Clinical Usefulness of Multi-Detector Computed Tomography in Diagnosis of Patients with Microscopic Hematuria

Song, Ho Cheol; Lim, Hyun Wook; Jeong, Hyeon Hwa; Shin, Seok Jun; Kim, Byung Soo; Kim, Young Ok; Kim, Yong Soo; Choi, Euy Jin

Abstract

PURPOSE: The number of patients with microscopic hematuria has increased for etiological reasons. The first diagnostic step for microscopic hematuria is usually intravenous pyelography (IVP). Nowadays, multi-detector computerized tomography urography (MDCT urography), which can evaluate the whole urinary tract, has been widely used. The objective of this study was to investigate the clinical usefulness of MDCT urography for diagnosis of microscopic hematuria in comparison with IVP.
METHODS
510 patients were selected randomly and underwent MDCT urography or IVP from October 2004 to September 2006 (MDCT 267 patients, IVP 243 patients).
RESULTS
In 267 cases of MDCT urography, normal 158 (59%), simple renal cyst 75 (28%), renal stone 14 (5.3%), ureteral stone 8 (3%), and malignancy 7 (2.6%) (renal cell carcinoma 2, transitional cell carcinoma of ureter 2, bladder cancer 3) were detected. In 243 cases of IVP, normal 221 (91%), simple renal cyst 3 (1.2%), renal stone 4 (1.6%), ureteral stone 7 (2.9%), and malignancy 1 (0.4%) were detected. The detection rates of simple cyst, renal stone and urothelial carcinoma in MDCT urography were higher than those of IVP significantly (p<0.05), but the detection rate of ureteral stone between MDCT urography and IVP was not significantly different.
CONCLUSION
MDCT urography is a valuable modality for evaluation of patients with microscopic hematuria. It seems to have a high detection rate in simple renal cyst, renal stone, and urethelial carcinoma, although prospective studies for its efficacy are needed.