Rm. Kowalchuk et al., EFFICACY OF PRONE POSITIONING DURING INTRAVENOUS UROGRAPHY IN PATIENTS WITH HEMATURIA OR UROTHELIAL TUMOR BUT NO OBSTRUCTION, Academic radiology, 5(6), 1998, pp. 415-422
Rationale and Objectives. The authors prospectively explored the effic
acy of using prone positioning during intravenous urography to improve
diagnostic visualization and eliminate the need for retrograde pyelou
reterography in patients with no obstruction but with hematuria, histo
ry of urothelial tumor, or abnormal results of urine cytology. Materia
ls and Methods. Prone radiography was added to the usual intravenous u
rography protocol in 510 patients (347 men, 163 women) without urinary
tract obstruction. Interpretations of intravenous urograms and recomm
endations for retrograde pyeloureterography were made before and after
evaluation of the prone image. Results. Confidence in the urographic
interpretation was improved with acquisition of the prone radiography
in 100 of 510 patients (19.6%) (95% confidence interval, 82.1, 118). R
etrograde pyeloureterography was obviated in 46 of 510 patients (9.0%)
(95% confidence interval, 33.1, 58.9). The prone image was most helpf
ul in evaluating the distal ureters (sacral and pelvic segments). Conc
lusion. Prone patient positioning during intravenous urography is usef
ul when complete visualization of the upper urinary tract is desirable
. Obtaining the additional image is cost-effective, even when only a f
ew retrograde pyeloureterography studies are obviated.