Moloney Fiachra, Murphy Kevin P, Twomey Maria, O'Connor Owen J, Maher Michael M
Department of Radiology, Cork University Hospital, Wilton, Cork, Ireland.
Adv Urol. 2014;2014:414125. doi: 10.1155/2014/414125. Epub 2014 Jul 17.
This paper discusses the current status of imaging in the investigation of patients with haematuria. The physician must rationalize imaging so that serious causes such as malignancy are promptly diagnosed while at the same time not exposing patients to unnecessary investigations. There is currently no universal agreement about the optimal imaging work up of haematuria. The choice of modality to image the urinary tract will depend on individual patient factors such as age, the presence of risk factors for malignancy, renal function, a history of calculus disease and pregnancy, and other factors, such as local policy and practice, cost effectiveness and availability of resources. The role of all modalities, including conventional radiography, intravenous urography/excretory urography, ultrasonography, retrograde pyelography, multidetector computed tomography urography (MDCTU), and magnetic resonance urography, is discussed. This paper highlights the pivotal role of MDCTU in the imaging of the patient with haematuria and discusses issues specific to this modality including protocol design, imaging of the urothelium, and radiation dose. Examination protocols should be tailored to the patient while all the while optimizing radiation dose.
本文讨论了血尿患者检查中影像学检查的现状。医生必须合理安排影像学检查，以便能及时诊断出诸如恶性肿瘤等严重病因，同时又不让患者接受不必要的检查。目前对于血尿的最佳影像学检查方案尚无普遍共识。用于泌尿系统成像的检查方式选择将取决于个体患者因素，如年龄、存在恶性肿瘤的风险因素、肾功能、结石病史和妊娠情况，以及其他因素，如当地政策和实践、成本效益和资源可用性。本文讨论了所有检查方式的作用，包括传统放射摄影、静脉肾盂造影/排泄性肾盂造影、超声检查、逆行肾盂造影、多排螺旋计算机断层扫描尿路造影（MDCTU）和磁共振尿路造影。本文强调了MDCTU在血尿患者成像中的关键作用，并讨论了该检查方式特有的问题，包括检查方案设计、尿路上皮成像和辐射剂量。检查方案应根据患者情况进行调整，同时始终优化辐射剂量。
