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Objective To investigate and evaluate the clinical signiifcance of lfexible ureteroscopy in computed tomography urography negative patients with upper urinary tract hematuria. To improve the diagnostic rate of patients with upper urinary tract hematuria. Methods We retrospectively reviewed the cases of 10 computed tomography urography negative patients with upper urinary tract hematuria. The age ranges from 38 to 75 years old, and the average of them is 45.2 years old. The patients consist of 7 male patients and 3 female patients. Among them, 4 cases were on the left upper urinary tract cases, 6 cases were right upper urinary tract. All patients received lfexible ureteroscopy to conifrm the diagnosis and take the relevant treatment. Results In the total of 10 patients, 3 patients (30%) were diagnosed with tumors of renal pelvis, a renal arteriovenous ifstula was found in 1 case (10%), 3 patients (30%) were considered non-specific inflammation, other 3 patients (30%) had no obvious abnormalities. Conclusions Flexible ureteroscopy has significantly clinical diagnosis in computed tomography urography negative patients with upper urinary tract hematuria.
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Objective To evaluate the image quality,diagnosis accuracy and dose reduction of split-bolus CT urography (CTU) with low voltage scan and sinogram affirmed iterative reconstruction (SAFIRE).Methods A total of 80 cases of consecutive patients with confirmed or suspected urinary system disease needed CTU examination were divided into two groups (control group and test group) by using random number table.In control group,convention scan (120 kV) with one time injection was used.But low voltage scan (80 kV) with SAFIRE algorithm and split-bolus injection (SBI) was used in experiment group.The radiation dose,image quality and diagnosis accuracy were compared.Results A total of 77 cases completed CTU examination successfully in the two groups,including 39 cases in control group and 38 cases in test group.The effective dose reduced from (26.68 ± 4.07) in control group to (3.93 ± 0.85) mSv in test group (t =-33.78,P ＜ 0.05).Subjective image quality score was (4.49 ± 0.79) in control group and (4.39 ± 1.53) in test group,with no significantly statistical difference (Z =2.71,P ＞ 0.05).Signal-to-noise ratio (SNR) of objective image quality in test group was higher than that in control group (127.3±15.9 vs.109.6 ± 13.2,t =4.49,P＜0.05).But there was no significantly statistical difference in contrast-to-noise ratio (CNR) between control group(100.8 ± 12.9)and test group (109.0 ± 14.4,P ＞ 0.05).For diagnosis accuracy,no statistical difference were found between two groups(84.62％ and 81.58％,P ＞ 0.05).Conclusions The combination of low voltage scan with SAFIRE algorithm and split-bolus injection CTU could reduce the radiation dose significantly,but the objective image quality,CNR (except SNR) of subjective image quality and diagnosis accuracy were all unaffected obviously.
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Intravenous urography (IVU) and unenhanced helical computed tomography (UHCT) urography are the two main procedures performed in the radiological investigation for urolithiasis (urinary stone). However, exposure to ionizing radiation is the main concern in both procedures. Therefore, a dose comparison study was conducted between IVU and UHCT urography procedures to determine the optimum exposure parameters in this study. An anthropomorphic whole body phantom was used following the exact procedure of UHCT urography and series of imaging for IVU with an administration of contrast media. Three different exposure parameters were used for IVU with 75 kVp, 80 kVp and 85 kVp while 100 kVp, 120 kVp and 140 kVp for UHCT urography respectively. As a result, the radiation doses for IVU were 1.40 mSv, 2.10 mSv and 2.79 mSv corresponding to 75 kVp, 80 kVp and 85 kVp. On the other hand, the radiation doses for UHCT urography were 0.76 mSv, 1.32 mSv and 1.82 mSv for 100 kVp, 120 kVp and 140 kVp, respectively. However the optimum image was obtained at 85 kVp for IVU and 120 kVp for UHCT urography. In conclusion, the doses obtained from IVU were consistently higher than UHCT urography but not signifi cantly different
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Objective To probe the technique and clinical applications of spiral CT (SCT) scan in urinary system. Methods 40～80 ml angiografin was injected into the vein by high voltage injection in six cases,and 5～10 minute later, SCT scan was performed. The original data were sent to workstation, then reconstructed. 3D pictures of urinary system including renal calyx, ureter and bladder were clearly demonstrated in all cases. Results Of 6 cases, there were 3 ones with ureter stone,1 case with kidney calyx cancer, and 2 case with ureter repetitive. Conclusion CTU is a safe, convincible, convenient and fast technique. It may provide high resolving urinary tract image and will be a kind of non-injury imaging technique in diagnosing the diseases of urinary system.