Department of Radiology, University College Cork, Cork, Ireland.
AJR Am J Roentgenol. 2010 Oct;195(4):W263-7. doi: 10.2214/AJR.09.4181.
In this article, we will discuss the current status of imaging in patients with hematuria of urologic origin. Issues impacting evaluation of these patients with radiography, excretory urography, retrograde pyelography, and sonography will be discussed.
Conventional radiography has no role in the detection of renal or urothelial carcinoma. Low-dose CT offers much greater sensitivities for the detection of urinary tract calculi than radiography at doses equivalent to conventional radiography. Ultrasound alone is insufficient for imaging of hematuria. Using ultrasound alone, it is often difficult to differentiate renal transitional cell carcinoma from other causes of filling defects of the renal collecting system such as blood clots, sloughed papillae, or fungus balls. The prominence of the role of excretory urography in the evaluation of patients with hematuria has diminished, and MDCT urography is now preferred to excretory urography in most cases.
本文将讨论源于泌尿科的血尿患者的影像学现状。将讨论影响这些患者放射摄影、排泄性尿路造影、逆行肾盂造影和超声检查评估的问题。
常规放射摄影在检测肾或尿路上皮癌方面没有作用。与常规放射摄影剂量相当的低剂量 CT 对尿路结石的检测具有更高的敏感性。单独的超声检查不足以对血尿进行成像。单独使用超声，通常很难将肾移行细胞癌与肾集合系统充盈缺损的其他原因（如血块、脱落的乳头或真菌球）区分开来。排泄性尿路造影在血尿患者评估中的作用已显著降低，在大多数情况下，现在更倾向于使用 MDCT 尿路造影而非排泄性尿路造影。
