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The utility of retrograde pyelography to follow up incompletely opacified ureters on CT urography
Purpose Retrograde pyelography (RPG) is used in some centers to further evaluate patients with incompletely opacified segments on CT urography (CTU). This study intends to evaluate the utility of this imaging combination in terms of the yield of abnormal findings on the follow up RPG. Methods In thi...
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Published in: | Abdominal imaging 2020-03, Vol.45 (3), p.807-811 |
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description | Purpose
Retrograde pyelography (RPG) is used in some centers to further evaluate patients with incompletely opacified segments on CT urography (CTU). This study intends to evaluate the utility of this imaging combination in terms of the yield of abnormal findings on the follow up RPG.
Methods
In this retrospective study, we searched the radiology database over a three-year period (11/1/2015–10/30/2018) for patients who had a CTU and then a diagnostic RPG within 180 days. Images and reports were reviewed from this period for patients who met the inclusion criteria.
Results
292 patients underwent a CTU with follow up RPG over the search period. 131/292 RPGs (44.9%) were performed because the CTU described at least one incompletely opacified ureteral segment. Of the 148 ureters evaluated in these 131 patients, 4 ureters (2.7%) showed an abnormality on follow up retrograde pyelogram—two revealed a stricture at the unfilled segment, and two revealed contour irregularity in the distal ureter (biopsy showed urothelial cell carcinoma in these two).
Conclusion
There is a relatively low yield for detecting ureteral abnormalities when a retrograde pyelogram is performed after a CTU to evaluate an incompletely opacified ureteral segment—2.7% in our study, with only two of these incompletely opacified segments containing urothelial cancer (1.4%). In these two cases, a ureteral abnormality was visible on the CTU and RPG would seem to have a very low yield for follow up of unopacified ureteral segments if the ureters are otherwise normal-appearing on CTU and there is no hydronephrosis. |
doi_str_mv | 10.1007/s00261-019-02121-0 |
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Retrograde pyelography (RPG) is used in some centers to further evaluate patients with incompletely opacified segments on CT urography (CTU). This study intends to evaluate the utility of this imaging combination in terms of the yield of abnormal findings on the follow up RPG.
Methods
In this retrospective study, we searched the radiology database over a three-year period (11/1/2015–10/30/2018) for patients who had a CTU and then a diagnostic RPG within 180 days. Images and reports were reviewed from this period for patients who met the inclusion criteria.
Results
292 patients underwent a CTU with follow up RPG over the search period. 131/292 RPGs (44.9%) were performed because the CTU described at least one incompletely opacified ureteral segment. Of the 148 ureters evaluated in these 131 patients, 4 ureters (2.7%) showed an abnormality on follow up retrograde pyelogram—two revealed a stricture at the unfilled segment, and two revealed contour irregularity in the distal ureter (biopsy showed urothelial cell carcinoma in these two).
Conclusion
There is a relatively low yield for detecting ureteral abnormalities when a retrograde pyelogram is performed after a CTU to evaluate an incompletely opacified ureteral segment—2.7% in our study, with only two of these incompletely opacified segments containing urothelial cancer (1.4%). In these two cases, a ureteral abnormality was visible on the CTU and RPG would seem to have a very low yield for follow up of unopacified ureteral segments if the ureters are otherwise normal-appearing on CTU and there is no hydronephrosis.</description><identifier>ISSN: 2366-004X</identifier><identifier>EISSN: 2366-0058</identifier><identifier>DOI: 10.1007/s00261-019-02121-0</identifier><identifier>PMID: 31270562</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Abnormalities ; Adult ; Aged ; Aged, 80 and over ; Biopsy ; Bladder ; Bladder cancer ; Cancer ; Carcinoma, Transitional Cell - diagnostic imaging ; Computed tomography ; Diagnostic systems ; Female ; Gastroenterology ; Hematuria ; Hepatology ; Humans ; Imaging ; Kidneys ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Patients ; Radiology ; Retroperitoneum ; Retrospective Studies ; Segments ; Stricture ; Tomography, X-Ray Computed - methods ; Ureter ; Ureteral Diseases - diagnostic imaging ; Ureters ; Urinary Bladder Neoplasms - diagnostic imaging ; Urography ; Urography - methods ; Urology ; Urothelial cancer ; Visualization</subject><ispartof>Abdominal imaging, 2020-03, Vol.45 (3), p.807-811</ispartof><rights>Springer Science+Business Media, LLC, part of Springer Nature 2019</rights><rights>Abdominal Radiology is a copyright of Springer, (2019). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c326t-d1b14c1f4d670e0d6f79577f90746023dbb627b075ac34c9394c56e5264067e43</cites><orcidid>0000-0001-7815-9159 ; 0000-0001-8956-4483</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31270562$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Paspulati, Anirudh</creatorcontrib><creatorcontrib>Gupta, Akshya</creatorcontrib><creatorcontrib>Hill, Paul A.</creatorcontrib><creatorcontrib>Morgan, Matthew A.</creatorcontrib><title>The utility of retrograde pyelography to follow up incompletely opacified ureters on CT urography</title><title>Abdominal imaging</title><addtitle>Abdom Radiol</addtitle><addtitle>Abdom Radiol (NY)</addtitle><description>Purpose
Retrograde pyelography (RPG) is used in some centers to further evaluate patients with incompletely opacified segments on CT urography (CTU). This study intends to evaluate the utility of this imaging combination in terms of the yield of abnormal findings on the follow up RPG.
Methods
In this retrospective study, we searched the radiology database over a three-year period (11/1/2015–10/30/2018) for patients who had a CTU and then a diagnostic RPG within 180 days. Images and reports were reviewed from this period for patients who met the inclusion criteria.
Results
292 patients underwent a CTU with follow up RPG over the search period. 131/292 RPGs (44.9%) were performed because the CTU described at least one incompletely opacified ureteral segment. Of the 148 ureters evaluated in these 131 patients, 4 ureters (2.7%) showed an abnormality on follow up retrograde pyelogram—two revealed a stricture at the unfilled segment, and two revealed contour irregularity in the distal ureter (biopsy showed urothelial cell carcinoma in these two).
Conclusion
There is a relatively low yield for detecting ureteral abnormalities when a retrograde pyelogram is performed after a CTU to evaluate an incompletely opacified ureteral segment—2.7% in our study, with only two of these incompletely opacified segments containing urothelial cancer (1.4%). In these two cases, a ureteral abnormality was visible on the CTU and RPG would seem to have a very low yield for follow up of unopacified ureteral segments if the ureters are otherwise normal-appearing on CTU and there is no hydronephrosis.</description><subject>Abnormalities</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biopsy</subject><subject>Bladder</subject><subject>Bladder cancer</subject><subject>Cancer</subject><subject>Carcinoma, Transitional Cell - diagnostic imaging</subject><subject>Computed tomography</subject><subject>Diagnostic systems</subject><subject>Female</subject><subject>Gastroenterology</subject><subject>Hematuria</subject><subject>Hepatology</subject><subject>Humans</subject><subject>Imaging</subject><subject>Kidneys</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Patients</subject><subject>Radiology</subject><subject>Retroperitoneum</subject><subject>Retrospective Studies</subject><subject>Segments</subject><subject>Stricture</subject><subject>Tomography, X-Ray Computed - methods</subject><subject>Ureter</subject><subject>Ureteral Diseases - diagnostic imaging</subject><subject>Ureters</subject><subject>Urinary Bladder Neoplasms - diagnostic imaging</subject><subject>Urography</subject><subject>Urography - methods</subject><subject>Urology</subject><subject>Urothelial cancer</subject><subject>Visualization</subject><issn>2366-004X</issn><issn>2366-0058</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp9kU9L7DAUxYM8UVG_gAsJuHFTvflvlzL4VBDcjOAutOmtVjJNTVpkvr3pm1HBxYNATsjvnIR7CDlhcMEAzGUC4JoVwMoCOONZ7ZADLrQuANTVn28tn_fJcUpvAMC0YoyrPbIvGDegND8g1fIV6TR2vhvXNLQ04hjDS6wapMMa_SyH1zUdA22D9-GDTgPtehdWg8cRffYMlevaDhs6ZS_GRENPF8t82nqPyG5b-YTH2_2QPP29WS7uiofH2_vF9UPhBNdj0bCaScda2WgDCI1uTamMaUswUgMXTV1rbmowqnJCulKU0imNimsJ2qAUh-R8kzvE8D5hGu2qSw69r3oMU7Kcq7yulICMnv1C38IU-_y7mWIyz0nOFN9QLoaUIrZ2iN2qimvLwM4d2E0HNndg_3VgZ9PpNnqqV9h8W74mngGxAVK-6l8w_rz9n9hPfgyQqQ</recordid><startdate>20200301</startdate><enddate>20200301</enddate><creator>Paspulati, Anirudh</creator><creator>Gupta, Akshya</creator><creator>Hill, Paul A.</creator><creator>Morgan, Matthew A.</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>JQ2</scope><scope>K7-</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>M7Z</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-7815-9159</orcidid><orcidid>https://orcid.org/0000-0001-8956-4483</orcidid></search><sort><creationdate>20200301</creationdate><title>The utility of retrograde pyelography to follow up incompletely opacified ureters on CT urography</title><author>Paspulati, Anirudh ; Gupta, Akshya ; Hill, Paul A. ; Morgan, Matthew A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c326t-d1b14c1f4d670e0d6f79577f90746023dbb627b075ac34c9394c56e5264067e43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Abnormalities</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biopsy</topic><topic>Bladder</topic><topic>Bladder cancer</topic><topic>Cancer</topic><topic>Carcinoma, Transitional Cell - diagnostic imaging</topic><topic>Computed tomography</topic><topic>Diagnostic systems</topic><topic>Female</topic><topic>Gastroenterology</topic><topic>Hematuria</topic><topic>Hepatology</topic><topic>Humans</topic><topic>Imaging</topic><topic>Kidneys</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Patients</topic><topic>Radiology</topic><topic>Retroperitoneum</topic><topic>Retrospective Studies</topic><topic>Segments</topic><topic>Stricture</topic><topic>Tomography, X-Ray Computed - methods</topic><topic>Ureter</topic><topic>Ureteral Diseases - diagnostic imaging</topic><topic>Ureters</topic><topic>Urinary Bladder Neoplasms - diagnostic imaging</topic><topic>Urography</topic><topic>Urography - methods</topic><topic>Urology</topic><topic>Urothelial cancer</topic><topic>Visualization</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Paspulati, Anirudh</creatorcontrib><creatorcontrib>Gupta, Akshya</creatorcontrib><creatorcontrib>Hill, Paul A.</creatorcontrib><creatorcontrib>Morgan, Matthew A.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Computer Science Collection</collection><collection>Computer science database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biological Science Database</collection><collection>Biochemistry Abstracts 1</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest advanced technologies & aerospace journals</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Abdominal imaging</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Paspulati, Anirudh</au><au>Gupta, Akshya</au><au>Hill, Paul A.</au><au>Morgan, Matthew A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The utility of retrograde pyelography to follow up incompletely opacified ureters on CT urography</atitle><jtitle>Abdominal imaging</jtitle><stitle>Abdom Radiol</stitle><addtitle>Abdom Radiol (NY)</addtitle><date>2020-03-01</date><risdate>2020</risdate><volume>45</volume><issue>3</issue><spage>807</spage><epage>811</epage><pages>807-811</pages><issn>2366-004X</issn><eissn>2366-0058</eissn><abstract>Purpose
Retrograde pyelography (RPG) is used in some centers to further evaluate patients with incompletely opacified segments on CT urography (CTU). This study intends to evaluate the utility of this imaging combination in terms of the yield of abnormal findings on the follow up RPG.
Methods
In this retrospective study, we searched the radiology database over a three-year period (11/1/2015–10/30/2018) for patients who had a CTU and then a diagnostic RPG within 180 days. Images and reports were reviewed from this period for patients who met the inclusion criteria.
Results
292 patients underwent a CTU with follow up RPG over the search period. 131/292 RPGs (44.9%) were performed because the CTU described at least one incompletely opacified ureteral segment. Of the 148 ureters evaluated in these 131 patients, 4 ureters (2.7%) showed an abnormality on follow up retrograde pyelogram—two revealed a stricture at the unfilled segment, and two revealed contour irregularity in the distal ureter (biopsy showed urothelial cell carcinoma in these two).
Conclusion
There is a relatively low yield for detecting ureteral abnormalities when a retrograde pyelogram is performed after a CTU to evaluate an incompletely opacified ureteral segment—2.7% in our study, with only two of these incompletely opacified segments containing urothelial cancer (1.4%). In these two cases, a ureteral abnormality was visible on the CTU and RPG would seem to have a very low yield for follow up of unopacified ureteral segments if the ureters are otherwise normal-appearing on CTU and there is no hydronephrosis.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>31270562</pmid><doi>10.1007/s00261-019-02121-0</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0001-7815-9159</orcidid><orcidid>https://orcid.org/0000-0001-8956-4483</orcidid></addata></record> |
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subjects | Abnormalities Adult Aged Aged, 80 and over Biopsy Bladder Bladder cancer Cancer Carcinoma, Transitional Cell - diagnostic imaging Computed tomography Diagnostic systems Female Gastroenterology Hematuria Hepatology Humans Imaging Kidneys Male Medicine Medicine & Public Health Middle Aged Patients Radiology Retroperitoneum Retrospective Studies Segments Stricture Tomography, X-Ray Computed - methods Ureter Ureteral Diseases - diagnostic imaging Ureters Urinary Bladder Neoplasms - diagnostic imaging Urography Urography - methods Urology Urothelial cancer Visualization |
title | The utility of retrograde pyelography to follow up incompletely opacified ureters on CT urography |
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