| Objective: To evaluate Multislice spiral CT urography(CTU) is indicated asdiagnosis value in non-glomerular hematuria.Methods: We conducted a prospective study on consecutive patients whoattended a modern protocol-driven hematuria clinic from October2009to February2012. Standard tests (history taking, physical examination, urinalysis via dipstickmethod, ultrasonography of kidneys and bladder performed by urologists,CTU) weredirected to all patients. according to the ultrasonic examination and MSCTUresults,further make other tests such as cystoscopy, ureter endoscope and pathologicalexamination to define clearly cause of hematuria. The added value of crosssectionalurography (CTU) supplementary to ultrasonography (by urologists) to detect renalmasses, UUT tumors, and stones was assessed. Univariate and multivariate analysis onpredictive factors for cross-sectional urography result were performed.Results: From the total of112patients, lesions that might account for hematuriacould not be identified in31, whereas in43and38patients, hematuria was from benignand malignant disease, respectively. Cross-sectional urography revealed relevant UUTlesions in81of112patients. Only resultof ultrasonography (odds ratio [OR]6.224,95%confidence interval [CI]1.094–10.536), P=0.001) and type of hematuria (OR4.047,95%CI1.693–9.669, P=0.02) were significant predictors for cross-sectional urographyresult. In37of112(9.6%) patients with no abnormalities on ultrasonography, CTUrevealed that these were false negatives,with most lesions missed being stones. In28patients with microscopic hematuria, no lesions were detected in the UUT on CTU, incontrast to18patients with microscopic hematuria were found lesions in the UUT. Conclusion: For patients who present with microscopic hematuria,ultrasonography is sufficient to exclude significant UUT disease. For patients withmacroscopic hematuria, the likelihood of finding UUT disease is higher, and a CTU as afirst-line test seems justified. |
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