Hematuria other imaging findings

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

Other Imaging Findings

Intravenous Urography (IVU)

Advantages

• IVU is good at detecting abnormalities of the urothelium (UCC of the ureter and renal pelvis) and stones.

Disadvantages

• Poor at detecting small renal parenchymal lesions that do not distort the renal outline.
• It cannot distinguish cystic from solid masses.

Endoscopy/ Fluoroscopy

Advantages

• Used to investigate intravenous urography filling defects and to treat stones.
• In patient with continued undiagnosed hematuria, this can be used to collect urine or brushings from each ureter, allowing cytology to determine the site of bleeding and the presence of very small tumors of carcinoma in-situ.

Disadvantages

• Requires general anaesthesia for the procedure.

Magnetic Resonance Imaging (MRI)

Advantages

• MRI can been used for equivocal cases and planning treatment.
• Has a high specificity and sensitivity for investigating the causes of hematuria.
• Useful in the setting of a contraindication (e.g. Pregnancy, Iodinated contrast allergy, Renal insufficiency) to CT urogram.

Disadvantages

• MRI is expensive.
• Contraindicated in patients with specific conditions.( e.g. Pacemaker, Significant renal function compromise (i.e., estimated GFR <30) when the administration of gadolinium risks nephrogenic systemic fibrosis).