Role of multidetector computed tomography in comprehensive assessment of non-traumatic hematuria

Hematuria is one of the commonest presentations in urology practice. Evaluation includes complete urine examination (CUE), ultrasonography (USG) and if required computed tomography (CT). The aim was to study the efficacy of multidetector computed tomography (MDCT) urography in hematuria evaluation in comparison with ultrasonography. The present study was conducted in Government Coimbatore Medical College and Hospital from December 2022 to February 2024. A total of 110 patients with either gross or microscopic hematuria referred from various departments were included. All the patients were subjected to initial ultrasound study and proceeded to MDCT urography triple phase protocol. Maximum number of cases with hematuria were found in the age group > 40 years. The prevalence of malignancy was 45%, more in gross hematuria group with 34.5% and 8.9% in microscopic hematuria group. Neoplasms were found in urinary bladder (25.45 %), renal cell carcinoma (12.72%), ureters (1.8%). Calculous disease was the second common etiology accounting to 20.5%. Other causes of hematuria were pyelonephritis, cystitis, benign prostatic hyperplasia, bladder diverticulum, renal infarct, renal vein thrombosis and autosomal dominant polycystic kidney disease. The sensitivity and accuracy of CT in diagnosing neoplastic etiology were 90 % and 92 % whereas USG had 74 % and 87 % respectively. The sensitivity and accuracy of CT in diagnosing other causes were 91.6 % and 94.6 %, whereas USG had 71.3 % and 87 % respectively. Multidetector CT using its multiplanar and 3D capabilities is highly accurate and specific in detecting the causes of hematuria.