Abstract Objectives To evaluate the diagnostic value of triple-bolus CTU for UPJO in comparison with split-bolus CTU. Methods In this single-center retrospective study, patients under clinical suspicion of UPJO referred from the urology clinic for CTU examination from January 1, 2017, to January 31, 2022, were included. CTU examinations were performed with split-bolus or triple-bolus protocols. The images were reviewed by two radiologists for assessment of arterial and venous renal pelvis enhancement and arteriovenous differentiation. Interobserver agreement on arteriovenous differentiation were calculated. Results A total of 23 triple-bolus CTU and 70 split-bolus CTU examinations were included. The Hounsfield unit (HU) values for the renal artery, renal vein, and upper urinary tract were all significantly higher in the triple-bolus group. The proportion of high enhancement of arteries and veins was also significantly higher in the triple-bolus group (p 0.001). Both radiologists evaluated triple-bolus CTU as providing greater arteriovenous differentiation with strong interobserver agreement (κ = 0.77). Conclusions Triple-bolus CTU exhibited superior arteriovenous differentiation in comparison with split-bolus CTU, with an acceptable radiation dose. Advances in knowledge For patients with suspicion of UPJO, triple-bolus CTU may be the imaging modality of choice for evaluating anatomical structures for further management.
Lin et al. (Thu,) studied this question.