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CT scan of the bladder is one of the best ways to get detailed information about diseases, pathologies and structure of the organ.
This procedure is based on 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, surgeon, oncologist can refer you for a CT scan of the bladder.
CT of one bladder is performed quite rarely, much more often doctors prescribe a comprehensive examination of the urinary system, which includes CT of the kidneys, ureters, and prostate.
Pathologies of the bladder constitute 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 the standard diagnostic approach for evaluating many conditions where other methods may be of little help.
Cystoscopy has its drawbacks, including its high cost and invasiveness, which can lead to iatrogenic bladder injury and urinary sepsis, so CT is usually recommended as a non-invasive radiological diagnostic method for evaluating the bladder, but CT also has some disadvantages, for example, this the study has low sensitivity to the detection of small lesions.
For CT to depict 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 that is accompanied by symptoms such as nausea, vomiting, diarrhea, or urinary problems 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, gallstones 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 the organ and to detect anatomical abnormalities. CT provides an opportunity to obtain detailed and complete information about the bladder. This study visualizes all its walls and cavities, makes it possible to see the presence of neoplasms in this organ, and accurately assess the degree of damage to the organ.
Your doctor may order a CT scan of the bladder if you have the following features, symptoms, and dysfunction:
- if there is a burning sensation or acute pain during urination;
- urinary incontinence, if there is no known cause (for example, pregnancy);
- periodic appearance of shooting pains in the pelvic area;
- with the appearance of a symptom of nocturia (frequent urination at night);
- when the consistency or smell of urine changes;
- the presence of impurities in the urine;
- with suspicion of a neoplasm in the bladder.
An absolute indication for computed tomography of the bladder is its injury, as well as the presence of strictures.
Preparing for the procedure
The patient may need to remove certain items of clothing, accessories, jewelry, and metals before undergoing a CT scan, as they are often opaque and can interfere with the scanning process and the quality of the results. On the day of the examination, the patient should not eat anything, the day before the procedure, the patient is recommended to eat light food that will not lead to gas formation. CT is performed with a full bladder.
CT may be contraindicated in children and pregnant women due to the fact that radiation exposure is used during the examination.
There are several more contraindications for CT of the bladder with contrast. These include severe renal failure and an allergy to the contrast agent. In some cases, it may be difficult to examine overweight patients, since some devices are limited in their allowable weight.
What happens during the procedure
Any drug names taken by the patient in the previous days should be reported to the doctor to ensure that they are not contraindicated for the procedure. In addition, the possibility of pregnancy should be excluded in order to avoid the negative impact on the developing child of the teratogenic effects of radiation.
The patient is placed in the supine position in the CT scanner and must remain still during the procedure. The advantage of lying down is that it allows a better assessment of urinary stones at the vesicoureteral junction. The results of the study are evaluated by the radiologist, who then creates a report and sends it to the doctor, who is responsible for treating the patient.
Risks of CT
Exposure to ionizing radiation is the main risk factor associated with a CT scan of the bladder. This can cause damage to biological tissues and increase the tendency, albeit slightly, to develop cancer in the future.
This risk is cumulative over a lifetime and represents a small price to pay for the ability to diagnose acute conditions that can be life-threatening and require urgent imaging. During pregnancy, alternative imaging modalities are preferred where possible, such as ultrasound or MRI, which do not expose the pregnant woman to ionizing radiation.
Relevance of CT of the bladder
CT can be equally informative both for primary diagnosis and for further monitoring of chronic bladder diseases in dynamics. Very often, CT is indispensable for the doctor, especially in cases where there is not enough data from basic laboratory tests to make a diagnosis.
If there is blood in the urine, doubtful impurities, or if its shade or smell has changed, an urgent CT scan should be done.
CT and MRI are two research methods that are fundamentally similar, they allow specialists to obtain images of a very high degree of resolution of organs and tissues. These images will be further processed and recorded on digital media and on film. These methods provide an opportunity for specialists to study the results. Which of these methods is better – CT or MRI – can only be said by the attending physician, depending on the clinical picture of a particular patient.