Haematuria: intravenous urography, ultrasound or both?
OBJECTIVE
To compare the diagnostic value of intravenous urography (IVU), ultrasound (US) and their combination in detecting upper urinary tract malignancies in patients with haematuria.


METHODS
In a prospective study, 360 consecutive patients who consulted the urologist for haematuria without renal colic were scheduled for IVU and US on the same day. The two procedures were performed by two different radiologists and reported independently. Histology or clinical follow-up of one year served as the gold standard.


RESULTS
63 patients dropped out. Of the remaining 297 patients, 9 (3%) had a malignancy in the upper urinary tract. Sensitivity and specificity with regard to the upper urinary tract pathology were 67% and 91% for IVU and 56% and 94% for US, respectively. For both techniques combined this was 79% and 88%, respectively.


CONCLUSIONS
An acceptable sensitivity for detecting upper urinary tract malignancies is obtained only by combining IVU and US.
Speelman
H R
HR
Department of Diagnostic Radiology, De Wever Hospital, Heerlen.
Kessels
A G
AG
Bongaerts
A H
AH
Delaere
K P
KP
de Korte
P J
PJ
van Engelshove
J M
JM
D000230:Adenocarcinoma / Q000000981:diagnostic imaging; D002292:Carcinoma, Renal Cell / Q000000981:diagnostic imaging; D002295:Carcinoma, Transitional Cell / Q000000981:diagnostic imaging; D005260:Female; D005500:Follow-Up Studies; D006417:Hematuria / Q000209:etiology*; D006801:Humans; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging; D008297:Male; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging; D012680:Sensitivity and Specificity; D013997:Time Factors; D014463:Ultrasonography; D014516:Ureteral Neoplasms / Q000000981:diagnostic imaging; D001749:Urinary Bladder Neoplasms / Q000000981:diagnostic imaging; D014567:Urography; D014571:Urologic Neoplasms / Q000150:complications / Q000000981:diagnostic imaging*