Utilization of furosemide to increase urine production as a negative contrast media in CT urography

Abstract

Non-contrast CT scan is a mainstay in diagnosing urolithiasis and obstruction of the urinary tract. In diagnosing urolithiasis, non-contrast CT scan needs tracking images to distinguish urolithiasis from appendicolith, phlebolith, or calcification in the iliac artery. The making process of tracking is difficult due to the small size of the ureter and isodense with the intestine and psoas muscle. CT urography is generally carried out with iodine contrast media, but in patients with contraindications to iodine, trypanophobia and lack of funds, CT urography fails. The author intended to do a study using urine as a negative contrast medium, a substitute for iodine contrast media. This study aims to identify differences in the degree of distention and density of the urinary tract between pre-diuretic and post-diuretic using 40 mg of furosemide tablet as a diuretic agent.

This study type was pre-experiment with one group pretest-posttest design. Measurement of distention and the degree of density was performed on coronal image tracking of urinary tract CT urography pre and post diuretic by using Measured Distance software to determine the degree of distention and Region of Interest software to determine the density of the urinary tract. Data analysis used paired t test with a 95% significance level.

The results showed that there were significant differences in the degree of distention and density of the urinary tract between pre-diuretic and post-diuretic with the p values of the degree of distention of right renal pelvis of 0.001, right ureter of <0.001, left renal pelvis of 0.002, left ureter of 0.001, and the p values of the density of right renal pelvis of <0.001, right ureter of 0.003, left renal pelvis of 0.001, left ureter of <0.001.

Administration of 40 mg of furosemide tablets to CT urography patients could increase the degree of distention and reduce the density of the urinary tract.