Computed tomography urography technique, indications and limitations

Abstract

Purpose of review: The review discusses the different techniques of computed tomography urography reported in the literature and presents the author's preferred approach.

Recent findings: Multiphase computed tomography urography offers a comprehensive evaluation of the urinary tract but at the cost of a large dose of contrast medium (100-150 ml), high radiation dose and massive number of images for interpretation. Diuresis induced by frusemide (10 mg) is reported to improve the depiction of ureters in the excretory phase of the examination. The author's preferred approach is a limited computed tomography urography which includes precontrast scanning of the kidneys, followed by an excretory phase 5 min after intravenous injection of 50 ml of contrast medium and 10 mg of frusemide. This limited examination in the author's experience provides a satisfactory evaluation of the urinary tract in the majority of patients, without inflicting a high radiation dose on the patient.

Summary: A limited computed tomography urography examination is adequate for the majority of patients requiring excretory urography and a superior replacement of conventional intravenous urography. Information provided by a multiphase computed tomography urography examination is beneficial only in a small number of patients.