Role of Multidetector Computed Tomography Urography in Evaluating Obstructive Uropathy in a Tertiary Hospital in Rural India.

INTRODUCTION

This study aims to evaluate the role of multidetector computed tomography (MDCT) urography in cases of obstructive uropathy to determine the cause, side, site, and level of obstruction and to differentiate between acute and chronic cases of obstructive uropathy based on imaging features.

METHODS

Using Cochran's formula, a sample size of 121 patients was calculated. The patients underwent computed tomography (CT) urography to assess the obstructing agents causing obstructive uropathy. The conducted scan had four phases: the non-contrast phase, corticomedullary phase, nephrographic phase, and excretory phase. We assessed the obstructive agents and the changes they caused in the urinary tract.

RESULTS

A total of 74 patients (61.16%) had calculus as their obstructive agent, followed by stricture (14.88%). The obstructive agents were intraluminal in 102 patients (84.3%) and extraluminal in 19 patients (15.7%). The ureter was the most common site of obstruction, accounting for 41.32%. The acute cases were 66 (54.55%), and the chronic cases were 55 (45.45%). A statistically significant (p<0.05) association was found using the chi-square test in the comparison of the enhancement and excretion of the kidneys and the type of case (acute or chronic). A statistically significant (p<0.05) association was found using the chi-square test in the comparison of the distribution of the secondary findings, such as perinephric fat stranding and perinephric fluid collection, and the type of case (acute or chronic).

CONCLUSION

MDCT urography is a highly reliable method of imaging the cause of obstructing agents in cases of obstructive uropathy and the damage caused by them. The type of enhancement and excretion and the secondary findings play an important role in determining the acuteness or the chronicity of the obstructive agent.