title: CT urography for the diagnosis of medullary sponge kidney.
abstract: BACKGROUND
  Medullary sponge kidney (MSK) is characterized by malformation of the terminal collecting ducts and is associated with an increased risk of nephrolithiasis, nephrocalcinosis, urinary tract infections, renal acidification defects, and reduced bone density. It has been historically diagnosed with intravenous pyelography (IVP), which is falling out of favor as an imaging modality. CT urography (CTU) performed with multidetector CT (MDCT) has been shown to create images of the renal collecting system with similar detail as IVP; however, its utility in diagnosing MSK has not been defined.
  
  
  METHODS
  We present the first 15 patients with recurrent symptomatic nephrolithiasis who were evaluated in our renal stone clinic with CTU. Four patients were diagnosed with MSK after visualization of the characteristic radiologic findings.
  
  
  CONCLUSIONS
  CTU effectively demonstrates the characteristic radiologic findings of MSK including collecting tubule dilatation, medullary nephrocalcinosis, nephrolithiasis, and medullary cysts. Dose reduction protocols can reduce radiation exposure below that associated with conventional IVP. We propose CTU be considered for the diagnosis of MSK.
authors: Section of Nephrology, Yale University School of Medicine, New Haven, Conn., USA.
authors: Farrukh M
authors: FM
authors: Koraishy
authors: Thuy-Trang T
authors: TT
authors: Ngo
authors: Gary M
authors: GM
authors: Israel
authors: Neera K
authors: NK
authors: Dahl
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007685:Kidney Tubules, Collecting / Q000000981:diagnostic imaging; D008297:Male; D007691:Medullary Sponge Kidney / Q000000981:diagnostic imaging*; D008875:Middle Aged; D009397:Nephrocalcinosis / Q000000981:diagnostic imaging*; D053040:Nephrolithiasis / Q000000981:diagnostic imaging*; D011829:Radiation Dosage; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014567:Urography / Q000379:methods*; D055815:Young Adult