CT UROGRAM

A CT urogram is a specialized, minimally invasive diagnostic imaging test designed to provide your doctor with extremely detailed pictures of your entire urinary system. This includes your kidneys, the ureters (the tubes connecting the kidneys to the bladder), and the bladder itself. To achieve this level of clarity, the procedure requires an intravenous (IV) injection of a special contrast material, which highlights these organs and allows for a comprehensive evaluation of both their structure and function. At Cadabams Diagnostics, we use advanced CT technology to ensure a safe, efficient, and highly accurate examination.

What is a CT Urogram?

A Computed Tomography (CT) scan uses a combination of sophisticated X-rays and advanced computer technology to create detailed, cross-sectional images, or "slices," of your body. A CT urogram builds on this by adding a crucial element: an intravenous (IV) contrast dye.

This iodine-based contrast material is injected into a vein in your arm. It travels through your bloodstream and is filtered out by your kidneys, just like waste products. As it passes through your urinary tract, it makes the kidneys, ureters, and bladder appear bright white on the CT images. This process allows radiologists to not only see the anatomy of your urinary system in high definition but also to assess how well it is functioning. This makes it an exceptional CT scan for kidneys, ureters, and bladder, capable of identifying abnormalities that might be missed on other types of scans.

Types of CT Urogram

The "type" of CT urogram isn't about different machines, but rather the specific multi-phase imaging process used to capture your urinary system at different points in time. This timed approach is what makes the test so effective.

• Non-contrast phase: An initial scan is performed before the contrast dye is injected. This scan is excellent for detecting kidney stones or other calcifications, which are easily visible without contrast.
• Nephrographic phase: This scan is done shortly after the contrast injection, while the dye is highly concentrated within the kidney tissue (parenchyma). This is the best phase for evaluating the kidneys themselves for tumors or infections.
• Excretory/Delayed phase: This final set of images is taken several minutes later. By this time, the contrast-filled urine has traveled from the kidneys into the ureters and is filling the bladder. This phase provides a detailed "road map" of the drainage system, clearly showing the ureters and bladder.

During your CT urogram, our expert radiologists meticulously examine the images, evaluating several key parameters to assess the health of your urinary system. They look for:

• Kidney Characteristics: The size, shape, and position of both kidneys.
• Abnormal Growths: The presence of any masses, such as solid tumors or fluid-filled cysts.
• Stones (Calculi): The location, size, and number of kidney stones.
• Ureteral Patency: Whether the ureters are open and allowing urine to pass freely, or if there are signs of obstruction like hydronephrosis (swelling of the kidney).
• Bladder Integrity: The thickness of the bladder wall, and the presence of any out-pouchings (diverticula) or filling defects that could indicate a tumor.
• Structural Anomalies: Any congenital (present from birth) differences in your urinary tract anatomy.

While there are several reasons to perform this test, the single most important indication is to investigate the source of blood in the urine.

• Primary Reason: To find the cause of hematuria (blood in urine). A CT scan for blood in urine (hematuria) is the gold-standard test because it can visualize the entire tract where bleeding could originate—from the smallest structures in the kidney to the lining of the bladder.
• Other Key Reasons:
  • To diagnose or stage suspected cancers of the kidney, ureter, or bladder.
  • To evaluate individuals with recurrent kidney stones.
  • To assess damage to the urinary system after physical trauma.
  • To investigate congenital abnormalities of the urinary tract.

When and Who Needs to Take a CT Urogram?

Your doctor may recommend a CT urogram if you are experiencing symptoms that suggest a problem within your urinary tract. The most common indications include:

• Hematuria: Unexplained blood in the urine, which is the primary reason for this test.
• Persistent Flank Pain: Pain in your side or back that could be related to a kidney stone or blockage.
• Suspected Obstruction: Symptoms that point to a blockage somewhere in the urinary tract.

A CT urogram is often recommended for adults, especially those with known risk factors for urinary tract cancers (like a history of smoking or certain chemical exposures) or those with complex or recurring urinary symptoms that haven't been diagnosed by other methods.

Benefits of Taking the Test

Opting for a CT urogram provides significant diagnostic advantages:

• Comprehensive View: It is the only test that provides a highly detailed, all-in-one view of the entire urinary system's structure and function.
• High Accuracy: It is exceptionally good at detecting very small tumors, stones, and other abnormalities that can be missed by other imaging tests like a standard ultrasound or X-ray.
• Effective Treatment Planning: The precise information from a CT urogram helps your doctor accurately diagnose your condition, which is a critical step in planning the most effective surgery or treatment.

Illnesses Diagnosed with CT Urogram

A CT urogram is instrumental in diagnosing a wide range of conditions affecting the urinary tract, including:

• Cancers: Renal Cell Carcinoma (kidney cancer) and Urothelial Carcinoma (cancer of the bladder or ureters).
• Kidney Stones (Nephrolithiasis): Precise location and size to guide treatment.
• Ureteral Strictures: Narrowing of the ureters that can cause blockages.
• Hydronephrosis: Swelling of a kidney caused by a downstream blockage.
• Pyelonephritis: A serious kidney infection, to check for complications like an abscess.
• Congenital Anomalies: Such as a duplex kidney (a kidney with two collecting systems).
• Traumatic Injury: Lacerations or bleeding in the kidneys, ureters, or bladder.

Proper preparation is simple but essential for a successful scan.

• Fasting: You will likely be asked to fast from solid foods for about 4 hours before your scheduled appointment.
• Hydration: You are encouraged to drink plenty of clear fluids (like water, clear juice, or black tea/coffee) before the test. Being well-hydrated helps your kidneys process the contrast dye.
• Clothing: Please wear loose, comfortable clothing without metal parts like zippers, snaps, or belt buckles in the abdominal area. You may be asked to change into a hospital gown.

Pre-requisites

To ensure your safety and the quality of the scan, two things are required:

1. Doctor's Referral: A CT urogram must be prescribed by your doctor. Please bring your referral form with you.
2. Kidney Function Test: You must have a recent (usually within 30 days) serum creatinine blood test result. This confirms that your kidneys are healthy enough to safely filter the IV contrast material.

Best Time to Take the CT Urogram

There is no specific biological timing necessary for this test. A CT urogram can be performed at any time of day. It is scheduled by appointment to ensure the CT scanner and our expert team are ready for you.

Eligibility

Most adults are eligible for a CT urogram. However, certain conditions require special consideration:

• Pregnancy: The test is not recommended for patients who are or may be pregnant.
• Kidney Function: Caution is required for patients with known poor kidney function.
• Contrast Allergy: Inform us immediately if you have a known severe allergy to iodine or have had a previous serious reaction to CT contrast dye.
• Metformin: If you take Metformin (or a medication containing it, like Glucophage) for diabetes, you may be asked to temporarily stop taking it after the scan. Please discuss this with your referring doctor and inform our staff.

Procedure for Taking a CT Urogram

Understanding the CT urogram procedure can help you feel more comfortable on the day of your test. The process involves a CT urogram with IV contrast and is managed by a skilled technologist.

• Step 1: Check-in & Preparation: When you arrive at Cadabams Diagnostics, our staff will confirm your details and review your safety questionnaire. You may be asked to change into a gown.
• Step 2: IV Line Placement: A technologist will gently place a small, flexible IV catheter into a vein in your arm or hand. This is used to administer the contrast dye.
• Step 3: Initial Scan (Non-contrast): You will lie down on the padded scanner table, which will slide into the open, ring-shaped CT machine. An initial quick scan will be taken before any contrast is given.
• Step 4: Contrast Injection: The technologist, from an adjacent control room, will inject the IV contrast material through your IV line. It is very common to feel a warm sensation spreading through your body or notice a temporary metallic taste in your mouth. This is a normal effect of the dye and passes quickly.
• Step 5: Timed Scans (Phased Imaging): The scanner will then take several sets of images at specific, timed intervals as the dye moves through your kidneys, ureters, and bladder. The technologist will communicate with you through an intercom and may ask you to hold your breath for 10-15 seconds at a time to prevent blurry images.

The entire process in the scanner room typically takes about 30-45 minutes.

Caution Before Taking the Test

For your safety, it is critical that you inform the technologist before the scan begins if you:

• Are, or think you could be, pregnant.
• Have any known allergies, especially to iodine, shellfish, or previous X-ray dyes.
• Have a history of kidney disease, kidney failure, or diabetes.
• Are currently taking Metformin (Glucophage).