Comparison of Excretory Phase, Helical Computed Tomography with Intravenous Urography in Patients with Painless Haematuria

• Published in: Clinical radiology Vol. 58; no. 4; pp. 294 - 300
• Main Authors: O'Malley, M.E, Hahn, P.F, Yoder, I.C, Gazelle, G.S, McGovern, F.J, Mueller, P.R
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Ltd 01.04.2003; Elsevier
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Carcinoma, Transitional Cell - complications; Carcinoma, Transitional Cell - diagnostic imaging; Female; genito-urinary system; Hematuria - diagnostic imaging; Hematuria - etiology; hemorrhagic pyelitis; Humans; Investigative techniques, diagnostic techniques (general aspects); Male; Medical sciences; Middle Aged; Nephrology. Urinary tract diseases; Prospective Studies; Radiodiagnosis. Nmr imagery. Nmr spectrometry; ROC Curve; Tomography, Spiral Computed - methods; Urinary Bladder Neoplasms - complications; Urinary Bladder Neoplasms - diagnostic imaging; Urinary Calculi - diagnostic imaging; Urinary system; Urinary system involvement in other diseases. Miscellaneous; Urinary tract. Prostate gland; urography; Urography - methods; Urologic Diseases - diagnostic imaging; Urologic Diseases - etiology; CT; genito-urinary system; urography; Performance evaluation; Human; Urinary system disease; Intravenous administration; Radiodiagnosis; Hematuria; Helical computed tomography; Hemorrhage; Urography; Etiology; Medical imagery; Comparative study
• ISSN: 0009-9260; 1365-229X
• DOI: 10.1016/S0009-9260(02)00464-6

AIM: To compare excretory phase, helical computed tomography (CT) with intravenous (IV) urography for evaluation of the urinary tract in patients with painless haematuria. MATERIALS AND METHODS: Ninety-one out-patients had IV urography followed by helical CT limited to the urinary tract. Both IV urograms and CT images were evaluated for abnormalities of the urinary tract in a blinded, prospective manner. The clinical significance of abnormalities was scored subjectively and receiver operator characteristic curve analysis was performed. RESULTS: In 69 of 91 patients (76%), no cause of haematuria was identified. In 22 of 91 patients (24%), the cause of haematuria was identified as follows: transitional cell cancer of the bladder ( n=15), urinary tract stones ( n=3), cystitis ( n=2), haemorrhagic pyelitis ( n=1) and benign ureteral stricture ( n=1). With IV urography, there were 15 true-positive, seven false-negative and three false-positive interpretations. With CT, there were 18 true-positive, four false-negative and two false-positive interpretations. There was no significant difference between IV and CT urography for the significance of the positive interpretations ( n=0.47). CONCLUSION: Excretory phase CT urography was comparable with IV urography for evaluation of the urinary tract in patients with painless haematuria. However, the study population did not include any upper tract cancers. O'Malley M. E. et al. (2003). Clinical Radiology 58, 294–300.