The importance of computerized tomographic urography in evaluation of the patients with hematuria

Yıl 2018, Cilt: 10 Sayı: 4, 483 - 491, 01.12.2018

Mustafa Özdemir , Aysel Türkvatan Cansever Fatma Ayça Edis Özdemir Muharrem Tola , Onur Tutar

https://doi.org/10.21601/ortadogutipdergisi.373455

Öz

ObjObjective: The aim of this study is
to evaluate the results of computerized tomographic (CT) urography in cases
with hematuria complaints and to investigate the efficacy of CT urography in
detecting the cause of hematuria.

Material and Method: We retrospectively
screened 59 patients (27 female, 32 male) aged between 20 and 90 (mean 50.5)
who had macroscopic or microscopic hematuria between January 2007 and May 2008
and underwent CT urography in our clinic. All of the cases were examined using
the same examination protocol (pre-contrast, nephrographic phase, pyelographic
phase) with a 16-detector multislice CT device. Two-and three-dimensional
images were generated using basal images from multiplanar reformat, maximum
intensity projection and volume rendering techniques.

Findings: In 6 out of 59 patients
(10.2%) with hematuria, no findings were found with CT urography. Causes of
hematuria detected by CT urography in the remaining 53 cases; renal cell
carcinoma (n = 3), Bosniak category 4 renal cyst (n = 1), renal papillary
necrosis (n = 1), ureteropelvic junction obstruction (n = 2), pelvicaliceal
multiple renal cysts (n = 8), multiple intrarenal lymphadenopathy (n = 1),
ureteral tumor (n = 1) and bladder abnormalities (n = 11) causing pneumatic and
dilatation of the pelvicalyceal structures. In addition, 41 of 52 (79%) cases
had extraurinar findings.

Conclusion: CT urography allows
comprehensive evaluation of hematuria in a single examination. For this reason,
CT urography can be used as an initial examination if there is no contraindication
in any of these patients.

Anahtar Kelimeler

Hematuria, computerized tomograpy, urography

Hematürili hastaların değerlendirilmesinde bilgisayarlı tomografik ürografinin yeri

Öz

AmaAmaç: Bu çalışmanın amacı hematüri
yakınması ile gelen olgularda bilgisayarlı tomografik (BT) ürografi
sonuçlarının değerlendirilmesi ve hematürinin nedeninin saptanmasında BT ürografinin etkinliğinin
araştırılmasıdır.

Gereç ve Yöntem: Ocak 2007 ile Mayıs 2008 tarihleri
arasında makroskopik veya mikroskopik hematürisi bulunan ve kliniğimizde BT
ürografi çekilen, yaşları 20 ile 90 ( ortalama 50,5) arasında değişen 59
olgunun (27 kadın, 32 erkek) görüntüleri retrospektif olarak tarandı. Olguların
tümünün incelenmesinde 16-dedektörlü çok kesitli BT cihazı ile aynı inceleme
protokolü (prekontrast, nefrografik faz, 
pyelografik faz ) kullanıldı. Alınan ham görüntülerden multiplanar reformat,
maksimum intensity projection ve volum rendering teknikleri kullanılarak iki ve
üç boyutlu görüntüler oluşturuldu.

Bulgular: Hematürisi bulunan toplam 59 olgunun
6’sında (%10,2) BT ürografi ile hematüriye neden olabilecek herhangi bir bulgu
saptanmamıştır. Geriye kalan 53 olguda BT ürografi ile saptanan hematüri
nedenleri; taş (n=25), renal hücreli karsinom (n=3), Bosniak kategori 4 renal
kist (n=1), renal papiller nekroz (n=1), üreteropelvik bileşke darlığı (n=2),
pelvikaliksiyel yapılarda basıya neden olan multiple renal kist (n=8),
pelvikaliksiyel yapılarda bası ve dilatasyona neden olan multiple intrarenal
lenfadenopati (n=1), üretelyal tümör (n=1) ve mesane anormallikleri (n=11)
şeklindeydi. Ayrıca 52 olgunun 41’inde (%79) ekstraüriner bulgu mevcuttu.

Sonuç: BT ürografi hematürili olguların tek
bir incelemede kapsamlı olarak değerlendirilebilmesine olanak tanımaktadır. Bu
nedenle hematürili olgularda BT ürografi daha kapsamlı bilgi vermesi açısından
giderek artan bir kullanım alanına sahip olup bu hastalarda herhangibir
kontrendikasyon yoksa ilk tetkik olarak kullanılabilir.

Anahtar Kelimeler

Hematüri, bilgisayarlı tomografi, ürografi

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