title: Computerized tomography tailored for the assessment of microscopic hematuria.
abstract: OBJECTIVE
  We report the results of a multicenter study of arterial, corticomedullary, nephrographic and excretory phase helical computerized tomography (CT) for detecting and characterizing abnormalities causing asymptomatic microscopic hematuria.
  
  
  METHODS
  We evaluated 350 consecutive patients, including 216 men and 134 women 23 to 88 years old, with asymptomatic microscopic hematuria of undetermined cause at 4 medical centers. Patients with known urological pathology were excluded from study. We performed 4 helical CT sequences, including pre-enhancement phase imaging from kidney to symphysis pubis, arterial phase imaging of the kidney and lower pelvis, corticomedullary nephrographic phase imaging of the kidney and lower pelvis, and excretory phase imaging from kidney to symphysis pubis with 2 to 5 mm. collimation and 1 to 1.5 pitch.
  
  
  RESULTS
  Of 171 proved lesions 158 were correctly diagnosed. There were 10 false-positive and 13 false-negative diagnoses, indicating 0.9239 sensitivity, 0.9441 specificity, 0.9404 positive and 0.9285 negative predictive values, (p <0.001). All cases of congenital renal lesions, calculous disease, ureteral lesion and neoplastic lesion of the bladder were correctly diagnosed, as were 40 of 41 inflammatory renal, 21 of 23 renal masses and 13 of 16 inflammatory bladder lesions. In 27 patients with renal calculi the study was limited to pre-enhancement spiral CT.
  
  
  CONCLUSIONS
  A positive diagnosis rate of 45.1% (158 of 350 cases) for the causes of heretofore refractory cases of hematuria with high sensitivity and specificity attest to the effectiveness of our hematuria CT protocol and support its use.
authors.affiliation: Department of Radiology, Tulane University Health Sciences Center, New Orleans, Louisiana, USA.
authors.forename: Erich K
authors.initials: EK
authors.lastname: Lang
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Macchia
authors.forename: Raju
authors.initials: R
authors.lastname: Thomas
authors.forename: Gilberto
authors.initials: G
authors.lastname: Ruiz-Deya
authors.forename: Richard A
authors.initials: RA
authors.lastname: Watson
authors.forename: Frank
authors.initials: F
authors.lastname: Richter
authors.forename: Robert
authors.initials: R
authors.lastname: Irwin R
authors.forename: Michael
authors.initials: M
authors.lastname: Marberger
authors.forename: Jack
authors.initials: J
authors.lastname: Mydlo
authors.forename: Gerhard
authors.initials: G
authors.lastname: Lechner
authors.forename: Kyunghee C
authors.initials: KC
authors.lastname: Cho
authors.forename: Brian
authors.initials: B
authors.lastname: Gayle
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006417:Hematuria / Q000000981:diagnostic imaging* / Q000209:etiology; D006801:Humans; D007674:Kidney Diseases / Q000150:complications / Q000000981:diagnostic imaging*; D007680:Kidney Neoplasms / Q000150:complications / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012680:Sensitivity and Specificity; D001745:Urinary Bladder Diseases / Q000150:complications / Q000000981:diagnostic imaging*