Retroperitoneal CT is a study of the retroperitoneal space by obtaining and reconstructing layered scans performed using a computed tomograph. The most important anatomical structures are located in the retroperitoneal space: kidneys and paranephral tissue, ureters, adrenal glands, lymph nodes and vessels – these organs are the main objects of CT examination. With intravenous administration of special iodine-containing drugs, it is possible to contrast the renal arteries. Indications for CT of the retroperitoneal space can be abdominal and lumbar injuries, tumors of the kidneys and adrenal glands, purulent processes, suspicion of metastases in this area, lymph node damage, etc. CT of the retroperitoneal space can be an independent diagnostic study or performed in conjunction with CT of the abdominal cavity.
Retroperitoneal CT is a highly informative method of diagnosing diseases of internal organs located in the retroperitoneal space. During the scan, a tomograph equipped with an X-ray tube and sensors is used. The X-ray tube emits radiation that is partially absorbed by tissues. Sensors detect the change in radiation, the information is transmitted to a computer, processed by special programs, after which a three-dimensional image of the area under study is simulated. CT of the retroperitoneal space allows to diagnose pathological processes with high accuracy at the early stages of development, which is important for the timely detection of various pathologies and the appointment of adequate therapy.
When CT of the retroperitoneal space uses a minimum dose of radiation, which makes the technique safer in comparison with standard radiography. At the same time, it is possible to obtain a large number of layered images in different projections and detect even minimal deviations in the structure of internal organs. During the study, the specialist can change the scale of the images. Retroperitoneal CT in Moscow is widely used in urology, angiology, and endocrinology. Scanning in oncology is no less popular, since the procedure makes it possible to diagnose even small primary and metastatic neoplasms. Examination of the retroperitoneal space can be used as an independent method or in combination with CT of the abdominal cavity.
Comparing MRI and CT of retroperitoneal space, it is worth noting that the latter is more in demand due to its availability. Computed tomography is characterized by a lower cost and at the same time less time-consuming compared to the magnetic resonance method. However, MRI uses a magnetic field and electromagnetic waves, which makes the technique absolutely safe and allows you to repeat the study the required number of times. X-ray radiation is used in retroperitoneal CT, so there are restrictions regarding the scanning frequency.
Retroperitoneal CT is prescribed to patients after passing laboratory tests and undergoing ultrasound scanning, if these methods proved to be uninformative and did not allow for an accurate diagnosis of the disease. The procedure is used for pathologies of the urinary system. With its help, it is possible to diagnose amyloidosis of the kidneys, hydronephrosis. Scanning is effective in detecting cysts, during CT of the retroperitoneal space, it is possible to establish the exact localization and size of such formations. Tomographic examination is prescribed for inflammatory and purulent processes, allows you to identify nephritis, abscesses, phlegmons, assess the prevalence of changes and decide on further treatment tactics.
Retroperitoneal CT is widely used in cases of suspected congenital anomalies. Using this study, it is possible to diagnose megacalicosis, a spongy kidney. The procedure is also performed to detect stones in the kidneys and ureters. A scan is also prescribed if a malignant kidney lesion is suspected. During the scanning process, it is possible to establish the presence of tumors such as hypernephroma, kidney cancer, etc. During CT of the retroperitoneal space, even neoplasms of insignificant size are visible, not accompanied by clinical symptoms. In addition, the technique is used for the diagnosis of extra-organ retroperitoneal tumors, detection of metastases.
CT of the retroperitoneal space is performed during the diagnosis of adrenal tumors. The technique is effective when it is necessary to assess the functionality of the renal arteries. The examination is also used for traumatic injuries of the lumbar region with suspected violation of the integrity of internal organs. Indications for CT of the retroperitoneal space may be the presence of blood in the urine, lower back pain and hypertension of unknown etiology. Scanning is used before surgical interventions and after surgical treatment of pathologies of the organs of the retroperitoneal space in order to determine the effectiveness of the operation.
The absolute contraindications to retroperitoneal CT are pregnancy due to the harmful effects of X-rays on the fetus. During lactation, scanning with contrast is possible if the child is transferred to artificial feeding for 2 days. Contrast examination is prescribed with extreme caution in the presence of signs of acute inflammation in the upper urinary tract. In chronic kidney diseases, the procedure is recommended to be carried out during remission. The presence of hyperkinesis that prevents the preservation of immobility is considered a relative contraindication, if necessary, CT of the retroperitoneal space is carried out after appropriate medical preparation. There is a weight limit, various models of tomographs are able to withstand a load of no more than 120-200 kg. Scanning is not recommended for children under 14 years of age and is prescribed for vital indications when other methods are not informative enough.
Preparation for CT
A referral for a retroperitoneal CT scan is issued by the attending physician – urologist, oncologist, endocrinologist. If the study involves contrast enhancement, it is necessary to assess the functionality of the kidneys. For high-quality visualization of the retroperitoneal space, care should be taken to prepare the intestines. 2-3 days before the scan, you need to give up products that increase gas formation – black bread, legumes, fresh vegetables and fruits. Contrast CT of the retroperitoneal space is performed on an empty stomach, the time of the last meal is 5-6 hours before the examination. Immediately before the procedure, the patient should take off metal objects, including jewelry, dentures and electronic devices, and put on a disposable medical gown.
Methodology of conducting
CT of the retroperitoneal space is performed using a tomograph. The patient is placed on the couch in a supine position, after which the couch moves into the ring of the device. When contrasting, the drug is administered immediately before the start of the procedure. During a CT scan of the retroperitoneal space, a tube rotates around the patient’s body, emitting X-ray waves that are absorbed by the tissues. The radiation is detected by sensors, the information is transmitted to the computer. During the scan, the patient must remain motionless so that the images are as clear as possible. The duration of the tomographic examination is no more than 5 minutes, with the use of contrast enhancement, the duration of the procedure can increase up to half an hour.
You can get the results of a retroperitoneal CT scan on the same day. When studying the images, the X-ray diagnostics doctor makes a conclusion about the detected violations of the structure of the studied structures, the presence of inflammatory changes and purulent foci. It is also possible to determine neoplasms, establish their exact localization, size and prevalence. After performing a CT scan of the retroperitoneal space, the patient is given a written conclusion and pictures on paper or on digital media. Then the patient should contact the attending physician to make an accurate diagnosis and determine the subsequent treatment tactics.