Diagnostic Yield of Non Contrast Computed Tomography in evaluation of Hematuria in young adults: A prospective study

Abstract

Aim: To evaluate the diagnostic yield of the role of Non Contrast Computed Tomography (NCCT) in evaluation of hematuria in young adults Material and Methods: All the young adults (40 years or less in age) who presented with macroscopic or microscopic hematuria and were advised computed Tomography were included in the study. Detailed history and findings of clinical examination were recorded. NCCT scans were performed and findings were recorded in detail and tabulated. CECT scans and urographic scans were performed wherever indicated. Results: Mean age of patients in the study was 29 years with male to female ratio of 2.7:1. Of all the examined cases, clinically significant cause of hematuria was seen in 43 patients (48.9%). The most common clinically significant findings were renal or ureteric calculi seen in 32 patients (74.4%); three cases of malignancy were also seen. Thirty seven (86.0%) of 43 clinically significant causes were evident on non contrast images. Tiny vesical mass, urinary tract infections, PUJ obstruction, ureteric stricture, double collecting system and parapelvic cysts were detected only on contrast enhanced scans and were not apparent on non contrast images. Conclusions: Clinically significant cause of hematuria was seen in 48.9 % of Contrast enhanced CT of the young adults. Non contrast images alone were diagnostic in majority of these cases thereby reducing the requirement of additional CT examination and hence radiation exposure in radiosensitive individuals.