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      Applications of Computed Tomography in Renal Imaging

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          Abstract

          There have been huge advances in CT technology since its introduction more than 30 years ago. Modern, multislice CT scanners are fast and produce truly volumetric data, allowing it to be reconstructed in almost any plane. In this article, we explore the impact of these developments on the use of CT in imaging of the renal tract. Whilst it may take the radiologist longer to review and process the increased amount of data that is produced, diagnostic accuracy is unquestionably improved and new and exciting challenges are presented to the radiologist as he learns to manipulate and interpret the data in a way that he has never done before.

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          Most cited references 6

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          Multi-detector row CT urography in the evaluation of hematuria.

          Hematuria can be well evaluated with a comprehensive contrast material-enhanced multi-detector row computed tomography (CT) protocol that combines unenhanced, nephrographic-phase, and excretory-phase imaging. Unenhanced images are obtained from the kidneys to the bladder and allow optimal detection of renal calculi, a common cause of hematuria. Renal parenchymal abnormalities, particularly masses, are best visualized on nephrographic-phase images, which also provide excellent evaluation of the other abdominal organs. Thin-section delayed images obtained from the kidneys to the bladder demonstrate the urinary tract distended with contrast material and are useful in detecting urothelial disease. Intravenous urography, ultrasonography, CT, retrograde ureterography and pyelography, cystoscopy, and ureteroscopy can all be used to evaluate patients with hematuria. In the past, a combination of several of these examinations was necessary to fully evaluate these patients. Now, however, this CT protocol may permit evaluation of hematuria patients with a single comprehensive examination, although more experience and data are needed to determine its efficacy in this setting. Copyright RSNA, 2003
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            Determination of glomerular filtration rate per unit renal volume using computerized tomography: correlation with conventional measures of total and divided renal function.

            Previous studies suggest that functional computerized tomography (CT) can measure glomerular filtration rate (GFR) per unit renal volume. We compared this index with conventionally determined GFR measurements. A total of 16 men and 8 women 63.3 +/- 14.9 years old (range 31 to 88) were studied using with contrast enhanced CT. A single slice of kidney was scanned sequentially after bolus injection (0.5 to 1.0 ml. per second(-1)) of 20 ml. iopamidol (300 mg. iodine per ml.(-1)). GFR per volume of kidney was calculated using a Patlak graphical analysis, and this index was multiplied by renal volume on CT to yield global GFR (ml. per minute(-1)). Divided function was also calculated. GFR and divided renal function were calculated in all cases from radioisotope renography with 99m diethylenetetraminepentaacetic acid. In 12 subjects in whom 24-hour urine collection was possible GFR was also calculated from creatinine clearance. A strong correlation was observed between divided renal function, expressed with respect to the right kidney calculated from CT (52.7 +/- 14.8%, range 19.9% to 97.4%) and by radioisotope renography (51.7 +/- 14.6%, range 18.9% to 92.6%, r = 0.97, p <0.0001). A strong correlation (r = 0.92, p <0.0001) was also seen between global GFR determined by CT (80.1 +/- 43.9 ml. per minute(-1), range 38.2 to 197.9) and creatinine clearance (72.4 +/- 47.5, range 14.6 to 168.5), and was stronger than the correlation between the radioisotope and creatinine clearance method (r = 0.67, p = 0.02) in the same patients. Functional CT using nonionic contrast material can measure GFR normalized to renal volume and is an accurate alternative to conventional methods of renal function evaluation.
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              Pictorial review: CT urography and virtual endoscopy: promising imaging modalities for urinary tract evaluation.

              CT urography and virtual endoscopy images are generated from dedicated multislice helical CT data sets and various three-dimensional reconstruction techniques. These imaging techniques can provide external and endoscopic images of the urinary tract and also provide high spatial resolution images helping overcome some of the limitations of intravenous urography and ultrasound. This pictorial review presents clinical applications of CT urography and virtual endoscopy in various urinary tract abnormalities.
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                Author and article information

                Journal
                NEC
                Nephron Clin Pract
                10.1159/issn.1660-2110
                Nephron Clinical Practice
                S. Karger AG
                978-3-8055-8074-8
                978-3-318-01315-3
                1660-2110
                2006
                March 2006
                10 March 2006
                : 103
                : 2
                : c29-c36
                Affiliations
                Department of Radiology, University College Hospital, London, UK
                Article
                90606 Nephron Clin Pract 2006;103:c29–c36
                10.1159/000090606
                16543753
                © 2006 S. Karger AG, Basel

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                Page count
                Figures: 5, References: 15, Pages: 1
                Product
                Self URI (application/pdf): https://www.karger.com/Article/Pdf/90606
                Categories
                Radiologic Imaging

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