Hematuria CT

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Adnan Ezici, M.D[2] Venkata Sivakrishna Kumar Pulivarthi M.B.B.S [3]

Overview

Computed tomography(CT) may be helpful in the diagnosis of bladder cancer in a patient with gross hematuria without any obvious etiology. However, ultrasonography plus cystoscopy are usually enough, less costly, and safer as opposed to CT which includes the use of contrast material. Computed tomography(CT) of the kidneys and urinary tract is better than ultrasound in detecting stones in patients with hematuria, and it has the highest sensitivity, at 94% to 98%. Noncontrast helical CT is excellent for the detection of urinary stones.

CT

• Computed tomography(CT) may be helpful in the diagnosis of bladder cancer in a patient with gross hematuria without any obvious etiology. However, ultrasonography plus cystoscopy are usually enough, less costly, and safer as opposed to CT which includes the use of contrast material.
• CT urography has been increasingly supplanting intravenous urography when a urological cause for hematuria is suspected, as a result of its higher accuracy in detecting lesions in the renal parenchyma and the rest of the urinary tract.
• CT urography involves the injection of iodinated contrast media, with subsequent high-resolution nephrogenic phase and delayed phase imaging to evaluate the renal pelvis, ureter, and bladder.

Advantages

• Distinguish equivocal cases, for planning treatment options and determining the nature of small renal parenchymal lesions.
• Has a high specificity and sensitivity for investigating the causes of hematuria.

Disadvantages

• CT is expensive, time-consuming, carries a high radiation exposure, and includes contrast material.