Multi–Detector Row CT Urography of Normal Urinary Collecting System: Furosemide versus Saline as Adjunct to Contrast Medium

Silverman, Stuart G.; Akbar, Syed Ali; Mortelé, Koenraad J.; Tuncalı, Kemal; Bhagwat, Jui G.; Seifter, Julian L.

doi:10.1148/radiol.2403050233

Cited by 97 publications

(54 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The CT attenuation of iodine solution reaches 3,000 H at 80 kVp with an iodine concentration of 75.3 mg/dL, which corresponds to approximately 1,650 H at 120 kVp. Options to decrease the concentration of iodine in the urinary tract may include the use of the split contrast material injection technique, with a smaller dose of contrast material administered for the first of two injections [10,15], and the use of vigorous hydration or diuretics [16,17]. The other option is to use the 100-140 kVp pair instead of the 80-140 kVp pair.…”

Section: Discussionmentioning

confidence: 99%

Dual-Energy CT Iodine-Subtraction Virtual Unenhanced Technique to Detect Urinary Stones in an Iodine-Filled Collecting System: A Phantom Study

Takahashi

Hartman

Vrtiska

et al. 2008

American Journal of Roentgenology

120

View full text Add to dashboard Cite

OBJECTIVE-The objective of our study was to evaluate the feasibility of virtual unenhanced images reconstructed from a dual-energy CT scan to depict urinary stones in an iodine solution in a phantom study. MATERIALS AND METHODS-Twentyurinary stones of different sizes (1.4-4.2 mm in shortaxis diameter) were placed in plastic containers. The containers were consecutively filled with different concentrations of iodine solution (21, 43, 64, 85, and 107 mg/dL; CT attenuation value range, 510-2,310 H at 120 kVp). Dual-energy CT was repeated with 80-140 and 100-140 kVp pairs, two collimation-slice thickness combinations, and the presence or absence of a 4-cm-thick oil gel around the phantom. The iodine-subtraction virtual unenhanced images were reconstructed using commercial software. The images were evaluated by three radiologists in consensus for the visibility of the stones and the presence of residual nonsubtracted iodine. Stone visibility rates were compared between the 80-140 and 100-140 kVp pairs and the five different iodine concentrations.RESULTS-Stone visibility rates with the 80-140 kVp pair were 99%, 93%, 96%, 94%, and 3% and those with the 100-140 kVp pair were 98%, 95%, 99%, 94%, and 99% for an iodine concentration of 21, 43, 64, 85, and 107 mg/dL, respectively. The poor visibility rate with 80-140 kVp and 107 mg/dL iodine concentration was due to the failure of iodine subtraction.CONCLUSION-Dual-energy CT iodine-subtraction virtual unenhanced technique is capable of depicting urinary stones in iodine solutions of a diverse range of concentrations in a phantom study. Keywords dual-energy CT; genitourinary imaging; iodine-subtraction imaging technique; reconstructed images; urinary stonesCharacterization of tissue and materials using dual-energy CT was first described in the late 1970s when CT technology was still in its infancy [1,2]. The technique was not adapted widely for clinical use except for bone densitometry [3] due to immature CT technology. With new dual-source CT systems, dual-energy CT scans can be obtained simultaneously using two orthogonally positioned X-ray tube and detector sets. This capability eliminates the need for © American Roentgen Ray Society Address correspondence to N. Takahashi. NIH Public Access NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript two separate scans with two different energy X-ray spectra and, therefore, eliminates misregistration due to patient motion or change in the contrast distribution between the two scans [4,5].The use of dual-source CT scanners has been shown to be effective in improving temporal resolution in coronary CT angiography [4,[6][7][8]. Subtraction of bone or calcium plaques from vessels on CT angiography using the dual-energy CT technique also appears promising [4]. Outside the realm of cardiovascular imaging, little experimentation with current dual-energy scanning techniques and subtraction imaging has been performed.As a routine component of CT urograms for hematuria or suspected urothelial tumor, unenhanced...

show abstract

Section: Discussionmentioning

confidence: 99%

Dual-Energy CT Iodine-Subtraction Virtual Unenhanced Technique to Detect Urinary Stones in an Iodine-Filled Collecting System: A Phantom Study

Takahashi

Hartman

Vrtiska

et al. 2008

American Journal of Roentgenology

120

View full text Add to dashboard Cite

show abstract

“…A total of 150 ml of 300 mg/ml contrast media was administered with the triple-bolus protocol, similar to the 100-150 ml reported for single-bolus imaging and should not place patients at an increased risk of contrast-induced nephropathy [9][10][11][12][13][14][15][16]. Excretory phase artefacts related to high-density iodine solution were not seen in this study due to oral water hydration and furosemide administration prior to imaging [34,42]. Five patients had mean collecting system densities below the sculpting limit of 400 HU and although careful contouring of the collecting system was performed it is possible that small sections were included in the MDCT-derived volume and attenuation measurements used to calculate DRF.…”

Section: Discussionmentioning

confidence: 55%

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

et al. 2010

View full text Add to dashboard Cite

show abstract

“…Oral hydration with water is without any additional cost and promotes diuresis and thus distension of the urinary tract; however caution is required for patients with limited liquid intake. Several investigators used similar regimes describing that 20 min prior to scanning patients ingested up to 1l of tap water [16][17][18] or "six cups" of water during 60 min before scanning. [19] Saline infusion might be used as an alternative.…”

Section: Discussionmentioning

confidence: 99%

CT-Urography: Comparison of different methods for increasing the intra-abdominal pressure

Hage

Boll²,

Brantner³

et al. 2018

IJDI

View full text Add to dashboard Cite

Objective: Investigating the influence of increasing the intraabdominal pressure by Valsalva maneuvers and/or abdominal compression to reach best visualization of the entire urinary tract in computed tomography urography (CTU). Methods: After split-bolus technique, Valsalva maneuvers, compression or a combination of both were applied in 60 patients before late phase images were acquired. The degree of opacification and distension of three segments of the urinary tract were evaluated. Results: After split-bolus CT no significant difference among the groups regarding distention and opacification. A significant increase in distension and opacification was found during Valsalva and the combination of Valsalva and compression. Conclusions: A CTU protocol including a late phase scan with prior application of compression, Valsalva maneuvers or a combination of both showed beneficial effects for the distension and opacification, a significant difference was found by taking location as a covariate.

show abstract

Multi–Detector Row CT Urography of Normal Urinary Collecting System: Furosemide versus Saline as Adjunct to Contrast Medium

Abstract: To optimize opacification and distention of the normal urinary collecting system, contrast material-enhanced multi-detector row CT urography may be supplemented with intravenous furosemide alone.

Cited by 97 publications

References 25 publications

Dual-Energy CT Iodine-Subtraction Virtual Unenhanced Technique to Detect Urinary Stones in an Iodine-Filled Collecting System: A Phantom Study

Dual-Energy CT Iodine-Subtraction Virtual Unenhanced Technique to Detect Urinary Stones in an Iodine-Filled Collecting System: A Phantom Study

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

CT-Urography: Comparison of different methods for increasing the intra-abdominal pressure

Contact Info

Product

Resources

About