The aim of this study was to evaluate the potential of multiphasic multidetector-row CT (MDCT) in the detection and staging of transitional cell carcinomas (TCC) of the upper urinary tract. We performed a retrospective chart review of 39 consecutive patients with 41 histologically verified TCC of the renal pelvis and/or the ureter. The urinary tract was examined using MDCT performing unenhanced and contrast-enhanced scans during the corticomedullary (CMP), nephrographic (NP) and pyelographic phase (PP). Tumors were staged according to the TNM classification. MDCT and histopathological findings were correlated. The attenuation of the lesions was documented in Hounsfield units (HU). In MDCT, all 41 TCC--including two multicentric TCC--were detected. TCC confined to the organ (stage 0a-II) was correctly staged in 28/29 tumors (96.6%). Stage III-IV tumors were correctly staged in 8/12 patients (66.6%). Overall, MDCT was accurate in predicting pathologic TNM stage in 36/41 upper urinary tract TCC (87.8%). There was no significant difference of mean attenuation of TCC between CMP, NP and PP (P > 0.05). MDCT with its high spatial and temporal resolution is an accurate tool for detection TCC of the upper urinary tract, with 87.8% accuracy in predicting its stage.
Use of a high flow concentration of iodine in MDCT angiography of the pulmonary arteries significantly increases attenuation of the pulmonary arteries, thereby improving visualization of subsegmental pulmonary arteries.
3T MRI showed a high accuracy for the staging of clinically localized prostate cancer, and it was significantly more accurate in predicting the final pathological stage than the Partin tables.
The aim of this study was to describe the potential of three-dimensional ultrasound (3DUS) in the urinary tract of neonates, infants, and children. The potential applications are illustrated based on our experience in 80 patients using two different 3DUS techniques. Various disease entities throughout the neonatal and pediatric age have been evaluated. The potential of 3DUS is discussed based on comparison with conventional 2DUS or other imaging (as clinically indicated), focused on the potentially improved renal parenchymal volume assessment. In our experience, 3DUS is feasible in neonates, infants, and children without sedation. It reduces imaging time, improves demonstration of complex anatomy and allows for evaluation of anatomy/pathology in any plane. The 3DUS improves volume assessment and follow-up comparison by offering an improved standardization and documentation. Rendered views of the dilated collecting system enable a comprehensive demonstration of hydronephrosis similar to intravenous urography or MR urography images. Additionally, 3DUS offers an ideal tool for training and education. Yet, limitations have to be acknowledged: areas inaccessible for 2DUS; poor quality of the original 2DUS acquisition; limited resolution; patient motion and breathing; cardiac pulsation creating artifacts and misregistration; equipment cost; lack of 3D DICOM standards creating problems with data storage; as well as system-inherent technical limitations. Nevertheless, the 3DUS holds the potential to become a valuable additional imaging tool for sonographic evaluation of the pediatric urinary tract.
Pulmonary artery attenuation in CTA of the pulmonary arteries shows a small but significant correlation with body weight and body mass index independently of the iodine flow rate used. A higher iodine flow rate improves pulmonary artery enhancement.
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