Optimization of image quality of the urinary collecting system in MDCT urography : effectiveness of saline hydration

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Optimization of image quality of the urinary collecting system in MDCT urography : effectiveness of saline hydration

 

Author: Yiu, Tak-ching
Title: Optimization of image quality of the urinary collecting system in MDCT urography : effectiveness of saline hydration
Degree: M.Sc.
Year: 2010
Subject: Hong Kong Polytechnic University -- Dissertations
Urinary organs -- Imaging
Urinary organs -- Tomography
Urinary organs -- Diseases -- Diagnosis
Department: Dept. of Health Technology and Informatics
Pages: xii, 190 leaves : ill. (some col.) ; 31 cm.
InnoPac Record: http://library.polyu.edu.hk/record=b2356837
URI: http://theses.lib.polyu.edu.hk/handle/200/5677
Abstract: Purpose: To retrospectively examine the effects of intravenous saline hydration technique on the image quality of the urinary collecting system during multi-detector computed tomographic urography (MDCTU). Materials and Methods: Institutional review board approvals from hospital and teaching institute for review of patient images and medical records were obtained. Excretory phase images from multi-detector computed tomographic urography (MDCTU) in 100 patients (47 women, 53 men; age range, 20-75 years; mean, 56.3 years) were reviewed. Examinations were performed with, in addition to intravenous contrast medium, 100 mL of intravenous normal saline hydration (n = 50), and without saline hydration (n = 50). Two reviewers, blinded to the imaging technique used, individually measured urinary tract distention on 2D transverse images and graded the degree of opacification and distention on three dimensional Maximum Intensity Projection (3D MIP) coronal images to each of the four urinary collecting system segments. Mean ureteral diameter measurements, mean distention score and mean opacification score of each segment of both groups will be compared and analyzed by using unpaired Student t-test and one way ANOVA. Results: For both right and left ureters, the mean 2D diameters were greater in all three segments (S2, S3, S4) when MDCTU was performed with saline hydration than when it was performed without saline hydration (p≦ 0.002 for S2 segment; p<0.001 for S3 segment; p≦ 0.001 for S4 segment). The mean distention scores were significantly higher in all three segments when performed with saline hydration (p< 0.05 for S2 segment; p<0.001 for S3 segment; p< 0.001 for S4 segment). The mean opacification scores were higher in all four segments when performed with saline hydration (p≦0.002 for S1 segment; p≦0.037 for S2 segment; p≦0.005 for S3 segment; p<0.001 for S4 segment). Furthermore, for the saline group, no significant regional difference was found among four segments in terms of mean opacification score. On the other hand, for the non-saline group, there were regional differences in the distention as well as opacification quality among different ureteral segments. Conclusion: Intravenous saline hydration technique may be the possible and feasible solution to further enhance the image quality by improving distention and opacification of the urinary tract in MDCTU.

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