Julie H. Song MD, Presenter: Nothing to Disclose

Michael David Beland MD, Abstract Co-Author: Nothing to Disclose

William W. Mayo-Smith MD, Abstract Co-Author: Research support, Covidien AG Research support, Bracco Group

To describe the prevalence of clinically important incidental extraurinary findings at MDCTU performed for hematuria

This study was IRB approved and HIPAA compliant. A computer search of abdominal CT reports using the term “hematuria” identified 1221 MDCTU performed on 1209 patients from March 2004 to September 2008. The results were retrospectively reviewed to determine unsuspected extraurinary findings that are clinically important or potentially important, warranting further imaging studies or medical or surgical intervention. We further categorized these important findings into acute, requiring immediate medical attention, or non-acute, requiring further evaluation in a non-urgent manner. Using our electronic medical record, these findings were correlated to histologic diagnosis, further imaging evaluation, and clinical information.

There were 85 clinically important incidental extraurinary findings in 83 of 1221 exams (6.8%). Follow-up evaluation was available on 40 of 85 findings by: histologic diagnosis (7), imaging evaluation (31), or clinical information (2). There were 12 (1%) exams with acute findings including acute inflammation of the GI tract (4), pancreatitis (2), cholecystitis (1), sigmoid volvulus (1), DVT (1), retroperitoneal bleed (2), and splenic hematoma (1). Seventy-one (5.8%) exams had 73 non-acute but important findings: lung nodules larger than 4 mm (22), ovarian cystic mass (14), AAA (13), pancreatic cystic mass (6), iliac artery aneurysm (5), indeterminate liver lesion (4), post-menopausal endometrial thickening (4), adenopathy (2), avascular necrosis of hip (2), solid ovarian mass vs. fibroid (1). There were 4 histologically proven malignancies and 1 presumed lung cancer (SUV of 9.7 on PET), constituting 0.4 % of all exams. There were 12 benign diagnoses by: histology (3), imaging diagnosis (7), greater than 2 year stability on imaging (2).

In 1221 MDCTU, 6.8% of exams had clinically important extraurinary findings that warranted further evaluation. 1% of the exams had acute findings necessitating immediate medical management and 0.4% findings were malignant.

Clinically important extraurinary findings are uncommon on MDCTU performed for hematuria.

Song, J, Beland, M, Mayo-Smith, W, Incidental Extraurinary Findings on MDCT Urography: Prevalence in 1221 Consecutive Exams.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8007612.html