Hematuria other imaging findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Venkata Sivakrishna Kumar Pulivarthi M.B.B.S [2]

Overview

Other imaging studies for hematuria include intravenous urography, endoscopy, magnetic resonance imaging.[1]

Other Imaging Findings

Intravenous Urography (IVU)

Advantages

  • IVU is good at detecting abnormalities of the urothelium (UCC of the ureter and renal pelvis) and stones.[2]

Disadvantages

  • Poor at detecting small renal parenchymal lesions that do not distort the renal outline.
  • It cannot distinguish cystic from solid masses.

Endoscopy/ Fluoroscopy

Advantages

  • Used to investigate intravenous urography filling defects and to treat stones.
  • In patient with continued undiagnosed hematuria, this can be used to collect urine or brushings from each ureter, allowing cytology to determine the site of bleeding and the presence of very small tumors of carcinoma in-situ.[3]

Disadvantages

  • Requires general anaesthesia for the procedure.

Magnetic Resonance Imaging (MRI)

Advantages

Disadvantages

  • MRI is expensive.
  • Contraindicated in patients with specific conditions.( e.g. Pacemaker, Significant renal function compromise (i.e., estimated GFR <30) when the administration of gadolinium risks nephrogenic systemic fibrosis).

References

  1. Davis R, Jones JS, Barocas DA, Castle EP, Lang EK, Leveillee RJ et al. (2012) Diagnosis, evaluation and follow-up of asymptomatic microhematuria (AMH) in adults: AUA guideline. J Urol 188 (6 Suppl):2473-81. DOI:10.1016/j.juro.2012.09.078 PMID: 23098784
  2. Sharp VJ, Barnes KT, Erickson BA (2013) Assessment of asymptomatic microscopic hematuria in adults. Am Fam Physician 88 (11):747-54. PMID: 24364522
  3. Avellino GJ, Bose S, Wang DS (2016) Diagnosis and Management of Hematuria. Surg Clin North Am 96 (3):503-15. DOI:10.1016/j.suc.2016.02.007 PMID: 27261791



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