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Home Hydronephrosis on Prior Imaging-Unknown Cause
Variants
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Hydronephrosis, unknown cause, unilateral, asymptomatic, initial imaging 3197006
MRU without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MAG3 renal scan
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
CTU without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually appropriate
US color Doppler kidneys and bladder retroperitoneal
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRU without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
(Disagreement)
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
DTPA renal scan
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
(Disagreement)
US abdomen
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Fluoroscopy voiding cystourethrography
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
Fluoroscopy antegrade pyelography
1-10 mSv
☢☢☢
Usually not appropriate
Radiography abdomen and pelvis
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
Radiography intravenous urography
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
MRI abdomen and pelvis without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI abdomen and pelvis without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI abdomen without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI abdomen without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT abdomen with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
CT abdomen without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate