MRU MRU has decreased spatial resolution compared with CTU. Also, small nonobstructive renal calculi and other calcifications as well as small urothelial lesions may be difficult to detect at MRU [15]. However, MRI has shown comparable accuracy to CT in the detection and characterization of renal masses [16]. Hematuria MRI Abdomen and Pelvis For the purposes of this document, we make a distinction between MRU and MRI abdomen and pelvis without and with IV contrast. MRI abdomen and pelvis without and with IV contrast is defined as any protocol not specifically tailored for evaluation of the upper and lower urinary tracts, without both the precontrast and excretory phases, and without heavily T2-weighted images of the urinary tract. There is no relevant literature regarding the use of routine MRI with IV contrast in this patient population with microhematuria. Radiography Abdomen and Pelvis Conventional radiographs of the abdomen and pelvis (KUB) are not used as a first-line imaging modality for the evaluation of hematuria. There is no relevant literature regarding the use of radiographs for the initial evaluation of microhematuria. Radiography Intravenous Urography IVU is no longer used as a first-line imaging modality for the evaluation of hematuria. Multiple studies have shown that IVU has a low sensitivity for the detection of renal masses and urinary tract abnormalities in general compared with CT [9,10]. US Kidneys and Bladder Retroperitoneal US is not used as a first-line imaging modality for the evaluation of microhematuria. One study of 141 patients showed US had a lower sensitivity for the detection of urinary tract abnormalities compared with both CTU and MRU [17]. However, a recent large prospective study suggests that kidney and bladder US may be adequate for initial evaluation of microhematuria [18]. In this study, urinary cancer was diagnosed in 0.4% of patients who presented with microscopic hematuria, and all the patients had a renal carcinoma [18]. Variant 3: Microhematuria.
Hematuria. MRU MRU has decreased spatial resolution compared with CTU. Also, small nonobstructive renal calculi and other calcifications as well as small urothelial lesions may be difficult to detect at MRU [15]. However, MRI has shown comparable accuracy to CT in the detection and characterization of renal masses [16]. Hematuria MRI Abdomen and Pelvis For the purposes of this document, we make a distinction between MRU and MRI abdomen and pelvis without and with IV contrast. MRI abdomen and pelvis without and with IV contrast is defined as any protocol not specifically tailored for evaluation of the upper and lower urinary tracts, without both the precontrast and excretory phases, and without heavily T2-weighted images of the urinary tract. There is no relevant literature regarding the use of routine MRI with IV contrast in this patient population with microhematuria. Radiography Abdomen and Pelvis Conventional radiographs of the abdomen and pelvis (KUB) are not used as a first-line imaging modality for the evaluation of hematuria. There is no relevant literature regarding the use of radiographs for the initial evaluation of microhematuria. Radiography Intravenous Urography IVU is no longer used as a first-line imaging modality for the evaluation of hematuria. Multiple studies have shown that IVU has a low sensitivity for the detection of renal masses and urinary tract abnormalities in general compared with CT [9,10]. US Kidneys and Bladder Retroperitoneal US is not used as a first-line imaging modality for the evaluation of microhematuria. One study of 141 patients showed US had a lower sensitivity for the detection of urinary tract abnormalities compared with both CTU and MRU [17]. However, a recent large prospective study suggests that kidney and bladder US may be adequate for initial evaluation of microhematuria [18]. In this study, urinary cancer was diagnosed in 0.4% of patients who presented with microscopic hematuria, and all the patients had a renal carcinoma [18]. Variant 3: Microhematuria.