II. Indications
- Hematuria evaluation (preferred imaging study)
III. Contraindications
- Pregnancy
IV. Protocol
- Step 1: Patients given water (distends urinary tract)
- Step 2: Noncontrast helical CT of Kidneys (identifies renal stones)
- Step 3: Inject iodinated contrast
- Step 4: Nephrogenic phase - Obtain immediate high resolution (1-2 mm sections)
- Step 5: Delayed images - Obtain high resolution images, 5-10 minutes later
- Follows injected contrast as it is excreted from the Kidneys
V. Efficacy
-
Hematuria evaluation
- Preferred over other imaging modalities
- Gray Sears (2002) J Urol 168:2457-60 [PubMed]
-
Nephrolithiasis evaluation
- Noncontrast CT is preferred for evaluation of typical Renal Colic
- Sensitivity: 95 to 100%
- Specificity: 94 to 96%
- Originally replaced intravenous pyelogram (IVP) in Nephrolithiasis evaluation
- Worster (2002) Ann Emerg Med 40:280-6 [PubMed]
VI. Findings
- Renal and ureter morphology
- Urinary tract fistula
- Ureteral obstructive mass
- Nephrolithiasis and Ureteral Stone localization (non-contrast CT preferred)
- Solid Renal Masses
- Renal Infarct
- Pyelonephritis
VII. References
- Broder (2022) Crit Dec Emerg Med 36(5): 20-1
