[The usefulness of virtual endoscopy and CT urography in the diagnosis of upper urinary tract tumors]. / Utilidad de la endoscopia virtual y el Uro-Tc en el diagnóstico de tumores del tracto urinario superior.

OBJECTIVES: Upper urinary tract (UUT) tumors are a relatively low incidence pathology which often represents a diagnostic challenge for the urologist, because several imaging tests are usually necessary to achieve the final diagnosis. Over the last years CT scan has suffered a notable development and nowadays, with the arrival of new image processing hardware and software, it is possible to detect small urothelial lesions and to perform 3-D urinary tract reconstruction and virtual endoscopic navigation. METHODS: Between January 2004 and June 2005 we performed a total of 15 examinations in 15 patients for the study of asymptomatic hematuria of probable upper urinary tract origin. The technique included three phases to obtain images: basal phase, vascular phase and excretory phase. Processing and image analysis was performed by one radiologist. RESULTS: A total of 10 tumors were diagnosed, with pathological confirmation in all cases. We did not register any complication secondary to the technique, and all patients tolerated well the exam. CONCLUSIONS: The CT urography is a safe, well-tolerated, highly sensitive and efficient imaging test, very useful in the diagnosis of renal and UUT pathology. It may become the only imaging test performed in the study of asymptomatic hematuria and the test of choice for the study of urological tumoral pathology.

Utilidad de la endoscopia virtual y el uro-tc en el diagnóstico de tumores del tracto urinario superior / The usefulness of virtual endoscopy and CT urography in the diagnosis of upper urinary tract tumors

OBJETIVO: Los tumores del tracto urinario superior (TTUS) conforman una patología de incidencia relativamente baja que a menudo suponen un reto diagnóstico para el urólogo ya que, suelen ser necesarias varias pruebas de imagen para alcanzar el diagnóstico definitivo. En los últimos años la tomografía computerizada ha alcanzado un notable desarrollo, y gracias a la aparición de nuevo hardware y software de procesamiento de imágenes actualmente es posible detectar lesiones uroteliales de pequeño tamaño, así como realizar reconstrucciones tridimensionales del tracto urinario y navegación endoscópica virtual por el interior del mismo. MÉTODOS: Entre enero del 2004 y junio de 2005 hemos realizado un total de 15 exploraciones a 15 pacientes durante el estudio de hematuria asintomática de probable origen en el tracto urinario superior, todas ellas indicadas por el Servicio de Urología de nuestro hospital. La técnica incluyó tres fases en la adquisición de imágenes: fase basal, fase vascular y fase excretora. El procesado y análisis de las imágenes fue realizado por un solo radiólogo. RESULTADOS: Un total de 10 tumores fueron diagnosticados, obteniendo en todos los casos confirmación anatomopatológica. No registramos ninguna complicación derivada de la propia técnica, y todos los pacientes toleraron bien la exploración. CONCLUSIÓN: El Uro-TC es una prueba segura, bien tolerada, con una elevada sensibilidad y eficiencia, muy útil en el diagnóstico de la patología renal y del TUS, susceptible de ser utilizada en el futuro como única prueba de imagen radiológica en el estudio de hematuria asintomática y como prueba de elección en el estudio de patología tumoral urológica

OBJECTIVES: Upper urinary tract (UUT) tumors are a relatively low incidence pathology which often represents a diagnostic challenge for the urologist, because several imaging tests are usually necessary to achieve the final diagnosis. Over the last years CT scan has suffered a notable development and nowadays, with the arrival of new image processing hardware and software, it is possible to detect small urothelial lesions and to perform 3-D urinary tract reconstruction and virtual endoscopic navigation. performed a total of 15 examinations in 15 patients for the study of asymptomatic hematuria of probable upper urinary tract origin. The technique included three phases to obtain images: basal phase, vascular phase and excretory phase. Processing and image analysis was performed by one radiologist. RESULTS: A total of 10 tumors were diagnosed, with pathological confirmation in all cases. We did not register any complication secondary to the technique, and all patients tolerated well the exam. CONCLUSIONS: The CT urography is a safe, well- tolerated, highly sensitive and efficient imaging test, very useful in the diagnosis of renal and UUT pathology. It may become the only imaging test performed in the study of asymptomatic hematuria and the test of choice for the study of urological tumoral pathology