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Helical CT Urogram

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Helical CT Urogram, CT Urogram, CT Urography, Multidetector CT Urography

  • Indications
  1. Hematuria evaluation (preferred imaging study)
  2. Nephrolithiasis evaluation (preferred imaging study)
  • Contraindications
  1. Pregnancy
  • 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
  • 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]
  • Findings
  1. Renal morphology
  2. Nephrolithiasis and ureteral stone localization
  3. Solid Renal Masses
  4. Pyelonephritis