Multislice computed tomography urography who recognize the contribution of different preparation protocols

Computed Tomography Urography (CTU) is an imaging method that is used to evaluate the kidneys, the ureters and the bladder in the excretory phase with a multislice computed tomography (MSCT) by using an intravenous contrast agent (IVCA). CTU does not only show the urinary tract lumen, but it also shows the urinary tract wall structure and the surrounding tissues. There is no any well-proven specific preparation method in CTU. Therefore, there may be various methods applied in many radiology clinics.Many factors such as patient position, preparation before imaging, dose of the contrast agent used, injection duration, application of compression and imaging technique can affect the CTU image. This study aims to suggest the optimum preparation method by presenting the superiorities and disadvantages of the methods applied for patient preparation to be done before the CTU.100 cases that were investigated by diagnosing a CTU indication as a result of their examinations done in the clinics and polyclinics of the Faculty of Medicine at Fırat University during June 2010 and October 2011 were included in this study. These cases were randomly classified into 5 groups in 20s. During the preparation phase, the 1st group was made to drink 1000 ml water, the 2nd group was injected 250 ml saline infusion, the 3rd group was applied 0,1 mg/kg furosemide as IV after 250 ml saline infusion, the 4th group was given 0,1 mg/kg IV furosemide, and the 5th group was given 0,1 mg/kg IV furosemide after drinking 1000 ml water. After this preparation, the ureters were compared with each other at proximal, middle and distal segments according to their opacification levels with CTU examinations.Meaningful differences (p<0.05) were identified among groups for three ureter segments in comparison of the groups in terms of the imaging of all the ureters. In comparison of the groups with each other in oder to determine among which groups these differences are clear: statistically meaningful differences (p<0.05) were found between the second group and other four group for the proximal ureter segment, between the second group and the third and the fourth groups for the middle and distal ureter segment.Today, there is still no any specific preparation method suggested for CTU that has increasingly began to replace intravenous urography (IVU). In this study, it was observed that the imaging of the proximal ureters was better in the first group that was applied oral hidration when compared to the fourth group applied only furosemide, the third group applied furosemide combined with IV saline, the fifth group applied furosemide combined with oral hidration and the second group applied IV saline. And the imaging of the middle and distal ureters was better compared to the fourth group applied furosemide and the third group applied furosemide combined with IV saline, the second group applied IV saline.Key Words: CT urography, patient preparation, furosemide, saline, ureter