Last Updated on November 25, 2025 by

We use CT urography, a top-notch diagnostic tool, to see the urinary tract clearly. It’s key for spotting kidney stones, tumors, and other issues in the urinary system.

CT urography has several stages, each showing a different view of the urinary system. The main stages are non-contrast, nephrographic, and excretory phases. These stages help doctors check patients with bleeding in the urine and other urinary problems.

Knowing the stages of a CT urogram helps us diagnose and treat urinary tract issues better. This leads to better care for our patients.

Key Takeaways

• CT urography is a multiphase CT examination for imaging the kidneys, ureters, and bladder.
• The three main stages of a CT urogram are non-contrast, nephrographic, and excretory phases.
• CT urography is used to evaluate patients with hematuria and other urinary tract issues.
• This diagnostic tool is key for finding kidney stones, tumors, and other urinary tract problems.
• Understanding the different stages of a CT urogram improves the diagnosis and management of urinary tract conditions.

Understanding CT Urogram: Definition and Purpose

A CT urogram is a special CT scan that shows the kidneys, ureters, and bladder in detail. It’s key for spotting and treating many urinary tract problems.

What is a CT urogram and how it works

CT urography is a CT scan that focuses on the kidneys, ureters, and bladder. It uses contrast to show these parts clearly. This helps doctors find and treat issues more easily.

The scan has three parts: a non-contrast phase, a nephrographic phase, and an excretory phase. Each part gives different information about the urinary system. The contrast makes the system’s structures stand out, helping doctors spot problems.

Common medical conditions diagnosed with CT urography

CT urography is great for people with blood in their urine and those at risk for cancer. It’s used to find:

• Kidney stones and calcifications
• Structural issues in the urinary tract
• Renal masses and tumors
• Urothelial tumors and other problems in the collecting system and ureters

Advantages over traditional imaging techniques

CT urography beats old imaging methods in many ways. It checks the whole urinary tract at once, cutting down on the need for many tests. The clear images help doctors diagnose and plan treatments better.

The benefits of CT urography include:

1. Better view of the urinary tract
2. Spotting urinary tract issues more easily
3. Checking everything in one go

Knowing what CT urography is and why it’s used helps us see its value in today’s urology. It’s a big help for those needing detailed urinary tract scans.

The Three Main Stages of a CT Urogram Procedure

A CT urogram is a detailed imaging test with three stages. It helps see the urinary system clearly. This is key for finding and treating urinary problems.

Overview of the Complete Imaging Process

The CT urogram has three main parts: non-contrast, nephrographic, and excretory phases. Each part shows different details of the urinary tract. Together, they give a full view.

First, we do a non-contrast scan to see the urinary tract’s basic shape. Then, we add contrast material to make the structures clearer in the next scans.

Patient Preparation and Contrast Administration

Before starting, patients need to be empty-stomached and well-hydrated. The contrast material is given through an IV. Most patients find it comfortable, with some feeling warmth or a metallic taste.

The contrast material is key for the CT urogram. It makes the urinary tract easier to see, helping spot any issues.

Importance of Timing Between Phases

The timing between each CT urogram phase is very important. The nephrographic phase captures the contrast in the kidneys. The excretory phase shows the contrast moving through the urinary system.

Getting the timing right is essential for clear images. Our skilled radiologists plan each phase carefully to get the best results.

In summary, the CT urogram procedure is a detailed tool for diagnosing urinary issues. Knowing about its stages and timing helps patients understand its importance.

The Non-Contrast Phase: First Stage of CT Urogram

We begin the CT urogram with the non-contrast phase. This is a key step for accurate diagnosis. It gives us a baseline image of the urinary tract, which is vital for the next steps.

Baseline Imaging: Purpose and Technical Aspects

The non-contrast phase captures detailed images of the kidneys, ureters, and bladder without contrast. It’s essential for spotting any issues later on.

Technical aspects include using low-dose CT scans to reduce radiation. The images are made in thin slices for a detailed look.

Detecting Kidney Stones and Calcifications

The non-contrast phase mainly looks for kidney stones and calcifications. These hard deposits can cause a lot of pain and serious problems if not found early.

• Kidney stones are found by their density and where they are in the urinary tract.
• Calcifications show up as high-density areas on CT images.
• This phase can spot kidney stones very accurately, up to 80% in some cases (PMC10204399).

Identifying Structural Abnormalities

The non-contrast phase also looks for structural abnormalities in the urinary tract. This includes things like congenital issues, cysts, or other masses that might not be obvious at first.

The detailed images from this phase help us see the size, shape, and position of the kidneys and other parts of the urinary tract. This info is key for making a diagnosis and planning treatment.

The Nephrographic Phase: Enhanced Visualization

We use the nephrographic phase to see the renal parenchyma in detail. This helps us diagnose many renal conditions. It’s a key part of a CT urogram, happening 80-120 seconds after contrast is given.

Timing and Contrast Distribution

The timing of the nephrographic phase is key. It lets the contrast spread evenly in the renal parenchyma. At this time, the contrast material spreads well, showing the renal cortex and medulla clearly. This even spread is vital for spotting small issues in the renal parenchyma.

Enhancement Patterns in Renal Parenchyma

The nephrographic phase gives us important information on how the renal parenchyma enhances. Normal renal tissue usually enhances evenly, but problems might show different enhancement levels or none at all. By looking at these patterns, we can find renal masses and tumors.

Detection Capabilities for Renal Masses and Tumors

The nephrographic phase is very good at finding renal masses and tumors, with sensitivity rates over 90%. This is because of the even contrast spread and the ability to see small differences in enhancement. Using the nephrographic phase helps us diagnose better and treat patients faster.

The Excretory Phase: Complete Urinary Tract Assessment

The excretory phase is key in a CT urogram. It gives a full look at the urinary tract. This happens 5-15 minutes after the contrast is given, showing the collecting system and ureters clearly.

Optimal Timing Window

Getting the timing right is vital for a good diagnosis. Optimal timing means the contrast has filled the urinary tract well. This helps spot any problems.

We take pictures between 5 to 15 minutes after the contrast is given. The exact time can change based on the patient and the protocol.

Visualization of the Collecting System and Ureters

In the excretory phase, the contrast shows the collecting system and ureters. This helps find structural issues and tumors. Detailed visualization is key for spotting urothelial tumors and strictures.

• Visualization of the renal pelvis and calyces
• Assessment of the ureters for abnormalities
• Detection of tumors and other lesions

Identification of Urothelial Tumors and Abnormalities

The excretory phase is great for finding urothelial tumors, with a high specificity. We look closely at the contrast images to spot tumors and other issues like strictures and fistulas.

1. Urothelial tumors show up as filling defects or wall thickening.
2. Other problems, like strictures, are seen by the narrowing and irregularity of the ureters.

Using the excretory phase of a CT urogram, we get a full view of the urinary tract. This helps us make accurate diagnoses and plan effective treatments.

Conclusion: Advancements in CT Urogram Protocols

We’ve looked at the key parts of a CT urogram, a tool that has changed how we check the urinary tract. It has three main steps: non-contrast, nephrographic, and excretory phases. These steps help us see the kidneys, ureters, and bladder clearly.

New improvements in CT urography have made it even better. Techniques like split-bolus and triple-bolus contrast help get clearer images. This means we don’t need to take as many scans, which is good for patients.

These updates in CT urography are big for patient care. Now, doctors can spot and treat problems more easily. They use the ct urogram CPT code for billing. As we keep making CT urography better, we’ll get even more precise diagnoses and better care for patients.

FAQ

Reference

1. Van Der Molen, A. J., Cowan, N. C., Mueller-Lisse, U. G., Nolte-Ernsting, C. C., Takahashi, S., & Cohan, R. H. (2008). CT urography: Definition, indications and techniques. European Radiology, 18(1), 4“17. https://pubmed.ncbi.nlm.nih.gov/17973110/