Diagnostic Accuracy of CT Urography to Evaluate Haematuria

Background: Haematuria is a common clinical presentation that may indicate underlying genitourinary pathology, ranging from benign causes to malignancies. Early and accurate identification of the cause is crucial. Computed Tomography Urography (CTU) has emerged as valuable imaging modality for evaluating patients with haematuria. Objective: CT Urography is an advanced imaging technique that aims to identify causes of haematuria at both microscopic and macroscopic level by assessing the entire urinary tract, detected urothelial tumour for eg; transitional cell carcinoma a leading cause of painless haematuria, to evaluate renal parenchyma for masses, cysts and stones that might lead to bleeding, assess the collecting system , ureters and bladder for filling defects, strictures or other abnormalities and provide a single comprehensive examination that can simultaneously detect renal, ureteric and bladder pathologies reducing need for multiple tests. Moreover, rule out malignancies identify benign causes ANF guide further procedures like cystoscopy, biopsy etc. CTU offers anatomic and functional assessment of the entire urinary tract in a single study making it preferred imaging modality for investigations like haematuria. Methods: This prospective observational study included patients presenting with haematuria who underwent CT urography. Findings were compared with cystoscopy, ultrasonography or histopathological outcomes when available. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) of CTU were calculated. Results: CTU demonstrated high sensitivity (96.4%) and specificity (90.3%) in identifying urothelial malignancies and urolithiases. it was superior to ultrasonography in detecting small renal masses and transitional cell carcinoma. CTU also identified incidental findings in 12% patients. Conclusion: CTU is a highly accurate, non-invasive tool for the evaluation of haematuria offering comprehensive anatomical and pathological information.