INTRODUCTIONIn this study, we aimed to compare the split-bolus and single-bolus computerised tomography (CT) urography and determine if this offers a reduction in radiation dose without compromising image quality.

MATERIALS AND METHODSA retrospective evaluation was performed on 88 patients undergoing split-bolus CT urography and this was compared to a control group of 101 consecutive patients undergoing single-bolus CT urography. A radiation dose analysis was performed on each subject. Subjects with urinary bladder lesions, hydronephrosis, renal masses or cysts >3 cm in diameter were excluded. All images were classified according to image quality by 2 consultant radiologists.

RESULTSOpacification of  the renal parenchyma, pelvicalyceal system, proximal ureters and urinary bladder were comparable between the 2 techniques, whilst image quality of the middle and distal third of the ureters was better using the split-bolus technique. The mean dose length product (DLP) for the single-bolus technique was 1324.1 mGy-cm, whilst that of  the split-bolus technique was 885.7 mGy-cm. The mean effective dose reduction was calculated to be 31.1% between the 2 groups.

CONCLUSIONThe split-bolus technique gives a reduced radiation dose without compromising image quality. The associated reduction in images is beneficial for data storage and reporting efficiency. As such, our department will adopt the split-bolus technique for young, low-risk patients.

Appendiceal neoplasms are rare and often only discovered incidentally during surgery performed for acute appendicitis. Computed tomography (CT) has been demonstrated to be a reliable technique for accurately establishing the preoperative diagnosis of appendiceal neoplasms that manifest as acute appendicitis through the presence of certain imaging findings. Other manifestations of appendiceal neoplasms include appendiceal mass, mucocoele, localised abscess formation, ileus, increasing abdominal girth from pseudomyxoma peritonei, and intussusception. This pictorial essay illustrates varied CT findings of neoplasms of the appendix, with emphasis on the more commonly encountered manifestations of these tumours.