CT and MR Urography

Targeted CE per ARRT’s Discipline, Category, and Subcategory classification:
[Note: Discipline-specific Targeted CE credits may be less than the total Category A credits approved for this course.]

Computed Tomography: 1.25
Procedures: 1.25
Abdomen and Pelvis: 1.25

Magnetic Resonance Imaging: 1.50
Patient Care: 0.50
Patient Interactions and Management: 0.50
Procedures: 1.00
Body: 1.00

Nuclear Medicine Technology: 0.75
Patient Care: 0.50
Patient Interactions and Management: 0.50
Procedures: 0.25
Gastrointestinal and Genitourinary Procedures: 0.25

Radiography: 0.75
Patient Care: 0.50
Patient Interactions and Management: 0.50
Procedures: 0.25
Thorax and Abdomen Procedures: 0.25

Registered Radiologist Assistant: 2.00
Procedures: 2.00
Abdominal Section: 2.00

Sonography: 0.75
Patient Care: 0.50
Patient Interactions and Management: 0.50
Procedures: 0.25
Abdomen: 0.25

Radiation Therapy: 0.75
Patient Care: 0.50
Patient and Medical Record Management: 0.50
Procedures: 0.25
Treatment Sites and Tumors: 0.25

Outline

1. Introduction
2. CT Urography
   1. Rationale
   2. Techniques
   3. Yield and Clinical Effectiveness
   4. Indications
3. MR Urography
   1. Rationale
   2. Techniques
   3. Yield and Clinical Effectiveness
   4. Indications
4. Urography with CT and MR: What are the Issues

Objectives

Upon completion of this course, students will:

1. understand what type of CT technical advances have made CT urography possible
2. understand what urological problems CT has become the test of choice to evaluate
3. know what benefit MRI has over CT for evaluating the urinary tract
4. know what technology was replaced by CT urography as the exam of choice
5. understand what urological condition ultrasound is sensitive to detecting
6. know what benefits radiography has over CT urography
7. understand what baseline unenhanced CT images offer for urography
8. know the relative contraindications for using a compression device in CT urography
9. know how opacification of the urinary tract in CT urography can be improved
10. understand when furosemide is safe to use during CT urography
11. understand what abnormalities CT urography is able to depict
12. understand what CT urography methods have been used in evaluating the urothelium
13. understand how urothelial cancer typically appears in early phase enhanced images
14. know what percentage of all urological visits are represented by patients presenting with hematuria
15. understand the policy AUA established setting CT urography or intravenous urography as the initial test for a common clinical indication
16. understand how CT urography can be useful in surveillance for patients who need repeat exams
17. understand how nonenhanced CT urography scans may be the best choice
18. be familiar with the benefits of MR imaging compared to CT
19. understand ways in which CT urography and MR urography are similar and ways that they are different
20. be familiar with early MR urography techniques
21. understand the importance of T2-weighted imaging
22. be familiar with coil selection in MR urography
23. be familiar with benefits associated with moving from a 1.5T to a 3.0T MRI system
24. understand the limitations in utilizing a 3.0T MRI system for MR urography
25. be familiar with other imaging techniques used in MR urography
26. be familiar with the different kinds of T2-weighted imaging that can be used in MR urography
27. understand the type of excretory images typically acquired 5 minutes after administration of gadolinium
28. understand whether oral hydration is used in MR urography
29. be familiar with how furosemid is used in MR urography
30. be familiar with scan time reduction methods used for the MR urography exam
31. understand what MR is relatively insensitive for detecting
32. be familiar with the types of exams that MR can safely perform on sensitive patient populations
33. understand factors that minimize radiation dose during CT urography
34. applying the concept of ALARA, be familiar with what is an acceptable CT urography exam of a young patient presenting with hematuria
35. understand what imaging procedures are acceptable when a patient has a low GFR