CT of kidneys( computed tomography) with contrast medium and without: how is it conducted, to whom is contraindicated and how to prepare

Any diseases of internal organs in our time can be diagnosed quickly and painlessly thanks to the method of examination, such as computed tomography. In particular, the technique will help to identify all the pathologies of the kidneys and adrenal glands, which will allow us to appoint the right treatment.

CT of kidneys and adrenal glands - what's the procedure?

Many patients are interested in what is the difference between inexpensive ultrasound of internal organs from a modern, but much less economical CT scan? The fact is that computer tomography allows you to make a large number of images in different projections and sections. Next, the pictures will be processed using a special program, and, ultimately, the doctor will have a complete picture of the condition of the internal organ.

According to CT images, visualization of various pathologies is much more accurate than in ultrasound, which can be very important for some "doubtful" diseases. To obtain an even more accurate picture of the disease, CT with contrast is performed, as well as the latest techniques - multislice( multislice) CT with a huge number of sections and images - every 1-4 mm of the thickness of the organ.

Indications

Computer tomography of the kidneys, adrenal glands is often prescribed to clarify an already available diagnosis. But in recent years, because of the increased availability of CT, it is also recommended as the primary method of research in order to avoid delaying the time for less effective methods of examination. Also, CT is used to analyze the effectiveness of treatment for renal pathology.

Indications for computed tomography without contrast:

• Suspicion of kidney stones;
• Injury of back, abdomen;
• Congenital malformations of the kidney;
• Infectious, inflammatory process, including chronic;
• Regular renal colic;
• Kidney abscess;
• Polycystic kidney disease;
• Symptoms of cancer;
• Refinement of the diagnosis of a benign tumor;
• Assessment of the condition of the kidney bed after kidney removal;
• Deviations in tests for adrenal hormones.

CT is also prescribed before surgery on the kidneys, before and after kidney transplant, before organ biopsy. People with an irregular structure of organs such a study is shown regularly to assess the dynamics of the health of the urinary system.

The patient sometimes needs a CT scan with intravenous contrast. Contrast is a special substance based on iodine, which stains internal structures and allows them to be better visualized.

Since the contrast is best collected in pathological areas( they are more fully supplied with blood), the indications for this type of CT will be as follows:

• Differentiation of a benign tumor from a malignant one;
• Clarification of the diagnosis of a cancerous tumor by species, types;
• Specification of the extent of the cancer process;
• Search for thrombi in renal vessels;
• Visualization of the state of vessels, anomalies of their structure, extensions and constrictions;
• Determination of the glomerular filtration rate for diagnosis of renal failure.

Diagnostic capabilities of

Computed tomography combines the technologies of radiation diagnosis and the latest computer programs. The result of its implementation is the obtaining of layered images of an organ with a number of slices. Answering the question about what CT shows, it is worth saying that this procedure will give a complete picture of the state of the kidneys, adrenals, and retroperitoneal space. The examination will help the doctor not only to establish an accurate diagnosis, but also, often, to find the cause of the pathology.

Most often CT is used to search for kidney stones, analyze their size, type, quantity.

Also after the CT scan, you can find such problems:

1. Vascular disorders - thromboses, atherosclerosis, vasculitis.
2. Anomalies of organ development.
3. Hydronephrosis.
4. Foreign body in the kidney.
5. Neoplasms( cysts, adenomas, oncology, etc.).
6. Hyperfunction of the adrenal glands.
7. Tumors of the adrenal glands.
8. The degree of increase, the nature of changes in the lymph nodes.

Contraindications

The main contraindication is pregnancy. The dose of radiation during the survey is minimal, but still dangerous for the fetus.

Computed tomography is also contraindicated when:

• Severe pain syndrome;
• Hyperkinesis( involuntary movements);
• There are mental abnormalities.

Children under 3 years old receive CT only in extreme cases, it is preferable to replace it with an MRI.Difficulties can arise with the implementation of research in very complete people because of the impossibility of being placed in the tunnel of the apparatus. You can not do CT with contrast during lactation, but the procedure is possible if the mother refuses breastfeeding for 2-3 days. The introduction of contrast is prohibited when allergy to the active substance of the drug, with severe renal failure due to excretion by the kidneys and the risk of aggravation of the disease, with severe diabetes mellitus. With the use of contrast, there is a danger of weighting the course of thyroid and heart diseases.

Preparation of

No routine preparation is required to perform routine computed tomography.

But, if CT is planned with a contrast agent, you need to carefully prepare:

1. For 2 days before the procedure, give up products that increase gas formation, from coffee and alcohol. If necessary, take Espumizane 2-3 days before the test.
2. Do not eat 8 hours before the test.
3. Do not drink for 2-3 hours before doing CT.

How is the procedure performed?

Nowadays almost all CT devices have been replaced with spiral ones, in which the scanning sensors are located in a rotating tube. The main difference between spiral and multispiral computed tomography is that the sensors are arranged in several rows, and the scan continues continuously. For the patient, the difference will be only in the time of the procedure: with MSCT it will be only 10-15 minutes, with spiral CT done - up to 20-40 minutes.

If the use of contrast is required, then it is injected before scanning or after placing the patient on the working surface of the table. Usually for computed tomography of the kidneys and adrenals, drugs Hypac, Omnipak, Ultratwist are used, which are administered intravenously, and sometimes - oral preparations of iodine of nonionic type. They are completely safe for the human body, and the active substance will leave in a few hours with urine.

Preparation of a patient for CT with or without contrast, is that he is laid on the table, fixing his hands and feet with rivets, place it in the tunnel of the scanner. On the ears wear tight headphones, because the device is quite noisy. In one hand is usually given a device with a button, pressing which a person can call a specialist( in extreme, unforeseen cases).In the presence of claustrophobia, a person can be given sedatives beforehand. Young children should be on the survey with a loved one, or CTs make babies under anesthesia.

Special instructions in people with a tendency to an allergic reaction is mandatory to perform a sample with contrast by applying it to the skin. When there is an allergic rash, itching, burning, doing CT with contrast is prohibited. Any patient within 2 hours after drug administration may experience a metallic taste in the mouth, mild nausea, which is normal.
On the video about how to conduct the CT procedure:

Advantages of

Advantages of the technique are unquestionable:

• Kidneys and adrenal glands are viewed in full, in detail.
• The resolution of the devices is high and will not let even hidden pathologies pass.
• It is possible to review the condition of the entire retroperitoneal space in a comprehensive manner.

Radiation load during the examination is very small, it can not harm a person. But, of course, it is often not necessary to do CT, so if there is a short period of time between studies, it is better to replace CT with MRT.

Decoding of the results

The radiologist performs the decoding, but the final diagnosis is made by the attending physician.

Below are the data when the kidney state is normal:

• The density of the parenchyma is higher than that of the liver tissue and lower than that of the bone structures.
• Location of the kidneys unchanged.
• Dimensions, the shape of the organs corresponds to the age norm.
• Pathological zones, abnormalities, blood flow disorders are absent.

If the patient has various pathologies, then the following data can be obtained:

• There are areas of different density, of a different shade, with clear or blurred contours( benign and malignant tumors).
• There are zones with low density, with liquid contents( cysts of kidneys, adrenals).
• The concrements are visualized, etc.

The cost of CT of kidney and adrenal gland is from 4 to 8 thousand rubles, depending on the clinic and the application of contrast.