Medical research and diagnostics

Computed tomography (CT) scan of the bladder

Bladder CT is one of the best ways to get detailed information about diseases, pathologies and the structure of an organ.

The basis of this procedure is a layer-by-layer scanning of the body using X-rays. As a result, a two-dimensional or three-dimensional image can be created. A urologist, a surgeon, an oncologist can direct a bladder CT scan.

A single-bladder CT scan is performed quite rarely, much more often doctors prescribe a comprehensive examination of the urinary system, which includes a CT scan of the kidneys, ureters, and prostate.

Pathology of the bladder make up a large group of diseases of the genitourinary system. The most common complaints of bladder disease are microscopic and macroscopic hematuria, dysuria, and other urinary symptoms.

All these symptoms can be associated with inflammatory and neoplastic processes, stones, neurological, obstructive or congenital anomalies. Urogram, sonography, computed tomography, magnetic resonance imaging and many other radiological methods have been used for a long time to diagnose all these pathologies. However, CT is a standard diagnostic approach for assessing many conditions when other methods cannot be informative.

Cystoscopy has its drawbacks, including its high costs and invasiveness, which can lead to iatrogenic injuries of the bladder and urinary sepsis, therefore CT is usually recommended as a non-invasive radiological diagnostic method for assessing the condition of the bladder, but CT also has some drawbacks, for example, the study has a low sensitivity to detect minor damage.

For CT to portray a small bladder lesion, optimal imaging conditions must be met, including adequate stretching and fine scanning.

Indications for use

Acute undiagnosed abdominal pain without a clear etiology, which is accompanied by symptoms such as nausea, vomiting, diarrhea, or problems with urine excretion, is the main indication for bladder CT.

Many conditions can be associated with signs and symptoms in this area. These include, but are not limited to, intestinal obstruction, gall bladder or bladder stones, malignant tumors and complications of inflammation or infection.

Where applicable, a contrast agent can be used to obtain a detailed description of this organ and to identify anatomical anomalies. CT provides an opportunity to get detailed and complete information about the bladder. This study visualizes all its walls and cavities, provides an opportunity to see the presence of tumors in this organ, and accurately assess the extent of organ damage.

A doctor may prescribe a computed tomography of the bladder with the following features, symptoms, and impairment of function:

  • in the presence of a burning sensation or acute pain during urination;
  • urinary incontinence if there are no known causes (eg, pregnancy);
  • periodic appearance of shooting pains in the pelvic area;
  • when a nocturia symptom occurs (frequent urination at night);
  • when changing the consistency or smell of urine;
  • the presence of impurities in the urine;
  • if you suspect a tumor in the bladder.

The absolute indication for computed tomography of the bladder is its injury, as well as the presence of strictures.

Preparation for the procedure

Before a CT scan is taken, the patient may have to remove some items of clothing, accessories, jewelry and metals, as they are often opaque and can interfere with the scanning process and the quality of the results. On the day of the study, the patient can not eat anything, the day before the procedure, the patient is recommended to eat light food that does not lead to gas formation. CT scan is performed with a full bladder.

CT scan may be contraindicated in children and pregnant women, due to the fact that during the examination a strong radiation load is used.

For CT of the bladder with contrast, there are several more contraindications. These include diabetes mellitus, severe stage renal failure, and allergy to a contrast agent. In some cases, it is possible to slow down the examination of patients with obesity, as some devices are limited in permissible weight.

What happens during the procedure?

Any names of medications taken by the patient in the previous days should be communicated to the doctor to make sure that they are not contraindicated for the procedure. In addition, the possibility of pregnancy should be excluded in order to avoid excessive exposure of the teratogenic effects of radiation to the developing child.

The patient is either placed in a recumbent or reclining position in a CT scanner and must remain stationary during the procedure. The advantage of lying down is that it allows better evaluation of urinary stones in the vesicoureteral junction. The results of the study are brought by a radiologist, who then creates a report on the results and sends it to the doctor who is responsible for treating the patient.

CT risks

Exposure to ionizing radiation is a major risk factor associated with the bladder computed tomography procedure. This can damage biological tissue and increase the propensity, albeit only slightly, for the development of cancer in the future.

This risk is cumulative for the whole life and represents a small price to pay for the possibility of diagnosing acute conditions that can be life-threatening and require urgent visualization. During pregnancy, alternative imaging techniques are preferred, where possible, such as ultrasound or MRI, which do not expose a pregnant woman to ionizing radiation.

Urgency of bladder CT

CT can be equally informative for both primary diagnosis and further monitoring of chronic bladder diseases over time. Very often, CT is indispensable for a doctor, especially in cases when there is a lack of basic laboratory research data for making a diagnosis.

With the appearance of blood in the urine, questionable impurities, or if its shade, or the smell has changed, it is necessary to urgently make a CT scan. With CT, you can diagnose such diseases: acute or chronic cystitis, pyelonephritis, or nephritis, you can also diagnose some venereal diseases, although this method is not indicated, because it is not very reliable in this case. Also, CT helps visualize infectious processes in this organ . This method is very effective for the diagnosis of glomerulonephritis and urolithiasis with all its complications.

CT and MRI - are two methods of research that are fundamentally similar, they allow specialists to obtain images of a very high degree of resolution of the organs and tissues that are scanned. These images will be further processed and recorded on digital media and on film. These methods enable specialists to study the results. Which of these methods is better - CT, or MRI - can only be told by the attending physician, depending on the clinical picture of the particular patient.

Watch the video: CT of the Ureter and Bladder: Pearls and Pitfalls Part 1 (December 2019).