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Haematuria: intravenous urography, ultrasound or both?
H R Speelman1, A G Kessels, A H Bongaerts
1Department of Diagnostic Radiology, De Wever Hospital, Heerlen.
Purpose:
To compare the diagnostic value of intravenous urography (IVU), ultrasound (US) and their combination in detecting upper urinary tract malignancies in patients with haematuria.
Materials And Methods:
In a prospective study, 360 consecutive patients who consulted the urologist for haematuria without renal colic were scheduled for IVU and US on the same day. The two procedures were performed by two different radiologists and reported independently. Histology or clinical follow-up of one year served as the gold standard.
Results:
63 patients dropped out. Of the remaining 297 patients, 9 (3%) had a malignancy in the upper urinary tract. Sensitivity and specificity with regard to the upper urinary tract pathology were 67% and 91% for IVU and 56% and 94% for US, respectively. For both techniques combined this was 79% and 88%, respectively.
Conclusion:
An acceptable sensitivity for detecting upper urinary tract malignancies is obtained only by combining IVU and US.