What is a CT Urogram (CAT Scan)?

 

What is a CT Scan? October 23, 2020

Let's back up. Some people don't really understand what a CT is. 

A CT scan or CT or CAT scan is short for computed tomography scan. It allows doctors to see inside your body using thousands of x-rays, that are put into a computer program. It creates 2D complex pictures of your organs, bones, and other tissues. It shows a lot more detail than a regular x-ray. 

You can get a CT scan on any part of your body. The procedure doesn't take very long. If there is no contrast, then you don't need an IV. If there is contrast then a large IV will be started in the bend of your arm.

There is a large machine with an exam table that goes through the middle of the machine. You will be placed on the exam table. They will tell you how to place your body, and when to hold still and when to breath. It's a very quick test. As the test is being done, the exam table will move automatically. It's all programed into the computer to time everything just perfectly. 

It's super simple, and a very fast test. Once you enter the CT area, you will be done in less than 10-15 minutes.

What is a CT Urogram With Contrast?

A CT Urogram is a cat scan of the kidneys, ureters, bladder, and urethra – with IV contrast. 90% of all bladder cancers are in the urothelial layer of the bladder. People with bladder cancer may also
have tumors in these places. It is important that these other areas are also checked for tumors. This is often checked with a yearly or once every two years CT scan.

A CT of the kidney's and bladder is a CT without IV contrast.  

A CT urogram is different than just a regular CT in that they use a special dye (IV iodine contrast medium) to look at the urinary system. The contract medium helps the urinary system show more clearly on the test. It helps the urologist and radiologist (specialist that reads CT's) to see any abnormalities and structures of the urinary system, that they might regularly not be able to see without the contrast. 

So when you see the words "with contrast" it means you will get a large IV in the bend of your arm, and during the test, the contrast will be pushed very quickly into your vein, and will quickly spread throughout your body including your kidneys, ureters and bladder. Sometimes this contrast will make you feel very warm. The warmth will quickly spread to your groin area and sometimes will make you think you have wet your pants. But don't worry - you haven't! It's just the contrast going through your system very quickly.

Often when they order a CT with contrast, they will order one without contrast as well. It is so they can compare the two images. The one with contrast and the one without.

Without contrast is just that - a scan without any IV contrast. It means you will move through the scanner without using the IV contrast.  

Your urologist will probably order a CT to rule out cancer, and if there is cancer, it will also be to see if it has invaded other areas outside your urinary system.

CT Urogram Comes Back Clear

My CT Urogram came back back clear - showing no cancer. Everything looked healthy (including the bladder wall!), except they found a 3mm kidney stone and a 2mm kidney stone. I still haven’t passed them. Ugh. 😬

Thing is... I did have cancer. It was small enough that the CT didn't catch it. This is why a cystoscopy is so important. It's the gold standard in ruling out bladder cancer. You really have to look inside the bladder to see what is going on.

Before I went back to see the urologist, I was able to read the results of the CT from my patient portal. In case it was cancer, I wanted to be prepared to hear that before I went to see the doctor.

I was relieved everything was clear. I truly didn't think that it was cancer. Thus, it was all all the more of a surprise when we later found the cancer during my first cystoscopy.