CT scans of the urinary tractPeshab ke nizam ke CT scan

Yeh test kya hai aur kyun kiya jata hai

CT (computed tomography) scanner aap ke gird ghoomte hue bohat si X-ray tasveerein leta hai, aur computer unhein jod kar aise tukday (slices) banata hai jin mein kidneys, unhein nikaasi dene wali nalian, bladder aur aas paas ke aaza nazar aate hain. Yeh aam X-ray ya ultrasound se kahin zyada tafseel dikhata hai.

Aap ka urologist CT scan is liye maang sakta hai ke pathri dhoondni ho, peshab mein khoon ya pehlu ke achanak dard ki wajah maloom karni ho, ultrasound mein nazar aane wali gaanth ko dekhna ho, operation ki tayyari karni ho, ya yeh dekhna ho ke cancer phail to nahi gaya. Mukhtalif sawalon ke liye mukhtalif CT scan hote hain, jin ki wazahat agay hai.

Kaun sa CT kis liye

“CT” lafz kai mukhtalif scans ke liye istemal hota hai. Scanner wahi hota hai, lekin tayyari, dye aur tasveerein lene ka tareeqa mukhtalif hota hai. Aap ka urologist batayega ke aap ko kaun sa chahiye.

Saada CT KUB (dye ke baghair)

KUB ka matlab hai kidneys, ureters aur bladder. Yeh scan dye ke baghair hota hai aur jaldi ho jata hai. Pathri dhoondne ka sab se behtar test yahi hai: yeh lagbhag har qism ki pathri, us ka saiz aur jagah dikhata hai, aur yeh bhi ke kya pathri peshab ka bahao rok kar kidney ko soojha rahi hai. Pehlu mein achanak shadeed dard ke liye aksar yehi pehla scan hota hai. Bohat se markaz pathri ke scan ke liye kam radiation wali setting istemal karte hain. Yeh kidney ki gaanth ya bladder ki andar ki parat ko tafseel se nahi dikhata.

CT urogram (dye ke saath)

CT urogram mein dye rag ke zariye di jati hai, aur mukhtalif waqton par tasveerein li jati hain jab dye kidneys se guzar kar ureters aur phir bladder mein jati hai. Is se poora peshab ka nizam nazar aata hai. Yeh peshab mein aise khoon ki wajah dhoondne ke liye hota hai jo aam tests se wazeh na hui ho, kidney ya ureter ki parat mein koi gaanth dekhne ke liye, aur rukawat ki wajah jaanne ke liye. Aap se pehle paani peene ko kaha ja sakta hai, aur kabhi intezar karke doosri baar tasveerein li jati hain.

Kidney ka triphasic CT (marhalon mein scan)

“Triphasic” ka matlab hai teen marhalay. Tasveerein dye se pehle, dye ke foran baad, aur kuch der baad li jati hain, taake dekha ja sake ke kidney ki gaanth dye ko kaise leti hai aur kaise nikaalti hai. Is se cyst jaisi be-zarar cheez aur us gaanth mein farq karne mein madad milti hai jis ka ilaaj chahiye, aur yeh kidney ki khoon ki nalion ko bhi dikhata hai jo operation se pehle kaam aata hai. Jab ultrasound mein gaanth nazar aaye to aam tor par yehi scan maanga jata hai (dekhein kidney cancer guide).

Staging ke liye seene ka CT

“Staging” ka matlab hai yeh dekhna ke cancer kitna phailaa hai. Kidney, bladder, prostate ya testicle ke cancer mein aksar seene ka CT kiya jata hai, jo aam tor par pait ke scan ke saath hota hai, taake phephron mein phailao dekha ja sake. Yeh aik hi scan hota hai, aksar usi visit mein. Phephray ke scan mein chhota sa nishan aksar cancer nahi hota, aur aap ka urologist batayega ke is ka kya matlab hai aur kya dobara scan karna hai.

Test se pehle

• Khaane peene ke baare mein apne hospital ki hidayat par amal karein. Kuch scans mein khaali pait rehna parta hai aur kuch mein nahi. Aap ka hospital ya urologist aap ko durust hidayaat dega.
• Scan se pehle team ko batayein agar aap hamila hain ya ho sakti hain, doodh pilati hain, kidney ki bimari ya sirf aik kidney hai, diabetes hai (diabetes ki kuch goliyon ko dye ke aas paas khaas khayal chahiye, is liye apne taur par kuch band na karein), ya dama hai ya kabhi dye se rad-e-amal ya shadeed allergy hui ho.
• Dye wale scan se pehle aksar kidney ka khoon ka test zaroori hota hai. Agar aap ke paas haal ka nateeja ho to saath layein (dekhein kidney ke kaam ke khoon ke tests ki guide, jald aa rahi hai).
• Aaramdeh kapray pehnein jin mein dhaat na ho, aur jis hissay ka scan ho wahan se zewar, belt aur dhaat ki cheezein utaar dein.
• Purane scans aur reports saath layein. Purane scan se muqabla bohat madadgar hota hai. Meherbani karke tasveerein (disc ya film par) bhi layein, sirf likhi hui report nahi.
• Poochh lein ke qeemat mein kya shamil hai, khaas tor par dye. Markaz ke hisaab se qeemat mukhtalif hoti hai.

Test ke dauran

Aap table par aam tor par peeth ke bal letay hain, aur woh aahista se ring ke andar jati hai. Scanner dono taraf se khula hota hai, band nali nahi, is liye jin logon ko tang jagah se ghabrahat hoti hai woh bhi aksar aaram se guzar jate hain. Ring aap ke gird ghoomti hai aur halki si awaaz aati hai. Tasveerein lete waqt aap se thori der saans rokne ko kaha ja sakta hai. Radiographer agle kamray se dekh rahe hote hain aur aap ki baat sun sakte hain aur aap se baat kar sakte hain.

Agar dye ki zaroorat ho to aap ke bazu ki rag mein aik patli nali (cannula) lagayi jati hai aur scan ke dauran dye us ke zariye di jati hai. Bohat se log garmi ki lehar, moonh mein dhaat jaisa zaiqa, ya peshab aane ka ehsaas mehsoos karte hain. Yeh aam baat hai, jaldi guzar jati hai, aur aap ka peshab nikalta nahi. Scan khud mukhtasar hota hai, lekin tayyari ki wajah se poori visit mein zyada waqt lagta hai.

Test ke baad

• Zyadatar log foran ghar chalay jate hain aur aam tarah khaa pee sakte hain aur apna kaam kar sakte hain.
• Agar dye li ho to aam tarah paani peeyein taake kidneys use nikaal dein, siwaye is ke ke doctor ne paani kam karne ko kaha ho.
• Dye ke baad rad-e-amal ke khadshay mein aap se thori der rukne ko kaha ja sakta hai.
• Kabhi baad mein daane, khujli ya halka bimar hone ka ehsaas ho sakta hai. Aisa ho to apne doctor ko batayein.
• Agar jis bazu mein dye lagi wahan dard, surkhi ya soojan ho to team ko batayein.

Dye (contrast) aur aap ki kidneys

Dye kidneys ke zariye jism se nikalti hai. Zyadatar logon ke liye yeh masla nahi hota. Jin ki kidneys pehle se kam kaam karti hon, jin ke jism mein paani ki kami ho, jinhein diabetes ho, ya jo umar rasida hon, un mein dye se kidneys par bojh ka khatra zyada hota hai. Isi liye team pehle khoon ka test dekh sakti hai, yaqeeni bana sakti hai ke aap mein paani ki kami na ho, ya doosra scan chun sakti hai. Isi liye aap ko kidney ki bimari ke baare mein batana chahiye aur apna aakhri kidney ka khoon ka nateeja saath lana chahiye. Agar aap ka doctor faisla kare ke scan zaroori hai, to masla dhoondne ka fayda aam tor par khatray se zyada hota hai.

Mumkina khatrat

• Radiation. CT mein X-ray istemal hoti hai. Miqdar thori hoti hai, aur doctor CT tabhi maangte hain jab maloomat ki zaroorat ho. Agar aap hamila hain ya ho sakti hain to team ko batayein. Bachon ke liye miqdar un ke saiz ke mutabiq rakhi jati hai.
• Dye se rad-e-amal. Halke rad-e-amal jaise khujli, daane ya matli kam hote hain. Shadeed allergy bohat kam hoti hai, aur team us ka ilaaj karne ke liye tayyar hoti hai.
• Dye se kidney par bojh. Upar dekhein. Yeh khaas tor par us waqt masla hai jab kidneys pehle se kamzor hon.
• Sui lagane ki jagah. Neel parna aam hai. Dye ka khaal ke neeche reh jana bohat kam hota hai.

Aap ke nateeje

Radiologist report likhta hai, aur aap ka urologist report ko tasveeron aur aap ki alamaat ke saath parhta hai. Meherbani karke report aur tasveerein dono apne urologist ke paas layein. Sirf report se apna nateeja samajhna gumrah kar sakta hai, kyunke reports mein kabhi aisi cheezein likhi hoti hain jo dekhne mein fikar ki lagti hain lekin be-zarar hoti hain.

Report mein aap yeh alfaaz dekh sakte hain:

• Calculus ka matlab pathri hai.
• Hydronephrosis ka matlab kidney ki soojan hai, jo aksar rukawat se hoti hai.
• Cyst pani se bhari thaili hai. Saada cysts aam hain aur aksar be-zarar hote hain.
• Lesion ka matlab aisi jagah hai jo alag nazar aati hai. Is ka matlab hamesha cancer nahi hota.
• Incidental finding ka matlab aisi cheez hai jo itefaq se nazar aayi aur aap ki alamaat se mutaliq nahi. Yeh aksar be-zarar hoti hai, lekin aap ke urologist ko isay dekhna chahiye.

Har scan aur report aik hi file mein rakhein. Yeh agli visit par, aur kisi doosray hospital mein bhi bohat kaam aate hain.

Aam sawalaat

What it is and why it is done

A CT (computed tomography) scanner takes many X-ray pictures as it turns around you, and a computer joins them into slices that show the kidneys, the tubes that drain them, the bladder and the organs around them. It shows much more detail than an ordinary X-ray or an ultrasound.

Your urologist may ask for a CT scan to find a stone, to find the reason for blood in the urine or for sudden pain in the side, to look at a lump seen on an ultrasound, to plan an operation, or to see whether a cancer has spread. Different questions need different CT scans, which are explained next.

Which CT is which

The word “CT” covers several different scans. The scanner is the same, but the preparation, the dye and the way the pictures are taken are different. Your urologist will tell you which one you need.

Plain CT KUB (no dye)

KUB stands for kidneys, ureters and bladder. This scan is done without dye and is quick. It is the best test for finding stones: it shows almost all kinds of stone, how big they are and where they sit, and whether a stone is blocking the flow of urine and swelling the kidney. It is often the first scan for sudden severe pain in the side. Many centres use a low-dose setting for stone scans. It does not show kidney lumps or the lining of the bladder in detail.

CT urogram (with dye)

A CT urogram uses dye given through a vein, with pictures taken at different times as the dye passes through the kidneys, down the ureters and into the bladder. It outlines the whole urinary tract. It is used to look for the cause of blood in the urine that simple tests have not explained, to look for growths in the kidney or in the lining of the ureter, and to find out what is causing a blockage. You may be asked to drink water first, and sometimes to wait and have a second set of pictures.

Renal triphasic CT (kidney scan in phases)

“Triphasic” means three phases. Pictures are taken before the dye, soon after the dye, and later, so that we can see how a kidney lump takes up the dye and clears it. This helps to tell a harmless cyst from a growth that needs treatment, and it also shows the kidney’s blood vessels, which is useful before an operation. It is the scan usually asked for when a lump has been seen on an ultrasound (see the kidney cancer guide).

Chest CT for staging

“Staging” means finding out how far a cancer has reached. For cancers of the kidney, bladder, prostate or testicle, a CT of the chest is often done, usually together with a scan of the tummy, to check the lungs for spread. This is one scan, often in the same visit. A small spot on a lung scan is often not cancer, and your urologist will explain what it means and whether a repeat scan is needed.

Before the test

• Follow your hospital’s instructions on eating and drinking. Some scans need fasting and some do not. Your hospital or urologist will give you exact instructions.
• Tell the team before the scan if you are or might be pregnant, if you are breastfeeding, if you have kidney disease or only one kidney, if you have diabetes (some diabetes tablets need special care around dye, so please do not stop anything on your own), or if you have asthma or have ever reacted to dye or had a strong allergy.
• A kidney blood test is often needed before a scan with dye. Bring your most recent result if you have one (see the kidney function blood tests guide).
• Wear comfortable clothes without metal, and take off jewellery, belts and anything metal in the area being scanned.
• Bring your old scans and reports. Comparing with an earlier scan is very helpful. Please bring the pictures (on a disc, or films) as well as the written report.
• Ask what the price includes, especially the dye. Prices differ between centres.

During the test

You lie on a table, usually on your back, and it slides slowly into the ring. The scanner is open at both ends, not a closed tube, so most people who dislike tight spaces manage well. The ring turns around you with a whirring sound. You may be asked to hold your breath for a short time while pictures are taken, and the radiographer watches from the next room and can hear you and speak to you.

If dye is needed, a thin tube (cannula) is placed in a vein in your arm and the dye is given through it during the scan. Many people feel a warm flush, a metallic taste or a feeling of needing to pass urine. This is normal, it passes quickly, and you will not actually pass urine. The scan itself is short, although the whole visit takes longer because of the preparation.

After the test

• Most people go home straight away and can eat, drink and carry on as usual.
• If you had dye, drink fluids as usual to help your kidneys clear it, unless your doctor has told you to limit fluids.
• You may be asked to wait for a short time after the dye in case of a reaction.
• A rash, itching or a slight feeling of being unwell can sometimes appear later. Tell your doctor if this happens.
• Tell the team if the arm where the dye went in becomes painful, red or swollen.

Contrast dye and your kidneys

The dye leaves the body through the kidneys. For most people this is not a problem. People whose kidneys already work less well, who are dehydrated, who have diabetes, or who are older have a higher chance of the dye straining the kidneys. That is why the team may check a blood test first, make sure you are well hydrated, or choose a different scan. This is also why you should tell the team about kidney disease and bring your last kidney blood result. If your doctor decides the scan is needed, the benefit of finding the problem usually outweighs the risk.

Possible risks

• Radiation. CT uses X-rays. The dose is small, and doctors only ask for a CT when the information is needed. Tell the team if you are or might be pregnant. Children get a dose adjusted to their size.
• Reaction to the dye. Mild reactions such as itching, a rash or feeling sick are less common. A serious allergic reaction is rare, and the team is trained and equipped to treat it.
• Kidney strain from the dye. See above. This is mainly a concern if your kidneys are already weak.
• The injection site. Bruising is common. Leakage of dye under the skin is rare.

Your results

A radiologist writes a report, and your urologist reads it together with the pictures and your symptoms. Please take both the report and the pictures to your urologist. Judging your result from the report alone can be misleading, because reports sometimes mention things that look worrying but are harmless.

Words you may see on a report:

• Calculus means a stone.
• Hydronephrosis means a swollen kidney, often from a blockage.
• Cyst means a fluid-filled sac. Simple cysts are common and usually harmless.
• Lesion means an area that looks different. It does not always mean cancer.
• Incidental finding means something found by chance that is unrelated to your symptoms. It is often harmless, but your urologist should look at it.

Keep every scan and report in one folder. They are very useful at your next visit, and at a different hospital.

Common questions