A Study on Ureteric Abnormalities in Single Contrast Bolus CT Urography at A Tertiary Care Centre
Keywords:Computed Tomography urography, Ureteric abnormalities, Hydroureter, Hydronephrosis, obstructive uropathy, ureteral calculi and ureteral filling defects
Introduction: CT urography is an imaging technique in which the i.v contrast is injected and phases of CT scan are taken to study the entire urinary system. It has essentially replaced intravenous urography (IVU) in most imaging practices. CT Urography has evolved as an ideal imaging tool for comprehensive imaging assessment of patients with flank pain, malignancies, hematuria, trauma, renal calculi, suspected congenital malformations and in various clinical settings. Other CT advantages include the use of multiplanar reconstruction (MPR), curved planar reformatted images, maximum intensity projection (MIP) and three-dimensional (3D) reconstruction which gives valuable information to the clinician about the extent of the lesions and helps in management.
Aim: To study various types of ureteric abnormalities in CT Urography in various clinical presentation.
Materials and methods: This is a tertiary hospital based observational Descriptive Cross sectional study conducted on 360 patients referred for CT Urography with Clinical Signs & Symptoms of urinary tract abnormalities, having ureteric imaging abnormalities. Siemens somatum High Definition 128 slice CT scanner was used for single bolus CT urography.
Results: Males were more as compared to females with age group 31 to 50 years (44.4%). Abdominal pain with urinary complaints was seen in maximum number of patients (203 cases- 56.4%). Urinary complaints in known abdomino-pelvic malignancies was seen in 18% cases. 285 patients had obstructive urography findings like hydronephrosis or hydroureter, and 75 cases had non obstructive findings like ureteral filling defects due to calculi, clots, etc or abnormal ureteric course or only congenital abnormality. Most hydroureter cases were secondary to obstructive calculus followed by obstruction by external malignant mass.
Conclusion: This study outlines the most common ureteric abnormalities in patients referred for CT urography which were mostly obstructive findings most cases were secondary to obstructive calculus followed by obstruction by external malignant mass. The non obstructive findings like ureteral filling defects were due to calculi, clots, etc or abnormal ureteric course or only congenital abnormalities. Delayed phase of CT urography can also be applied in Contrast CT study of abdomen & Pelvic scans on case to case basis to study ureteric involvements & pathologies.