Know All About the Different Imaging Techniques of the Urinary System!

Introduction:

The urinary system consists of organs designed to filter blood, form urine and expel the waste products from the body. Sometimes, the urinary system fails to function because of the problem present in one or more organs comprising it. In such cases, it becomes necessary to know the exact cause of the problem before proceeding with the treatment. Therefore, imaging tests are done to provide a clear picture of the urinary tract and the abnormalities present. It helps the doctor identify the cause of the problems and proceed with the treatment accordingly.

What Is Imaging?

In medical terminology, imaging is a procedure in which pictures of organs, blood vessels, and bones present in the body are obtained. It helps the doctors to look at the organs closely, examine them and diagnose the condition affecting them. The imaging techniques commonly used are listed below:

• X-rays.

• Computed tomography (CT) scans.

• Radionuclide scans.

• Ultrasound.

• Magnetic resonance imaging (MRI).

Why Is the Imaging of the Urinary System Required to Be Done?

Several diseases affect the functioning of the urinary system. The patient presents with several symptoms of each of these diseases. In addition, there can be multiple causes for a single sign. For example, the restricted urine flow can be due to stones, tumors, or prostate gland enlargement. It might become confusing for the doctor to figure out the exact cause of the condition. Therefore, the imaging tests are done to clear out the confusion and frame a proper treatment plan for the patient. The conditions in which the doctors recommend the imaging tests are listed below:

1. Urinary Incontinence: It is a condition in which the urine leaks out during coughing, sneezing, and lifting heavy objects or weights. It is commonly seen in women due to pregnancy, urinary tract infections, vaginal infections, and constipation. As the condition has several causes, imaging tests are of great help in recognizing the exact cause.

2. Urinary Tract Infections: It is the infection of the urinary system due to bacterial entry. The infection subsides after the appropriate antibiotics are taken, but imaging tests need to be done if the infections occur repeatedly.

3. Pain: The patient presents with pain in the lower back or abdomen in the case of kidney diseases, urinary tract obstruction, infections, and restricted urine flow. Imaging tests help to know the causes of pain and the condition affecting the urinary system.

4. Presence of Tumor: If a tumor is present in the urinary system or the abdominal region, it blocks the urine flow, and the patient faces severe problems.

5. Urinary Retention: Enlargement of the prostate gland in males and uterus in females, the presence of kidney stones, and tumors are some of the conditions that block the urine flow resulting in urinary retention. The cause of urinary retention can only be confirmed after imaging tests.

6. Urinary Frequency: Urinary frequency is the urge to pass urine repeatedly during the day and night. If the person urinates more than eight to ten times a day, the doctor recommends undergoing imaging tests to know about the problem.

7. Kidney Failure: When the kidneys fail to carry out their normal functions, it is known as kidney failure. Imaging tests help the doctor examine the kidneys and treat the condition accordingly.

8. Vesicoureteral Reflux: When there is a change in the path of urine, that is, it flows back to the ureters and the kidneys; the condition is known as vesicoureteral reflux. Imaging tests help to check if the child is urinating properly or not.

What Instructions Are to Be Followed Before the Imaging Tests?

The following things are usually done before the imaging tests:

• The patient is required to fill out a medical history form which consists of questions related to the following:

  • The symptoms of the condition, their time of onset, and frequency.

  • If the patient has suffered from any severe illness in the past and undergone surgery for the same.

  • Female patients need to mention if they are pregnant or expecting to be.

  • If the patient is on medications, drinks alcohol, or has any other habit, the doctor must be aware of it.

• Drink plenty of water two hours before the test to fill the urinary bladder.

• The patient should not eat anything twelve hours before the test.

• In the case of transrectal ultrasound, a laxative should be taken in the morning as it facilitates bowel movement.

• If the patient is suffering from constipation, fluid needs to be injected into the rectum to stimulate bowel movements (enema).

• The patient is required to inform the doctor if any metal device, pacemakers, metal plates, catheters, pins, or screws have recently been implanted in the body. These devices can interfere with the images, especially in the magnetic resonance imaging (MRI) technique.

• If the patient is anxious about the procedure, sedatives (drugs that calm a person) should be taken to carry out the procedure smoothly.

What Are the Different Types of Imaging Techniques?

The different types of imaging techniques are listed below:

1. X-rays (Conventional Radiology) - X-rays of the urinary system help detect the presence of a tumor or stone that obstructs urine flow. The patient presents with pain if the urine does not flow freely. Another cause of restricted urine flow in men is the enlargement of the prostate gland, which is located near the urethra. X-rays show the prostate gland clearly and help determine the size of the gland. The X-ray procedures that produce images of the urinary system are listed below:

   • Intravenous Pyelogram: It is an imaging test in which a particular type of material (contrast medium) is injected through the veins. The material reaches the kidneys, and the urine becomes visible on the X-ray. As a result, X-ray images of the kidneys, ureters, and urinary bladder are obtained, giving the doctor an idea if any blood is present in the urine or any other abnormality.
   • Voiding Cystourethrogram: A tube known as a catheter is inserted into the bladder through the urethra. The tube consists of a special type of liquid (contrast medium) filling the bladder. X-rays are taken from different angulations after the bladder is full. The catheter is then removed, and the X-rays are taken when the patient urinates. This procedure aims to detect problems in the flow of urine from the bladder. It also helps to check if there is any backflow of the urine to the ureters in the case of vesicoureteral reflux.

2. Ultrasound - It is a type of imaging test in which sound waves are sent to the body organs with the help of a device known as a transducer. The advantage of this procedure is that the person is not exposed to X-ray radiation. The doctor moves the transducer at different angles to obtain images of the internal organs. The two types of ultrasound most commonly done are listed below:

   • Transrectal Ultrasound: It is usually performed in males to examine the prostate gland. In this procedure, the doctor inserts the transducer into the rectum (the organ that holds stool). As a result, an image of the prostate gland is obtained on the computer screen that enables the doctor to check the problems.
   • Abdominal Ultrasound: In this procedure, a gel is applied to the abdomen of the patient so that the transducer moves freely. The images of the entire urinary system are obtained on the computer screen. It is also done in pregnant females to check the position and development of the baby in the womb.

3. Magnetic Resonance Imaging (MRI) - As the name suggests, this technique uses a combination of magnetic fields along with radio waves to produce images of the internal organs. The patient is laid on a table that slides into a tunnel-like device where the images are obtained. The images are taken at various angulations to create a detailed picture of the urinary system. The patient might hear some noises while the images are taken, but he must remain still during the procedure. The two types of magnetic resonance imaging (MRI) procedures are listed below:

   • Magnetic Resonance Angiogram: It is a type of magnetic resonance imaging (MRI) technique that provides a detailed view of the blood vessels supplying the kidneys (kidney arteries). The kidneys fail to function if the arteries supplying blood become narrow. The condition in which the arteries of the kidneys become narrow is known as renal artery stenosis. It can be very well detected on the magnetic resonance angiogram (MRA).
   • Magnetic Resonance Urography (MRU): It is the most commonly used test to detect blood in the urine (hematuria), kidney stones, and urinary system cancer.

4. Computed Tomography (CT) Scans - It produces three-dimensional (3D) images of the body organs using computer technology and X-rays. In this procedure, the patient is laid on a table, and a liquid (contrast medium) is injected into his body. The table slides into a tunnel-like device where the images are obtained. The presence of stones, tumors, and infections in the urinary system can be easily detected by computed tomography (CT) scans.

5. Radionuclide Scans - It is a diagnostic test that detects the problems of the urinary system with the help of radioactive chemicals. In this procedure, radioactive material is inserted through a tube into the urethra of the child. The images are then obtained with the help of a gamma camera as the liquid flows into the urinary tract.

What Happens After an Imaging Test?

The patient can go home and continue his daily activities after the test is over. If a catheter was placed at the time of the test, the patient might feel uncomfortable for a few hours. Drinking eight glasses of water, a warm bath, and placing a warm damp washcloth near the urethra provides relief to the patient. If the contrast medium was injected during the test, some patients might experience itching, headache, nausea, and vomiting. Kidney failure occurs if the patient has diabetes and other kidney diseases.

When Will the Test Reports Be Available?

The test reports of X-rays and ultrasounds will be available in a few days, and the patient can discuss the report with the doctor. The reports of computed tomography (CT) and magnetic resonance imaging (MRI) scans will be available later.

Conclusion:

Imaging the urinary system allows the doctor to figure out the exact cause of the condition and prepare a treatment plan accordingly. The patient should undergo the imaging tests recommended by the doctor without any delay. The condition will subside only if the factors responsible for it are known and treated. These tests do not interfere with the daily activities of the patient. If the imaging tests are done properly, and the patient follows all the instructions, rarely do any complications arise.