Contrast Enhanced Spiral Computerized Tomography in Patients With Chronic Obstructive Uropathy and Normal Serum Creatinine: A Single Session for Anatomical and Functional Assessment

El-Ghar, M. Abo; Shokeir, Ahmed A.; El-Diasty, Tarek; Refaie, Hoda F.; Gad, Hossam M.; El-Dein, Ahmed B. Shehab

doi:10.1097/01.ju.0000135368.77589.7c

Cited by 36 publications

(24 citation statements)

References 12 publications

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“…Evidence has shown the differential renal parenchyma volume measured by noncontrast CT provides a fairly accurate prediction of differential creatinine clearance (7). El-Dein et al demonstrated that contrast enhanced spiral CT is as accurate as nuclear renography for calculating total and separate renal function (8). There are, however, major drawbacks to these forms of renal function estimation.…”

Section: Commentsmentioning

confidence: 99%

“…There are, however, major drawbacks to these forms of renal function estimation. Primarily, these studies required sophisticated software to calculate total renal volume based on CT reconstructions (8). Such scans must be performed as a dedicated study as data from existing scans may not be adequate for the sophisticated reconstructions and volume rendering required.…”

Section: Commentsmentioning

confidence: 99%

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Renal parenchyma thickness: a rapid estimation of renal function on computed tomography

et al. 2009

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Purpose: To define the relationship between renal parenchyma thickness (RPT) on computed tomography and renal function on nuclear renography in chronically obstructed renal units (ORUs) and to define a minimal thickness ratio associated with adequate function. Materials and Methods: Twenty-eight consecutive patients undergoing both nuclear renography and CT during a six-month period between 2004 and 2006 were included. All patients that had a diagnosis of unilateral obstruction were included for analysis. RPT was measured in the following manner: The parenchyma thickness at three discrete levels of each kidney was measured using calipers on a CT workstation. The mean of these three measurements was defined as RPT. The renal parenchyma thickness ratio of the ORUs and non-obstructed renal unit (NORUs) was calculated and this was compared to the observed function on Mag-3 lasix Renogram. Results: A total of 28 patients were evaluated. Mean parenchyma thickness was 1.82 cm and 2.25 cm in the ORUs and NORUs, respectively. The mean relative renal function of ORUs was 39%. Linear regression analysis comparing renogram function to RPT ratio revealed a correlation coefficient of 0.48 (p < 0.001). The linear regression equation was computed as Renal Function = 0.48 + 0.80 * RPT ratio. A thickness ratio of 0.68 correlated with 20% renal function. Conclusion: RPT on computed tomography appears to be a powerful predictor of relative renal function in ORUs. Assessment of RPT is a useful and readily available clinical tool for surgical decision making (renal salvage therapy versus nephrectomy) in patients with ORUs.

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Section: Commentsmentioning

confidence: 99%

Section: Commentsmentioning

confidence: 99%

Renal parenchyma thickness: a rapid estimation of renal function on computed tomography

et al. 2009

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“…Müller-Lisse et al found in 26 patients that urothelial cancer can often be diagnosed or ruled out by MSCT without the need for an excretory phase [50]. Moreover, the cause of obstruction is often diagnosed on nephrographic-phase CT scans obviating excretory-phase imaging [51]. On the other hand, it is plausible that especially the diagnosis of subtle non-occluding or slightly obstructing urothelial lesions requires the best possible opacification of the entire urinary tract.…”

Section: Discussionmentioning

confidence: 99%

Understanding multislice CT urography techniques: many roads lead to Rome

2006

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CT urography has emerged as a serious alternative to conventional urography by utilizing the advantages of modern multislice CT techniques for the visualization of the entire upper urinary tract. Several different examination techniques have been developed in multislice CT (MSCT) urography for improving the opacification and distension of the urinary tract. All efforts in performing MSCT urography have to compromise between the best possible image quality and a reasonably low radiation exposure. Initial low-dose examination protocols are already available. Operating modern MSCT urography properly is not difficult, but it presupposes basic knowledge on the variety of current MSCT urography techniques, including such issues as present-day indications, split-bolus injection, compression, saline infusion, low-dose diuretic administration, hybrid scanning, timing of the acquisition delay, examination protocols, postprocessing, image analysis, and radiation exposure. This article is not intended to provide guidelines of how to conduct MSCT urography, but everyone will be able to understand the functionality of several robust operating MSCT urography techniques, which helps making an individual selection for the clinical practice. In the near future, systematic studies are awaited evaluating the morphologic and diagnostic accuracy of MSCT urography regarding diverse urinary tract disorders.

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“…This results in a small reduction in radiation exposure to the patient, reduced utilisation of imaging resources, and a more convenient assessment algorithm for the potential donor [44][45][46]. However, most analyses were based on correlation with significance testing of the differences between the two methods and so cannot provide a meaningful assessment [39].…”

Section: Discussionmentioning

confidence: 99%

Multidetector computed tomography with triple-bolus contrast medium administration protocol for preoperative anatomical and functional assessment of potential living renal donors

et al. 2010

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Contrast Enhanced Spiral Computerized Tomography in Patients With Chronic Obstructive Uropathy and Normal Serum Creatinine: A Single Session for Anatomical and Functional Assessment

Cited by 36 publications

References 12 publications

Renal parenchyma thickness: a rapid estimation of renal function on computed tomography

Renal parenchyma thickness: a rapid estimation of renal function on computed tomography

Understanding multislice CT urography techniques: many roads lead to Rome

Multidetector computed tomography with triple-bolus contrast medium administration protocol for preoperative anatomical and functional assessment of potential living renal donors

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