title: Multi-detector row CT urography of normal urinary collecting system: furosemide versus saline as adjunct to contrast medium.
abstract: OBJECTIVE
  To retrospectively evaluate whether intravenous furosemide, either alone or in addition to intravenous saline, improved depiction of the normal urinary collecting system at multi-detector row computed tomographic (CT) urography.
  
  
  METHODS
  Institutional review board approval for review of patient images and medical records was obtained; informed consent was not required for this HIPAA-compliant study. Excretory phase images from multi-detector row CT urography in 87 patients (44 women, 43 men; age range, 21-83 years; mean, 53 years) were reviewed. Examinations were performed with, in addition to intravenous contrast medium, 250 mL of intravenous normal saline alone (n = 35), both 250 mL of normal saline and 10 mg of intravenous furosemide (n = 26), or 10 mg of furosemide alone (n = 26). Three readers, blinded to the imaging technique used, individually assigned opacification scores to each of six urinary collecting system segments. Urinary distention was assessed by one reader by measuring transverse widths of the proximal, middle, and distal ureteral segments. Mean opacification scores for each segment and mean ureteral width measurements for each technique were compared by using the Student t test.
  
  
  RESULTS
  Mean opacification scores achieved with furosemide were significantly higher than those achieved with saline for the middle (P </= .008) and distal (P < .001) ureteral segments. Similarly, mean ureteral widths were significantly higher with furosemide than with saline for the middle (P </= .04) and distal segments (P = .01). There was no overall benefit of administering both saline and furosemide.
  
  
  CONCLUSIONS
  To optimize opacification and distention of the normal urinary collecting system, contrast material-enhanced multi-detector row CT urography may be supplemented with intravenous furosemide alone.
authors.affiliation: Division of Abdominal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115, USA. sgsilverman@partners.org
authors.forename: Stuart G
authors.initials: SG
authors.lastname: Silverman
authors.forename: Syed A
authors.initials: SA
authors.lastname: Akbar
authors.forename: Koenraad J
authors.initials: KJ
authors.lastname: Mortele
authors.forename: Kemal
authors.initials: K
authors.lastname: Tuncali
authors.forename: Jui G
authors.initials: JG
authors.lastname: Bhagwat
authors.forename: Julian L
authors.initials: JL
authors.lastname: Seifter
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D005260:Female; D005665:Furosemide; D006801:Humans; D007685:Kidney Tubules, Collecting / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012965:Sodium Chloride; D014057:Tomography, X-Ray Computed / Q000379:methods; D014567:Urography / Q000379:methods
chemical_list: D003287:Contrast Media; D012965:Sodium Chloride; D005665:Furosemide