This is an education resource only. Ordering of all procedure codes on this website are subject to the Canberra Health Services guidelines for imaging orders.
INDICATIONS (1-4)
From ACR Criteria:
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Haematuria, gross, initial imaging
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Bladder cancer
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muscle invasive, treated, surveillance
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non-muscle invasive, treated, symptomatic, surveillance
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non-muscle, invasive, treated, risk factors, surveillance
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UTI
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lower urinary tract, recurrent, complicated or frequent relapses, or no response to conventional therapy
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lower urinary tract, recurrent, risk factors
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PATHOLOGY DEMONSTRATED (1-4)
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Bladder tumour
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Tumours in KUB
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Renal obstruction
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Blood clot
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Pyelonephritis
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Urolithiasis
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Infection
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Kidney laceration
PATIENT PREPARATION
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Patient able to lie still for ten minutes
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Not claustrophobic (sedation may be given)
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Cognitively capable of following basic instructions
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Metal artefacts removed from the region of interest, including bras and necklaces
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No respiratory distress when lying supine
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Not allergic to Iodine based Contrast
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No known kidney disease (eGFR below 30 as per RANZCR), however, acute setting consultant may sign to continue with poor renal function
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No hyperthyroidism, may induce thyroid storm
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Patient to have 20G cannula in anterior cubital fossa.
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Preferably patient fasted for 4 hours
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Urinary catheter to be clamped if doing an CT IVP
ANATOMY INCLUDED (4)
For patients over the age of 40, a non contrast KUB, and seperate nephrogenic and excretory (delayed) phases will be performed. For all patients under the age of 40, a non contrast KUB and a COMBINED dual nephrogenic/excretory phase will be performed. Image examples of this can be seen below.
Under 40 Years of Age
CT Urogram- Nephrogenic + Excretory Phase (Axial)
CT Urogram- Nephrogenic + Excretory Phase (Coronal)
CT Urogram- Nephrogenic + Excretory Phase (Sagittal)
Over 40 Years of Age
CT Urogram- Nephrogenic Phase (Axial)
CT Urogram- Excretory Phase (Axial)
CT Urogram- Nephrogenic Phase (Coronal)
CT Urogram- Excretory Phase (Coronal)
CT Urogram- Nephrogenic Phase (Sagittal)
CT Urogram- Excretory Phase (Sagittal)
REFERENCES
1. American College of Radiology (ACR). Appropriateness Criteria. [Internet]. 2022 [Updated 2021, cited 10 Aug 2022]. Available from https://www.acr.org/Clinical-Resources/ACR-Appropriateness-Criteria​
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2. Radiopaedia. CT Abdomen-Pelvis (Protocol) [Internet]. 2008 [updated 7 April 2022, cited 23 Aug 2022]. Available from https://radiopaedia.org/articles/ct-abdomen-pelvis-protocol-1?lang=us
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3. Radiopaedia. CT Urography (Protocol) [Internet]. 2008 [updated 7 April 2022, cited 23 Aug 2022]. Available from https://radiopaedia.org/articles/ct-urography-protocol?lang=gb
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4. Radiopaedia. CT Split Bolus Technique [Internet]. 2008 [updated 7 April 2022, cited 23 Aug 2022]. Available from https://radiopaedia.org/articles/ct-urography-protocol?lang=gb