tailieunhanh - Genitourinary tract imaging - part 8

Hầu hết các chuyên gia tiết niệu ĐỒNG Ý Đó là một đánh giá hoàn chỉnh nên bao gồm hình ảnh của đường tiết niệu trên và kiểm tra cytoscopic tiểu của bàng quang. Vai trò của các tế bào học nước tiểu IS gây tranh cãi, như là một tế bào học âm Không bao giờ có thể hoàn toàn loại trừ sự hiện diện của một khối u bàng quang | 114 O Connor et al Most experts agree that a complete urologic evaluation should include imaging of the upper urinary tract and cytoscopic examination of the urinary bladder. The role of urine cytology is controversial as a negative cytology can never completely exclude the presence of a bladder tumor 12 . The goal of imaging is to detect neoplasms including renal cell carcinoma RCC and the less prevalent transitional cell carcinoma TCC of the renal pelvis and ureters urinary tract calculi renal cystic disease and obstructive lesions 11 . This article discusses the current status of imaging of patients suspected of having urologic causes of hematuria. The imaging of posttraumatic hematuria of patients with UTI and patients with glomerular causes of hematuria is beyond the scope of this review. The role of all modalities including plain radiography intravenous urography or excretory urography retrograde pyelography ultrasonography multidetector computed tomography MDCT including MDCT urography MDCTU and magnetic resonance MR urography is discussed. In recent years MDCTU has undergone significant development and has been the subject of research and investigation as a new technique for evaluation of patients with urinary tract pathology 13 14 . Evidence is accumulating which suggests that this technique is now ready to play a pivotal role in imaging of patients presenting with hematuria. This article highlights the current status of MDCTU in imaging of patients with hematuria and discusses various often controversial issues such as optimal protocol design accuracy of the technique in imaging of the urothelium and the significant issue of radiation dose associated with MDCTU. Common urologic causes of hematuria Urinary tract calculi Urolithiasis is associated with idiopathic hypercal-ciuria secondary hypercalciuria and hyperuricosu-ria 15 . Stones are most commonly composed of calcium oxalate and phosphate 34 calcium oxalate 33 calcium phosphate 6 mixed struvite and .