Urogenital radiology

Ultrasound or ultrasonography is a method that allows, through the use of ultrasound emitted by an ultrasound probe, the study of the soft parts of the body without the use of X-rays. The examination poses no risk to the patient and is the method of choice for the initial approach to various diseases of the urinary and genital system (kidneys, bladder, prostate, testicle).
Because of its rapidity of execution, noninvasiveness, and high sensitivity, it can provide important morphologic information needed for initial pathology framing or follow-up of known or postoperative pathology.

Principal indications
With ultrasonography, various urogenital inflammatory/infectious pathologies (nephritis, cystitis, prostatitis, orchi-epididymitis), renal lithiasis (calculosis) pathology, traumatic pathology in emergency/emergency, and initial approach/follow-up of neoplastic pathology can be accurately evaluated.

How it is performed.
The radiologist will review on a screen the images produced by a probe that is slid over the patient's body. The examination takes about 15 to 20 minutes.

Preparation needed
No specific preparation is necessary.

Computed axial tomography (CT) is a radiodiagnostic investigation technique by which sectional and three-dimensional images of the anatomy examined can be obtained, based on the attenuation of an X-ray beam as it passes through a body section.
To improve image quality and allow characterization of possible pathology, intravenous administration of an iodine-based contrast agent is often indicated.

Principal indications
In the urogenital field, CT examination allows, for example, visualization and localization of kidney stones or along the course of the ureter to allow the urologist to choose the best therapeutic approach.
There is also the possibility of administering contrast medium intravenously in order to obtain better visualization of the excretory tracts (kidneys, ureters, bladder), to differentiate various pathologies and obtain more information on the whole morphology and functioning of the apparatus under examination.

How it is performed
CT scan is not an invasive examination; however, it requires a certain degree of preparation and the cooperation of the patient, especially if it is performed with contrast medium. In order to obtain an excellent quality examination, the patient may be asked to present themselves fasting for 4 hours (drinking water is allowed) and to remain totally still during the entire duration of the examination, following the instructions of the technical staff regarding breathing.
The patient is positioned lying on the CT bed, which will move within a ring during the imaging process. In case a contrast agent has to be injected, a peripheral venous route will be placed usually to the upper extremity. It is important to report any allergies promptly. The examination is rapid; its duration can vary from a few minutes to a maximum of 25 minutes.

Risks
Rarely, contrast medium administered intravenously may cause a hematoma at the injection site or may extravasate out of the vein. A transient side effect may be a feeling of heat or nausea. True allergy or urticaria are rare. If the patient to undergo CT examination has known allergic reactions or has had previous allergies to contrast, they should be reported to the medical radiology technologist or their physician.

MRI does not require the use of X-rays: images of the human body are made using magnetic fields and radio waves.

Main indications:

• Prostate MRI: 45 min, with contrast medium in a vein.
• MRI kidney: approx. 30 min, with contrast medium in vein.
• MRI bladder: approx. 45 min, with contrast medium in vein.
• MRI whole body: ca 60 min, without contrast medium.

How it is performed
It is necessary to notify the hospital staff prior to the examination of the presence of any conditions that might contraindicate the examination, such as dental or hearing aids, implantation of pacemakers, heart valves, defibrillators, neuromodulators, drug infusion pumps and/or additional electrical devices in the body, vascular clips, prostheses and/or metal objects inside the body, tattoos, orthopedic, eye or head surgery. It is important to report any claustrophobia or previous adverse reactions to paramagnetic contrast medium.
It is very important for the quality of the images that the patient cooperates well. In particular, it is necessary to remain absolutely still with the whole body and carefully follow the commands for apnea periods (up to approx. 15 sec.) given by the radiology technician.
To perform the examination, the patient must lie supine on the MRI table, where a stand will be placed above the chest, containing the radiofrequency coils necessary to acquire the signal that will then form the images. During image acquisition there will be background noise, which will be attenuated by the use of special headphones. The examination can last from 30 to 60 minutes.
In case a contrast agent has to be injected, a peripheral venous route will be laid usually at the level of the upper limb. It is important to report any allergies promptly.

Risks
The risks of an MRI examination are minimal. Contrast may rarely cause, at the injection site, a hematoma or may extravasate out of the vein. True allergy or urticaria has rarely been described. If the patient has known allergic reactions or has already had allergies to contrast, they should still be reported to the medical radiology technologist or physician. It is recommended that the patient remain 30 min in the hospital after the examination if he or she has received contrast; if he or she presents late at home with redness on the skin or respiratory distress, it is important to contact and report them to the physician or emergency department.