AbstractBackground and Aim:
CT urography is a single comprehensive modality for the diagnosis of patients suspected with hematuria. Hence, the present study was designed to evaluate the efficacy of the diagnostic role of CTU in comparison with other diagnostic modalities.
Material and Methods: A total of 83 patients suspected with hematuria between 18-75 years of age presented at the Department of Radio-diagnosis, Kasturba Medical College (KMC), Manipal University, and Mangalore were selected. The patients were subjected to 3 phase CT examination after obtaining informed consent—first was an initial non-contrast phase followed by a nephrographic phase and then pyelographic phase. Patients' demographic details viz. age, gender, and clinical manifestations were recorded. Assessment parameters like sensitivity, specificity, positive predictive value, and negative predictive value were analyzed.
Results: The majority of study subjects with hematuria i.e. 28.92% belonged to the age group of 60-70 years followed by 25.30% in 50-60 years and 20.48% fallen in the age group of 40-50 years with male predominance. Ureteroscopy was done for 17 cases, nephroscopy for 4 cases. 6 were radiodense calculi and 2 were radiolucent calculi. USG showed renal, PUJ and one VUJ calculus and hydronephrosis but it was only after CTU ureteric calculi were detected. 9 patients had both renal and ureteric calculi. Cystoscopy was done for 25 cases, out of which 17 cases showed bladder transitional cell carcinoma (TCC). In 14 cases, 11 out of 14 cases showed masses confined to the kidney (<7 cm diameter), which is corresponding to stage T1 RCC according to TMN classification. Two study subjects subjected to renal trauma were analyzed by CTU. The sensitivity and specificity of CTU for the stone were reported as 98-100% and 92-100% respectively.
Conclusion: In the present study, CTU shows high accuracy, sensitivity, and specificity in the detection of different cases of hematuria. Hence, CTU could be recommended to diagnose hematuria precisely and accurately.