Accuracy of intermediate dose of furosemide injection to improve multidetector row CT urography.
OBJECTIVE
Evaluate the usefulness of intermediate dose furosemide to improve visualization of the intrarenal collecting system and ureter using MDCTU.


METHODS
Two groups of 100 patients without urinary tract disease or major abdominal pathology underwent MDCTU. Group I (various abdominal indications) was performed without any additional preparation and Group II (suspicion of urinary tract disease) 10 min after injection of furosemide (20mg). MIP images of the excretory phase were post-processed. Maximal short-axis diameter of the pelvis and ureter were measured on axial images for all phases. Visualization of the collecting system wall and the identification of the whole ureter were assessed.


RESULTS
Mean pelvic diameter before contrast was (7.4mm, S.D.+/-2.7; 13.4mm, S.D.+/-4.1), on cortico-medullary phase (8.4mm, S.D.+/-4.2; 14.3mm, S.D.+/-4), on nephrographic phase (8.1mm, S.D.+/-2.5; 14.8mm, S.D.+/-4) and on excretory phase (9.7 mm, S.D.+/-3.4; 14.9 mm, S.D.+/-4.5), respectively, for Groups I and II. Intrarenal collecting system wall was clearly identified on both corticomedullary and nephrographic phases in 91% of Group II against 20% of Group I. Opacification of the entire ureter was excellent on excretory phase in 96% of Group II against 13% of Group I. The difference between the mean values for the two groups was statistically significant for all phases (p<10(-9)).


CONCLUSIONS
Intermediate-dose furosemide (20mg) before MDCTU is a very simple add-on for accurate depiction of pelvicalyceal details and collecting system wall without artefacts. The procedure is associated with a constant and complete visualisation of the entire urete.
Roy
Catherine
C
Department of Radiology B, Universitary Hospital of Strasbourg-Civil Hospital, 1, Place de l'Hopital BP 426, 67091 Strasbourg Cedex, France. catherine.roy@chru-strasbourg.fr
Jeantroux
Jéremy
J
Irani
Farah G
FG
Sauer
Benoît
B
Lang
Hervé
H
Saussine
Christian
C
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D003287:Contrast Media / Q000008:administration & dosage; D004232:Diuretics / Q000008:administration & dosage*; D005260:Female; D005665:Furosemide / Q000008:administration & dosage*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007267:Injections; D007472:Iohexol / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D011857:Radiographic Image Interpretation, Computer-Assisted; D014057:Tomography, X-Ray Computed; D014567:Urography / Q000379:methods*; D014570:Urologic Diseases / Q000000981:diagnostic imaging*
D003287:Contrast Media; D004232:Diuretics; D007472:Iohexol; D005665:Furosemide