الفهرس 
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Abstract
Recent advances in CT including software developments have led to the use of three dimensional (3D) imaging reconstruction techniques and allow CT urography to be used in daily practice in evaluation of urinary tract disease.
In order to produce optimal CT urography, high-resolution and thin-slice CT data are necessary. Furthermore, dedicated CT protocols and the application of adequate 3D reconstruction techniques are necessary.
CTU study in which both axial and 3D images are evaluated are useful for revealing urinary tract anatomy and pathologic conditions where urinary tract abnormalities are strongly suspected. CTU has the potential to reveal even small or subtle collecting system abnormalities. Combining the known utility of CT as an aid in detecting and characterizing renal masses and evaluating patients suspected of having urolithiasis with its ability to depict urothelial and bladder lesions, CTU has the potential to enable a comprehensive evaluation of the genitourinary system in a single examination.
The aim of our study is to study the role of MDCT Urography in the diagnosis of the cause and the level of Urinary tract obstruction.
Our study included thirty patients of variable ages diagnosed as obstructive uropathy which were the major leading complaint. Following history taking & clinical assessment, patients were subjected to MDCT urography examination.
The causes of obstructive uropathy as detected by MDCT urography were as follow: fourteen caused by urinary tract stones (46.6%), four with urinary bladder masses involving ureteric orifices (13.3 %) , three with PUJ obstruction (10%) , three with compression of ureters ( 10%) , three with ureteric injuries (10%) , two with bladder neck obstruction (6.6%) and one case with ureteric stricture ( 3.3%). \
In our study fourteen patients with obstructive uropathy diagnosed by MDCT urography as urinary tract stones. The CT techniques including MPR , CPR as well as MIP & 3D techniques CT were highly sensitive and specific in detection the level & density of the stones (100%).MDCT had the advantage of detection of even the radiolucent stones.
Cases of bladder masses were diagnosed by MDCT urography that affects ureteric orifices & leads to obstructive uropathy, MPR & CPR were the techniques of choice for detection of the masses, extensions, and ureteric orifice infiltrations.
In cases of PUJ obstruction, CT urography technique with image reformatting using MPR , CPR , MIP and VRT gave an excellent data about the presence of UPJ obstruction, degree of the hydronephrotic changes as well as the renal cortical thickness. Sensitivity & specificity l00%.
Three cases of obstructive uropathy were caused by compression of the ureters like retroperitoneal fibrosis, as well as compression of the pelvic ureters by large pelvic masses exerting ureteric obstruction. The diagnosis were established by CT urography examination specially MPR& CPR. The sensitivity of both MIP & VRT were very low in detection of the cause of obstruction (33.3%) While their sensitivity in detection of the level were 100%.
Three cases of obstructive uropathy were caused by ureteric injury two of them iatrogenic injury during hysterectomy and one after road traffic accident, the three cases show unilateral ureteric injury. With excellent sensitivity of both MIP & VRT in detection of the level (100%).
Only one case of ureteric stricture associated with mild unilateral hydronephrosis due to bilhariziasis, associated with multiple urinary bladder polyps.
from this study we concluded that MDCT urography enabled an accurate diagnosis of the level of obstruction, as well as its etiology, including nephro-ureterolithiasis, pelvi-ureteric junction stenosis, ureteric strictures, ureteric injury, retroperitoneal fibrosis and pelvic masses.