Urology Book


Helical CT Urogram

Aka: Helical CT Urogram, CT Urogram, CT Urography, Multidetector CT Urography
  1. Indications
    1. Hematuria evaluation (preferred imaging study)
    2. Nephrolithiasis evaluation (preferred imaging study)
  2. Contraindications
    1. Pregnancy
  3. Protocol
    1. Step 1: Patients given water (distends urinary tract)
    2. Step 2: Noncontrast helical CT of Kidneys (identifies renal stones)
    3. Step 3: Inject iodinated contrast
    4. Step 4: Nephrogenic phase - Obtain immediate high resolution (1-2 mm sections)
    5. Step 5: Delayed images - Obtain high resolution images, 5-10 minutes later
  4. Efficacy
    1. Nephrolithiasis evaluation
      1. Sensitivity: 95 to 100%
      2. Specificity: 94 to 96%
      3. Preferred over intravenous pyelogram in Nephrolithiasis
      4. Worster (2002) Ann Emerg Med 40:280-6 [PubMed]
    2. Hematuria evaluation
      1. Preferred over other imaging modalities
      2. Gray Sears (2002) J Urol 168:2457-60 [PubMed]
  5. Findings
    1. Renal morphology
    2. Nephrolithiasis and ureteral stone localization
    3. Solid Renal Masses
    4. Pyelonephritis

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