CT urography

Last revised by Andrew Murphy on 06 Jun 2021

CT urography (CTU or CT-IVU) has now largely replaced traditional IVU in imaging the genitourinary tract. It gives both anatomical and functional information, albeit with a relatively higher dose of radiation.

Indications

  • hematuria
  • urothelial mass
  • obstructive uropathy
    • hydronephrosis
    • hydroureter
  • urothelial cancer surveillance
  • stricture
  • congenital collecting system abnormality
Purpose

The aim is to illustrate the collecting systems, ureters and bladder with intravenous contrast, albeit in a single acquisition as opposed to the multiple and more dynamic traditional IVU. Visualization of other structures in the abdomen is also better with CTU than with traditional IVU. Upper tract tumors, strictures and to a degree the function of the kidney can be assessed.

Technique

A variety of techniques have been described 1.  A CTU may be performed along with other CT studies of the genitourinary tract, such as a 3 or 4 phase or split bolus study.

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Cases and figures

  • Case 1: Normal IVU (as part of a split bolus study)
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  • Case 2: showing obstruction due to a VUJ stone
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  • Case 3: normal CTU
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