Ces Urol X:X | DOI: 10.48095/cccu2026021

Comparison of the quality of CT excretory urography with and without administration of normal saline (0.9% sodium chloride solution)

Alexandra Kucserová¹, 2 Gabriela Chudárková2 Kateřina Langová3 Lenka Bakaj Zbrožková¹

¹ Radiologická klinika LF UP a FN Olomouc

² Radiodiagnostické oddělení, Nemocnice AGEL Valašské Meziříčí a.s.

³ Ústav lékařské biofyziky, LF UP v Olomouci

^LF UP a FN Olomouc

^I. P. Pavlova 6

⁷⁷ 9 00 Olomouc Lenka.Zbrozkova@fnol.cz

Major statement: Intravenous administration normal saline (0.9% sodium chloride solution) during CT excretory urography does not lead to a demonstrable improvement in filling or opacification of the upper urinary tract, and its routine use is not justified.SummaryAim: The aim of this study was to retrospectively evaluate whether intravenous administration of normal saline 0.9% sodium chloride solution (0.9% NaCl) during CT excretory urography improves filling and opacification of the upper urinary tract.

Material and methods: A cohort of patients referred for CT excretory urography between January and June 2025 was analysed. The standard CT protocol consisted of non-enhanced, arterial, parenchymal and excretory phases. During the examination, 90 mL of contrast agent and 50 mL of 0.9% NaCl were administered using a power injector. In half of the patients, an intravenous infusion of 120 mL of 0.9% NaCl was administered between parenchymal and excretory phase, while the remaining patients did not receive 0.9% NaCl infusion. The ureters were bilaterally divided into four segments, and contrast opacification of each segment was assessed on a four-point scale by two independent radiologists. In addition, renal pelvis density and intra-renal anteroposterior diameter were measured, as well as diameter and density of abdominal portion of the ureterall assessed bilaterally.

Results: Very good interobserver agreement was demonstrated for all quantitative and ordinal parameters (intraclass correlation coefficient – ICC > 0.9; Cohen\'s κ = 0.556–0.837). No statistically significant differences were found between patients with and without intravenous 0.9% NaCl administration for any of the evaluated parameters (all P > 0.05).

Conclusion: Intravenous 0.9% NaCl administration during CT excretory urography did not result in a statistically significant improvement in urinary tract filling or opacification compared with patients who did not receive 0.9% NaCl infusion.

Keywords: 0.9% NaCl – CT excretory urography – opacification – urinary tract

Received: June 26, 2026; Revised: August 6, 2026; Accepted: August 26, 2026; Prepublished online: November 3, 2026