Arteriography Kidney Arteriography is not used as a first-line imaging modality for the evaluation of microhematuria. There is no relevant literature regarding the use of arteriography for the initial evaluation of microhematuria. CT Abdomen and Pelvis For the purposes of this document, we make a distinction between CTU and CT abdomen and pelvis without and with IV contrast. CT 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 and without both the precontrast and excretory phases. There is no relevant literature regarding the use of CT with IV contrast or CT without IV contrast in this patient population with microhematuria. Initial studies compared CTU with other modalities but without direct comparison to conventional contrast-enhanced CT. However, in current practice, CTU has replaced conventional CT in this situation because of improved detection of urothelial lesions on CTU. CTU CTU CTU has been shown to be the imaging study of choice for the evaluation of microhematuria because it can evaluate both nephrogenic and urogenic causes of hematuria [1,2,9-12]. In a meta-analysis, CTU proved to be a very sensitive and specific method for the detection of urothelial malignancy with pooled sensitivity of 96% and pooled specificity of 99% and was superior in direct comparison to IVU in terms of sensitivity and specificity [10]. For the detection of upper tract lesions (kidneys and ureters), CTU has been shown to be superior to IVU with an accuracy of 99.6% compared with 84.9% for IVU [12]. CTU has also been shown to be useful for the detection of lower tract lesions (bladder) [11,13]. In one study of 242 patients with microhematuria, the specificity and accuracy of CTU for the detection of lower tract lesions was 98.8% and 97.2%, respectively [11]. In comparison with MRU, one study showed that CTU provided better visibility of the urothelial structures and improved diagnostic confidence [14].
Hematuria. Arteriography Kidney Arteriography is not used as a first-line imaging modality for the evaluation of microhematuria. There is no relevant literature regarding the use of arteriography for the initial evaluation of microhematuria. CT Abdomen and Pelvis For the purposes of this document, we make a distinction between CTU and CT abdomen and pelvis without and with IV contrast. CT 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 and without both the precontrast and excretory phases. There is no relevant literature regarding the use of CT with IV contrast or CT without IV contrast in this patient population with microhematuria. Initial studies compared CTU with other modalities but without direct comparison to conventional contrast-enhanced CT. However, in current practice, CTU has replaced conventional CT in this situation because of improved detection of urothelial lesions on CTU. CTU CTU CTU has been shown to be the imaging study of choice for the evaluation of microhematuria because it can evaluate both nephrogenic and urogenic causes of hematuria [1,2,9-12]. In a meta-analysis, CTU proved to be a very sensitive and specific method for the detection of urothelial malignancy with pooled sensitivity of 96% and pooled specificity of 99% and was superior in direct comparison to IVU in terms of sensitivity and specificity [10]. For the detection of upper tract lesions (kidneys and ureters), CTU has been shown to be superior to IVU with an accuracy of 99.6% compared with 84.9% for IVU [12]. CTU has also been shown to be useful for the detection of lower tract lesions (bladder) [11,13]. In one study of 242 patients with microhematuria, the specificity and accuracy of CTU for the detection of lower tract lesions was 98.8% and 97.2%, respectively [11]. In comparison with MRU, one study showed that CTU provided better visibility of the urothelial structures and improved diagnostic confidence [14].