MSCT of the kidneys is a multi-slice (layered) examination of this paired organ, which allows to obtain the most detailed picture of the state of the kidneys. In modern clinical practice, MSCT is considered one of the most informative methods for diagnosing various pathologies of the kidneys, especially urolithiasis.
Indications for kidney MSCT are quite extensive. Among them:
- Suspected tumor process, the need to establish a tumor stage,
- Diagnosis of renal cell cancer, lymphoma and nephroblastoma,
- Kidney bruises
- Occlusion of the renal vessels
- Diagnosis of ureteral tumors,
- Detection of kidney stones
- Establishing the cause of renal colic.
The main contraindication to the study – the presence of pregnancy at any time. In this case, it is best to resort to alternative methods – ultrasound (best in the first trimester) and MRI (2nd and 3rd trimesters).
All other contraindications to MSCT of the kidneys are relative. These include:
- Age less than 14 years (it is not recommended to conduct MSCT unless absolutely necessary)
- Patient weight over 120 kg (due to the limited capabilities of tomographs),
- Severe diabetes mellitus,
- The overall serious condition of the patient, the inability to maintain immobility during the procedure (for example, with a strong pain syndrome).
If the procedure is carried out by a nursing mother and contrast is used during the examination, the break in feeding the baby after the examination should be at least 24 9a, or even better, 48) hours, until the contrast material is completely removed from the body. In addition, kidney MSCT with contrast is not permitted for patients who are allergic to iodine.
Special training MSCT of the kidneys does not require, however, 2-3 hours before the procedure, it is necessary to refuse to eat, and especially from carbonated drinks, if you plan to carry out the procedure with contrast.
Before the procedure, the patient should remove all metal jewelry, since they can cause distortions in the pictures. It is recommended that you wear comfortable loose clothing or a hospital gown during the MSCT procedure. The patient is placed on a special table, which is placed in the tomograph ring. During the procedure, the diagnostician is in the next room, managing the procedure remotely. If necessary, the patient has the opportunity to contact the doctor using two-way communication systems. The doctor completely controls the course of the examination, sees and hears the patient and is able to respond quickly to all complaints.
During the procedure, the patient must remain completely immobile, otherwise the result of the examination may be inaccurate and unreliable. At the request of the doctor, the patient may need to hold his breath for a few seconds.
The result of the study
According to the results of the examination, the doctor receives a series of images, on the basis of which is a medical report. Pictures with the conclusion are issued to the patient – in the form of printouts or recorded on a CD. On average, the preparation of the conclusion takes from several hours to 2-3 days. If necessary, the diagnostician also sends the patient for further consultation to the relevant specialist. Typically, expert advice, as well as recording the results on a CD, are charged separately.
Use of contrast
MSCT of the kidney with contrasting is performed to detect tumors, diagnose vascular blockage and detect kidney stones. Contrast – a special solution that is administered to the patient intravenously immediately before the procedure. Usually iodine or gadolinium acts as a contrast (in the latter case, gadolinium is introduced as part of a chelate compound, which contains an extremely small amount of this element). The information content of iodine and gadolinium are approximately the same. Contrast substances are excreted in the urine during the day. However, in severe renal failure, the implementation of MSCT with contrast is not recommended, since the outflow of contrast in this case is disturbed.
When carrying out the procedure with contrast, a series of pictures without contrast is first performed, and then with a contrast, to compare the results.
Contrast is introduced using an automatic injector, in some cases it can be administered orally.
MSCT is one of the most accurate diagnostic methods applied to patients with renal colic. In addition, the MSCT process reveals more kidney stones than using any other method, regardless of how much calcium is contained in the stones. In addition, the procedure makes it possible to identify signs of acute blockage of blood vessels, assess the extent of kidney damage during injury and infection.
MSCT is an invaluable method for planning kidney surgery.
MSCT of the kidneys is a fairly safe procedure, however, during the examination process, the patient is still affected by x-rays. The dose of this radiation is small, but conducting MSCT is too often not recommended – with each subsequent examination increases the risk of developing tumor diseases.
When the procedure with contrasting may be observed discomfort – a metallic taste in the mouth, a sensation of heat in the body, an allergic reaction (mild rash and swelling on the lips). More significant side effects (difficulty breathing, a sharp drop in pressure, renal failure) are practically not observed, and in the conditions of a modern clinic, doctors have everything necessary for stopping such manifestations.
Pregnant women with MSCT increase the risk of harm to the fetus.
Contrasting procedures are not recommended in patients with diabetes, as some drugs in combination with contrast can lead to side effects, including renal failure.
- MRI (magnetic resonance imaging) of the kidneys allows the doctor to analyze the condition of the kidneys and ureters, to detect the pathology at an early stage. MRI does not use X-rays and therefore is a completely harmless procedure.
- Ultrasound is one of the uninformative, but inexpensive and well-tolerated diagnostic methods by patients. Ultrasound does not require the introduction of contrast agents and is quite reliable in detecting stones, cysts, tumors and irregularities in the location of the kidneys. Ultrasound does not cause any side effects, the patient can be repeatedly subjected to this method, so ultrasound is considered a valuable technique if it is necessary to dynamically assess the patient’s condition.
- Computed tomography (CT) is widely used in the diagnosis of tumors, kidney injuries, congenital anomalies, in the detection of polycystic cytosis, before a biopsy of the kidneys and after the removal of the kidney, as well as for the detection of hematomas, before removing the kidney stone and after kidney transplantation.
In modern clinical practice, MSCT and MRI are considered approximately equivalent in diagnostic capabilities. Ultrasound is used more as a primary diagnostic method.
MSCT examination has an advantage over other methods in case of the need to detect stones and tumors. MRI is preferable in the presence of cysts and in the diagnosis of patients with impaired renal excretory function.
The price of MSCT of the kidneys in Moscow starts from 4000 rubles. A kidney CT scan will cost approximately 3,500 rubles, an ultrasound scan will cost about 1,000 rubles, and MRI prices start at 5,000 rubles, with the contrasting procedure costing several thousand more.