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British Journal of Radiology (2004) 77, S74-S86
© 2004 British Institute of Radiology
doi: 10.1259/bjr/13478281
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Multislice CT urography: state of the art

M Noroozian, MD, R H Cohan, MD1, E M Caoili, MD, N C Cowan, MD and J H Ellis, MD

1 Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA and Department of Radiology, The Churchill Hospital, Oxford, UK



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  		Figure 1. Three-dimensional reconstructions for multislice CT urography. The three most commonly employed reconstruction algorithms, (a) average intensity projection, (b) maximum intensity projection and (c) volume rendering, are illustrated in a 59-year-old male in whom the CT urogram failed to demonstrate any abnormalities.

 


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  		Figure 2. Transitional cell carcinoma. (a) Coronal reformatted image demonstrates a large mass in the mid left ureter (arrows). (b) This mass is also well visualized on the subsequent retrograde pyelogram.

 


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  		Figure 3. Transitional cell carcinoma. (a) Axial image demonstrates a circumferential mass surrounding the upper pole infundibulum of the left kidney. (b) This mass produces irregularity of the contour of the infundibulum, which is well seen on the coronal reformatted image (arrow). This was subsequently confirmed to represent a transitional cell carcinoma.

 


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  		Figure 4. Transitional cell carcinoma. Circumferential ureteral wall thickening is present in the mid left ureter of this patient who presented with haematuria (arrow). Note that the ureteral lumen is not narrowed significantly. No abnormality was detected on the three-dimensional reconstructions. It is likely that an excretory urogram would have been normal as well. Subsequent ureteroscopy confirmed that the thickening was produced by an infiltrative transitional cell carcinoma.

 


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  		Figure 5. Renal tubular ectasia. (a) Wide windowing while viewing the kidneys is necessary to visualize the discrete linear collections of contrast material (arrow) in the renal pyramids in this patient with renal tubular ectasia. (b) The ectasia is also well demonstrated on maximum intensity projection reconstructions (arrows).

 


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  		Figure 6. Ureteral kink mimicking a filling defect. (a) An axial image demonstrates an apparent tiny filling defect (arrow) in the proximal left ureter. This filling defect is caused by tortuosity of the ureter associated with a ureteral kink. (b) Although the presence of the kink can be suspected by reviewing the axial images sequentially, it is more easily identified on a coronal three-dimensionally reconstructed image.

 




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