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Helical CT UrogramAka: 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
2. Hematuria evaluation
  1. Preferred over other imaging modalities
  2. Gray Sears (2002) J Urol 168:2457
Findings
1. Renal morphology
2. Nephrolithiasis and ureteral stone localization
3. Solid Renal Masses
4. Pyelonephritis

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This page was written by Scott Moses, MD. This page was last revised on 10/17/2008 7:00:33 PM. This page was last published on 2/26/2010. Please send comments and questions to the editor. Contact information may be found on the page About the Family Practice Notebook. These pages are best viewed with Microsoft Internet Explorer 6.0.