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CT IVP Hematuria

Technique: Helical CT of the abdomen and pelvis was performed without contrast and following the uneventful administration of IV contrast acquiring contiguous 5 mm axial slices with reformations in the sagittal, coronal and coronal MIP planes. Findings: There is a filling defect within the bladder at the right ureterovesical junction measuring 1.5 x 2.1 cm. There are no urinary tract calculi. There is right-sided accessory renal artery supplying lower pole of the right kidney crossing the right-sided ureter just below the ureteropelvic junction. There is no hydronephrosis. There is prompt symmetric bilateral renal contrast excretion. The kidneys are normal in size, shape and position. No solid renal masses or cysts are visible. The ureters and bladder appear normal. The liver demonstrates mild dilatation of intrahepatic bile ducts, without evidence of mass. Renal lengths: Right kidney: 12 cm Left Kidney: 12 cm CONCLUSION: 1. Bladder filling defect at the right ureterovesical junction is suspicious for malignancy. Recommend direct visualization and tissue biopsy. 1. No evidence of urinary tract stone or tumor to explain hematuria. 2. Right-sided accessory renal artery crossing the right ureteropelvic junction, without hydronephrosis. 3. Intrahepatic bile duct dilatation. Recommend right upper quadrant ultrasound for further characterization. **** Findings: There are no urinary tract calculi. There is prompt symmetric bilateral renal contrast excretion. The kidneys are normal in size, shape and position. There is 18 mm cyst in the lower pole of the right kidney. No solid renal mass visible. The pyelocalyceal systems, ureters, and bladder appear normal. The prostate is enlarged measuring 5.6 x 5.2 cm in axial plane. Incidentally noted is left-sided IVC crossing to the right below diaphragm, normal vascular variant. Atherosclerotic calcifications are noted within the aorta. There is a small liver cyst within the anterior right liver lobe. Bilateral inguinal fat containing hernias are noted. Multilevel degenerative changes of the lumbar spine are noted. There is an L1 compression fracture, chronicity unknown. Renal lengths: Right kidney: 11.5 cm Left Kidney: 10. cm Conclusion: 1. No urinary tract stone or neoplasm to explain hematuria. 2. Prostatic enlargement. 3. Other findings as above.