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Abstract：
The purposes of this study were to determine whether patients with asymptomatic microscopic hematuria undergoing CT urography (CTU) meet the American Urological Association criteria for radiologic evaluation and to determine the yield of CTU for upper tract malignancy.
A retrospective review was conducted of consecutive CTU examinations performed for asymptomatic microscopic hematuria in adult patients. Patients with clinical evidence suggestive of a benign cause of hematuria (stone, urinary tract infection, trauma) or prior urologic malignancy were excluded. The study group included 419 patients (173 men, 246 women). CT reports were reviewed to identify causes of hematuria in all cases. Evaluate for appropriateness was conducted with 200 randomly allocated patients. Urinalysis results were reviewed, and appropriate use of CTU was defined as more than 3 RBCs per high-power field in the absence of urinary tract infection. Cystoscopy results after CTU were noted.
In total, 58 of 200 patients (29.0%; 95% CI, 23.2-35.6%) did not meet American Urological Association criteria for radiologic evaluation. Fifteen (7.5%) received dipstick analysis only. Thirty-eight (19.0%) had urinalysis results showing 0-2 RBCs per high-power field. Five patients (2.5%) were found to have urinary tract infections. No upper tract urothelial neoplasms were identified (0/419; 95% CI, 0.0-0.9%). One solid renal mass was identified without pathologic confirmation. One possible bladder mass was seen at CTU but not visualized at subsequent cystoscopy.
In 29.0% of examinations, CTU is performed for patients who do not meet the criteria for radiologic evaluation. The yield of CTU for upper urinary tract malignancy is low.
A retrospective review was conducted of consecutive CTU examinations performed for asymptomatic microscopic hematuria in adult patients. Patients with clinical evidence suggestive of a benign cause of hematuria (stone, urinary tract infection, trauma) or prior urologic malignancy were excluded. The study group included 419 patients (173 men, 246 women). CT reports were reviewed to identify causes of hematuria in all cases. Evaluate for appropriateness was conducted with 200 randomly allocated patients. Urinalysis results were reviewed, and appropriate use of CTU was defined as more than 3 RBCs per high-power field in the absence of urinary tract infection. Cystoscopy results after CTU were noted.
In total, 58 of 200 patients (29.0%; 95% CI, 23.2-35.6%) did not meet American Urological Association criteria for radiologic evaluation. Fifteen (7.5%) received dipstick analysis only. Thirty-eight (19.0%) had urinalysis results showing 0-2 RBCs per high-power field. Five patients (2.5%) were found to have urinary tract infections. No upper tract urothelial neoplasms were identified (0/419; 95% CI, 0.0-0.9%). One solid renal mass was identified without pathologic confirmation. One possible bladder mass was seen at CTU but not visualized at subsequent cystoscopy.
In 29.0% of examinations, CTU is performed for patients who do not meet the criteria for radiologic evaluation. The yield of CTU for upper urinary tract malignancy is low.
摘要：
这项研究的目的是确定接受CT尿路造影（CTU）的无症状镜下血尿患者是否符合美国泌尿外科协会的放射学评估标准，并确定CTU对上呼吸道恶性肿瘤的产量。
对成人患者无症状镜下血尿的连续CTU检查进行回顾性分析。有临床证据提示良性血尿的患者（结石，尿路感染,外伤）或先前的泌尿系恶性肿瘤被排除在外。研究组包括419名患者(173名男性，246名妇女)。对CT报告进行审查，以确定所有病例中血尿的原因。对200名随机分配的患者进行了适当性评估。对尿液分析结果进行了综述，CTU的适当使用定义为在没有尿路感染的情况下，每个高倍视野超过3个红细胞。记录CTU后的膀胱镜检查结果。
总共，200例患者中有58例（29.0％；95％CI，23.2-35.6％）不符合美国泌尿外科协会的放射学评估标准。15(7.5%)只接受试纸分析。38例（19.0％）的尿液分析结果显示每个高功率场0-2个RBC。发现五名患者（2.5％）患有尿路感染。未发现上尿路上皮肿瘤（0/419；95％CI，0.0-0.9％）。鉴定出一个实性肾肿块，无病理证实。在CTU观察到一种可能的膀胱肿块，但在随后的膀胱镜检查中未发现。
在29.0%的考试中，CTU适用于不符合放射学评估标准的患者。CTU用于上尿路恶性肿瘤的产量低。
对成人患者无症状镜下血尿的连续CTU检查进行回顾性分析。有临床证据提示良性血尿的患者（结石，尿路感染,外伤）或先前的泌尿系恶性肿瘤被排除在外。研究组包括419名患者(173名男性，246名妇女)。对CT报告进行审查，以确定所有病例中血尿的原因。对200名随机分配的患者进行了适当性评估。对尿液分析结果进行了综述，CTU的适当使用定义为在没有尿路感染的情况下，每个高倍视野超过3个红细胞。记录CTU后的膀胱镜检查结果。
总共，200例患者中有58例（29.0％；95％CI，23.2-35.6％）不符合美国泌尿外科协会的放射学评估标准。15(7.5%)只接受试纸分析。38例（19.0％）的尿液分析结果显示每个高功率场0-2个RBC。发现五名患者（2.5％）患有尿路感染。未发现上尿路上皮肿瘤（0/419；95％CI，0.0-0.9％）。鉴定出一个实性肾肿块，无病理证实。在CTU观察到一种可能的膀胱肿块，但在随后的膀胱镜检查中未发现。
在29.0%的考试中，CTU适用于不符合放射学评估标准的患者。CTU用于上尿路恶性肿瘤的产量低。
