Influence of diuretic (furosemide) on contrast medium distribution in computed tomography urography of high-grade hydronephrosis in children.

Introduction: Diuretics improve visualization of the urinary tract in computed tomography urography in adults, as well as in magnetic resonance urography in adults and children. Also, diuretics can help to diagnose upper urinary tract obstruction in intravenous urography, ultrasonography or dynamic scintigraphy. However, there are still missing data on evaluation of furosemide usefulness in computed tomography urography examinations in children with suspected congenital anomalies of the urinary tracts.The aim of this study was to compare the homogeneity of contrast medium distribution in high-grade hydronephrosis in pediatric computed tomography urographies performed with and without use of diuretic (furosemide).

Materials and method: We have restrospectively analyzed computed tomography urography image series performed in the Department of Pediatric Radiology, in children with suspected congenital anomalies of the kidney and the urinary tract. Kidney units with high-grade hydronephrosis were divided in two groups: non-furosemide (n = 25) and furosemide (n = 28) group, where diuretic in dose 1 mg/kg, with maximum 20 mg, was administered intravenously 3-5 min before contrast medium administration. Subjective image quality and diagnostic confidence were evaluated by two independent radiologists and compared between study groups.

Results: There were no significant differences in subjective image quality and diagnostic confidence between furosemide and non-furosemide groups.

Conclusions: Addition of furosemide to computed tomography urography does not improve homogeneity of contrast medium distribution in hydronephrotic kidneys in children.