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Opacification of the Genitourinary Collecting System During MDCT Urography with Enhanced CT Digital Radiography: Nonsaline Versus Saline Bolus

Gary S. Sudakoff1,2, Dell P. Dunn3, Robert S. Hellman1, Mario A. Laguna1, Charles R. Wilson1, Robert W. Prost1, Daniel C. Eastwood4 and Hyun J. Lim4

1 Department of Radiology, Medical College of Wisconsin, Milwaukee, WI.
2 Department of Radiology, Froedtert Memorial Lutheran Hospital, 9200 W Wisconsin Ave., Milwaukee, WI 53226.
3 Medical College of Wisconsin, Milwaukee, WI.
4 Department of Biostatistics, Medical College of Wisconsin, Milwaukee, WI.



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  		Fig. 1A —63-year-old man undergoing CT urography and enhanced CT digital radiography. Three-dimensional maximum-intensity-projection CT urography image shows incomplete opacification of right middle and distal ureter.

 


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  		Fig. 1B —63-year-old man undergoing CT urography and enhanced CT digital radiography. Enhanced CT digital radiographic image obtained 1 min after axial CT urography examination (A) shows complete opacification of right ureter (arrows).

 


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  		Fig. 2 —Schematic drawing shows segments of intrarenal collecting system (IRCS).

 


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  		Fig. 3A —64-year-old woman with transitional cell carcinoma of intrarenal collecting system. Three-dimensional maximum-intensity-projection (MIP) CT urographic image shows multiple filling defects representing multifocal transitional cell carcinoma of intrarenal collecting system and intraluminal blood clot (arrows).

 


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  		Fig. 3B —64-year-old woman with transitional cell carcinoma of intrarenal collecting system. Enhanced CT digital radiographic image shows nearly identical filling defects (arrows) to those seen on MIP image (A).

 


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  		Fig. 4A —46-year-old man with medullary sponge kidney. Three-dimensional maximum-intensity-projection (MIP) CT urographic image shows dilated and ectatic papillary collecting ducts (arrows).

 


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  		Fig. 4B —46-year-old man with medullary sponge kidney. Enhanced CT digital radiograph shows dilated and ectatic papillary collecting ducts (arrows). Ducts are more prominently seen on 3D MIP CT urography image (A).

 

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