A 3-Biomarker 2-Point-Based Risk Stratification Strategy in Acute Heart Failure

Abstract

Featured ApplicationThe clamp method for CT-Urethrography is easy and convenient, it proves more accurate than urethrography for measuring anterior urethral stenosis and it has better diagnostic efficacy in cases with periurethral fistula, previous urethroplasty, urethral stent or urethral lithiasis.The aim of the present study is to describe and evaluate a new technique for performing Computed-Tomography Retrograde Urethrography (CT-RUG). Males with urethral anomalies detected by retrograde urethrography (RUG) and/or retrograde sonourethrography (RSUG) underwent CT-RUG using the clamp method and three radiologists evaluated the anomalies in each technique separately and blindly. CT-RUG was done successfully in all the cases (n = 22), with means of 6 min duration and 95 mL of contrast; no pain was reported by 81% of the patients (VAS: 0) and very mild pain by the rest (VAS: 0.5-1.2). CT-RUG showed better diagnostic efficacy in cases of periurethral fistula (n = 8), urethral stent (n = 3), previous urethroplasty and urethral lithiasis (n = 2), a similar accuracy to RSUG for measuring the length of anterior urethral strictures (n = 9) and greater accuracy than RUG (p = 0.008). Six cases received 2 CT sweeps, with an effective dose of 4.96 mSv, and the remaining 16 had 1 sweep and received 3.456 mSv. To the best of our knowledge, this is the first study to describe the clamp method for CT-RUG, a method that is effective and comfortable for both the patient and the operator (retrograde infusion of contrast).