Multislice computed tomography-urography: intraindividual comparison of different preparation techniques for optimized depiction of the upper urinary tract in an animal model.
OBJECTIVE
We sought to evaluate intraindividually 3 different preparation protocols for achieving improved opacification and anatomic depiction of the upper urinary tract in multisclice computed tomography urography (MSCTU) using a porcine model.


METHODS
MSCTU was performed in 8 healthy pigs. Each animal underwent 3 MSCT urographies using 3 different preparations before the injection of contrast material: A, intravenous (iv) saline (250 mL); B, iv low-dose furosemide (0.1 mg/kg); and C, iv saline (250 mL) plus iv low-dose furosemide (0.1 mg/kg). Image analysis was performed blinded to the applied protocols and included the evaluation of the opacification and anatomic depiction of the upper urinary tract by means of graded scales. Ureteral distension was determined and density was measured within the collecting system.


RESULTS
Furosemide significantly improved both mean opacification scores and mean scores of anatomic depiction compared with the exclusive infusion of saline for MSCTU. There was no significant difference between the application of furosemide and the combination of furosemide plus saline. A significant increase of 25-26% for ureteral distension was found when furosemide was applied. Significant lower mean attenuation values (Hounsfield units) and standard deviation were found within the opacified urine for diuretic-enhanced MSCTU.


CONCLUSIONS
Low-dose furosemide injection is superior to saline infusion for achieving optimal enhancement in MSCTU. It is not necessary to combine furosemide and saline infusion. In MSCTU, low-dose furosemide is a simple add-on simplifying image acquisition timing and removing the need for abdominal compression devices.
Kemper
Joern
J
Department of Diagnostic and Interventional Radiology, University Hospital Hamburg-Eppendorf, Hamburg, Germany. jkemper@uke.uni-hamburg.de
Regier
Marc
M
Begemann
Philipp G C
PG
Stork
Alexander
A
Adam
Gerhard
G
Nolte-Ernsting
Claus
C
D000818:Animals; D003287:Contrast Media / Q000008:administration & dosage / Q000737:chemistry; D004232:Diuretics / Q000008:administration & dosage; D005665:Furosemide / Q000008:administration & dosage; D007668:Kidney / Q000000981:diagnostic imaging*; D023421:Models, Animal; D012965:Sodium Chloride / Q000008:administration & dosage; D034421:Sus scrofa; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014513:Ureter / Q000000981:diagnostic imaging*
D003287:Contrast Media; D004232:Diuretics; D012965:Sodium Chloride; D005665:Furosemide