CTU Without and With IV Contrast There is limited evidence to support the use of CTU without and with IV contrast for initial imaging of pregnant patients with asymptomatic hydronephrosis with unknown cause. DTPA Renal Scan Although DRG is the de facto standard of care in diagnosis of renal obstruction [10] and can be used to determine whether obstructive uropathy is truly present in cases of incidentally noted hydronephrosis or in suspected obstruction of renal transplant [11], DRG is not preferred for initial imaging in pregnant patients. Note that use of DTPA for diuretic renography may result in an equivocal or false-positive diuretic study compared with MAG3, particularly in patients with reduced function, and is not favored [11,12]. DRG with DTPA can also be used to estimate single-kidney GFR but may somewhat overestimate global GFR in the setting of obstructive hydronephrosis [13]. Fluoroscopy Antegrade Pyelography There is limited evidence to support the use of fluoroscopic antegrade pyelography for initial imaging of pregnant patients with asymptomatic hydronephrosis with unknown cause. Fluoroscopy Voiding Cystourethrography There is limited evidence to support the use of fluoroscopic voiding cystourethrography for initial imaging of pregnant patients with asymptomatic hydronephrosis with unknown cause. MAG3 Renal Scan Although DRG is the de facto standard of care in diagnosis of renal obstruction [10] and can be used to determine whether obstructive uropathy is truly present in cases of incidentally noted hydronephrosis or in suspected obstruction of renal transplant [11], DRG is not preferred for initial imaging in pregnant patients. MRI Abdomen and Pelvis Without and With IV Contrast There is limited evidence to support the use of MRI abdomen and pelvis without and with IV contrast (separate from MRU) for initial imaging of pregnant patients with asymptomatic hydronephrosis with unknown cause.
Hydronephrosis on Prior Imaging Unknown Cause. CTU Without and With IV Contrast There is limited evidence to support the use of CTU without and with IV contrast for initial imaging of pregnant patients with asymptomatic hydronephrosis with unknown cause. DTPA Renal Scan Although DRG is the de facto standard of care in diagnosis of renal obstruction [10] and can be used to determine whether obstructive uropathy is truly present in cases of incidentally noted hydronephrosis or in suspected obstruction of renal transplant [11], DRG is not preferred for initial imaging in pregnant patients. Note that use of DTPA for diuretic renography may result in an equivocal or false-positive diuretic study compared with MAG3, particularly in patients with reduced function, and is not favored [11,12]. DRG with DTPA can also be used to estimate single-kidney GFR but may somewhat overestimate global GFR in the setting of obstructive hydronephrosis [13]. Fluoroscopy Antegrade Pyelography There is limited evidence to support the use of fluoroscopic antegrade pyelography for initial imaging of pregnant patients with asymptomatic hydronephrosis with unknown cause. Fluoroscopy Voiding Cystourethrography There is limited evidence to support the use of fluoroscopic voiding cystourethrography for initial imaging of pregnant patients with asymptomatic hydronephrosis with unknown cause. MAG3 Renal Scan Although DRG is the de facto standard of care in diagnosis of renal obstruction [10] and can be used to determine whether obstructive uropathy is truly present in cases of incidentally noted hydronephrosis or in suspected obstruction of renal transplant [11], DRG is not preferred for initial imaging in pregnant patients. MRI Abdomen and Pelvis Without and With IV Contrast There is limited evidence to support the use of MRI abdomen and pelvis without and with IV contrast (separate from MRU) for initial imaging of pregnant patients with asymptomatic hydronephrosis with unknown cause.