AJR 2001; 177:849-855
Chow Lawrence C., Sommer F. Graham.
Painless hematuria is one of the most important warning signs of urologic malignancy, and whereas its cause are numerous, including benign entities, more ominous diagnoses must be excluded by urologic and radiologic evaluation. With the development of helical and, more recently, multidetector CT, unenhanced CT has largely replaced excretory urography in the evaluation of patients presenting with possible renal colic. In most institutions, however, excretory urography remains the mainstay in evaluating patients who present with painless hematuria. Multidetector CT is ideally suited for dynamic multiphase scans and allows the acquisition of isotropic or near-isotropic image data sets, making true multiplanar reconstruction of CT data a reality. These attributes, in conjunction with the traditional strengths of CT in the imaging of the renal parenchyma, make multidetector CT well suited for evaluation of patients with hematuria and provide a single examination capable of imaging both the renal parenchyma and collecting systems. At our institution, CT urography has virtually replaced conventional excretory urography in the evaluation of patients with hematuria and has proven successful in depicting a wide range of disease affecting the urinary tract.