Compression CT urography: a comparison with IVU in the opacification of the collecting system and ureters.
OBJECTIVE
The purpose of this study was to evaluate opacification of the collecting system and ureters using compression computed tomography (CT) urography compared with conventional intravenous urography (IVU).


METHODS
Fifty consecutive patients underwent compression CT urography as part of a dedicated renal CT. A compression belt was applied prior to nephrographic phase imaging. Excretory phase scans were acquired through the kidneys 3 minutes post injection with the compression belt in place. The compression belt was then released, and scans were obtained through the ureters. Three independent readers then scored opacification of the collecting system and ureters on a scale of 0-2 (0 = no opacification, 1 = partial opacification, 2 = full opacification and distension). Fifty consecutive nonmatched IVUs were scored by segment by the same readers. Comparison of the two modalities was made using the Mann-Whitney U test. Interobserver agreement was assessed by the Kappa coefficient.


RESULTS
CT demonstrated significantly better opacification (p < or = 0.02) of the upper and lower pole pelvicalyceal systems and midureters bilaterally. There was no difference in opacification of the proximal and distal ureters by CT compared with IVU. The Kappa coefficient was 0.53.


CONCLUSIONS
Compression CT urography yields equal or better opacification of the collecting system and ureters when compared with IVU, and shows promise for the routine evaluation of the renal excretory system.
Heneghan
J P
JP
Department of Radiology, Duke University Medical Center, Durham, North Carolina 27710, USA. Heneg002@mc.duke.edu
Kim
D H
DH
Leder
R A
RA
DeLong
D
D
Nelson
R C
RC
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D011312:Pressure; D018709:Statistics, Nonparametric; D014057:Tomography, X-Ray Computed; D014515:Ureteral Diseases / Q000000981:diagnostic imaging; D001745:Urinary Bladder Diseases / Q000000981:diagnostic imaging; D014567:Urography / Q000379:methods*; D014570:Urologic Diseases / Q000000981:diagnostic imaging*