CT urography: definition, indications and techniques. A guideline for clinical practice
CT urography: definition, indications and techniques. A guideline for clinical practice
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DOI：
10.1007/s00330-007-0792-x
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发表时间：
2008-01-01
影响因子：
5.9
通讯作者：
Cohan, R. H.
中科院分区：
文献类型：
--
作者：
Van der Molen, Aart J.;Cowan, Nigel C.;Cohan, R. H.
其目的是由欧洲泌尿生殖放射学会 (ESUR) 的一组专家制定多排计算机断层扫描尿路造影 (CTU) 的临床指南。同行评审的论文和评论都经过系统审查。 ESUR 2006 和 ECR 2007 会议上制作并讨论了一份摘要文件，旨在达成共识。无法制定真正的循证指南，但制定了适应症和 CTU 检查技术的专家指南。 CTU 被认为是尿路上皮癌高危肉眼血尿患者的一线检测。否则，CTU 可以用作解决问题的考试。提出了一种使用一相、两相或三相方案的差异方法，临床适应症和患者群体将决定采用哪种 CTU 方案。可以使用分次推注静脉注射造影剂后的组合肾造影-排泄阶段，或单次推注后的单独肾造影和排泄阶段。较低剂量（CTDIvol 5-6 mGy）用于良性病症，正常剂量（CTDIvol 9-12 mGy）用于潜在恶性疾病。可以根据指征添加低剂量（CTDIvol 2-3 mGy）非增强系列。基于专家的 CTU 指南提供了优化技术和统一放射科医生 CTU 方法的建议。
The aim was to develop clinical guidelines for multidetector computed tomography urography (CTU) by a group of experts from the European Society of Urogenital Radiology (ESUR). Peer-reviewed papers and reviews were systematically scrutinized. A summary document was produced and discussed at the ESUR 2006 and ECR 2007 meetings with the goal to reach consensus. True evidence-based guidelines could not be formulated, but expert guidelines on indications and CTU examination technique were produced. CTU is justified as a first-line test for patients with macroscopic haematuria, at high-risk for urothelial cancer. Otherwise, CTU may be used as a problem-solving examination. A differential approach using a one-, two- or three-phase protocol is proposed, whereby the clinical indication and the patient population will determine which CTU protocol is employed. Either a combined nephrographic-excretory phase following a split-bolus intravenous injection of contrast medium, or separate nephrographic and excretory phases following a single-bolus injection can be used. Lower dose (CTDIvol 5-6 mGy) is used for benign conditions and normal dose (CTDIvol 9-12 mGy) for potential malignant disease. A low-dose (CTDIvol 2-3 mGy) unenhanced series can be added on indication. The expert-based CTU guidelines provide recommendations to optimize techniques and to unify the radiologist's approach to CTU.