MDCT of the Urinary Tract: Free Hand Techniques

Technologic advances in computed tomography (CT) imaging have resulted in the ability to image the urinary tract in ways that surpass the prior mainstay of urinary tract maging, the intravenous urogram. In adults, for most, if not all, historical indications for intravenous urography, CT urography is now the preferred examination. Although a variety of techniques for CT urography examination have been described, the test provides more diagnostic information than does intravenous urography.

 With the introduction of multidetector technology, CT urography, to date, has emerged as the initial heir apparent to intravenous urography; many years of experience have now clearly demonstrated that CT is the test of choice for many urologic problems, including urolithiasis, renal masses, urinary tract infection, trauma, and obstructive uropathy.

 CT urography provides a detailed anatomic depiction of each of the major portions of the urinary tract—the kidneys, intrarenal collecting systems, ureters, and bladder—and thus allows patients with urinary problems to be evaluated comprehensively. Several issues create debate between radiologists and include reaching a consensus on the optimal protocols and appropriate utilization in an era of cost containment and heightened concerns about radiation exposure.