalities.

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Area of Science:

Radiology
Urology
Medical Imaging

Background:

Noncontrast computerized tomography (CT) is widely used for diagnosing kidney stones.
Ureteral duplication is a common congenital anomaly that can pose challenges in diagnosis.

Purpose of the Study:

To evaluate the diagnostic capability of noncontrast CT in detecting ureteral duplication.
To determine the frequency of underdiagnosis of ureteral duplication using noncontrast CT.

Main Methods:

Two genitourinary radiologists reviewed CT scans from 14 patients with known ureteral duplication and 5 controls.
Scans included noncontrast axial, noncontrast coronal, and contrast-enhanced axial CT.

Main Results:

Contrast-enhanced axial CT had the highest sensitivity (96%) and negative predictive value (95%) for detecting ureteral duplication.
Noncontrast axial CT sensitivity was 59%, and noncontrast coronal CT was 65%.
Contrast-enhanced CT accuracy was significantly higher than noncontrast CT (p <0.01).

Conclusions:

Noncontrast CT frequently underdiagnoses ureteral duplication.
Urologists and radiologists should consider contrast-enhanced CT when anatomical anomalies are suspected.