In-House Radiology

A DEXAscan is a test that measures bone mineral density.  Short for dual-energy X-ray absorptiometry, the DEXAscan helps evaluate bone health and determines the likelihood of osteoporosis or bone fractures.  It can also help detect if cancer has metastasized or spread to the bones.  
 
The test is easy, fast, non-invasive, painless and performed here in our office at Urological Associates.  The scan takes approximately 30 minutes but most of that time is spent preparing you to lay on the table.  Unlike MRI or CT scans, you will not have to lie inside a closed tunnel or ring but rather be on an open x-ray table.  You remain still as the scanner passes over your body.  
 
Once the procedure is concluded, the physician will read the test and relay the findings.  

The Radiology Department inside Urological Associates of Savannah’s DeRenne Avenue facility does a variety of radiology examinations for your convenience.  Several examinations are viewed and reported by the urologist prior to being placed in your medical record. Other examinations are interpreted by a contracted radiologist and a report is submitted to our office for your urologist to review.

All procedures are performed by registered radiology technologists. There are protocols for examinations which have been accepted by urologists and radiologists alike. We do not venture away from these standards as the safety and results of your examination are of extreme importance to us. You may be asked to drink oral contrast, have recent CMP (comprehensive metabolic panel) labs collected, or be given special preparations prior to IV contrast injections. All of these instructions will be given prior to scheduling if they pertain to your examination. If you have allergies to seafood, iodine, or have asthma, please be sure this is shared with us so it is noted in your chart. If you are a diabetic and are on the drug, METFORMIN, please make sure the nurse and scheduler are informed. Metformin cannot be used before a contrast study.

Here is a list of examinations that we perform here at Urological Associates of Savannah along with a brief description as to why your physician may order the test.

EXAMS WITHOUT CONTRAST:

KUB – This is a routine, flat plate x-ray of your abdomen to include kidneys, ureters and bladder. It is used to locate kidney stones and their locations along with the size of stones. It also can be used for constipation of your bowels and position of stents placed during surgical procedures.

AP and LATERAL PELVIS
These images are done for location and position either prior to or after InterStim installation. Interstims are used for bladder problems such as urination frequency or incontinence.

CHEST X-RAY
A chest x-ray consists of two images; a PA and Lateral.  Chest x-rays are performed prior to surgical procedures. The reason for pre-operative chest x-rays is to verify that your lungs are free and clear of fluid.  Your heart size is also evaluated before anesthesia.  Chest x-rays may be ordered routinely for renal cell cancer patients to evaluate metastatic disease.

DEXAscan is a test that measures bone mineral density.  Short for dual-energy X-ray absorptiometry, the DEXAscan helps evaluate bone health and determines the likelihood of osteoporosis or bone fractures.  It can also help detect if cancer has metastasized or spread to the bones.

ULTRASOUND PROCEDURES:

We offer ultrasound scans pertaining to urology at Urological Associates and they are performed by a Certified Abdominal Sonographer.  There are no preparations needed for US scans.

ABDOMINAL US
This is specifically done for kidneys, ureter and bladder anatomy.  The diagnosis for this exam may include:  hematuria, UTI’s, renal stones, a neurogenic bladder and renal and bladder cancers.  A radiologist will review and report to the urologist any findings and measurements taken.

SCROTAL US
This exam is for testicular cancer, epididymitis, hydroceles, varicoceles and torsion along with pain in the genital area.  A radiologist will review the images and a report will be sent to the urologist.

 

EXAMS WITH CONTRAST INSTILLED THROUGH TUBE

CYSTOGRAM for most cases in the facility, this is a post-operative examination.  In female patients, it may be done for a patient’s post-operative hysterectomy.  The patient will have a catheter placed in the bladder during surgery.  Cysto-Conray contrast media will be instilled into the catheter and several KUB images will be taken in different positions to reveal that there is no extravasation from the bladder into the pelvic cavity.  For men who are post-operative prostatectomy, often times a cystogram will be done a week to 10 days after surgery to show that the healing process is complete and that there are no extravasations from the bladder into the pelvic cavity.  These cases are reviewed by your urologist and if the study is normal, then the catheter is removed that day.

NEPHROSTOGRAM
This study is performed on patients who have kidney stones or other obstructing causes of the kidney.  Therefore, urine cannot drain into the ureter and bladder.  These patients are done post-operatively and have a small catheter tube coming from the kidney to the outside of their skin and attached to a drainage bag to catch urine.  Contrast media is instilled through the catheter and images are taken to show the drainage of the kidney to the bladder.  If the contrast finds a clear path to the ureter and into the bladder, then the catheter can be removed in the Radiology Department.

LOOPOGRAM
This study is done on patients who have had their bladder removed and now have a stoma on their right abdomen wall.  The purpose of this exam is to show bilateral connections of the ureters to the ileo conduit pouch created in surgery.  A foley catheter is placed into the stoma and contrast media is instilled to image the ileo conduit and the ureter connections.  This study is performed usually several months after the initial surgery and then periodically as urologists need to perform them.  Patients need to bring their appliances with them for their stomas as we no longer have these supplies in stock.

CT ABDOMEN AND PELVIS WITHOUT CONTRAST
These are performed on patients for renal stones.  Insurance precertification may be required prior to the exam.  There is no preparation required by the patient.  The patient is scanned from the bottom of the lung fields through the pubic bone.

EXAMINATIONS REQUIRING IV CONTRAST INJECTIONS

IVP
Patients are given IV contrast media and KUB images are taken in time increments following the contrast media.  The purpose for this examination is to see the renal function and flow of the kidneys.  Often times, if there are kidney stones or obstructions in the renal system, you may have extended images taken as the system visualizes.  At the end of the study, you will be asked to void and have a final image showing your ability to urinate.  Your urologist will review these images.  Average examination time takes 35 minutes.

CT ABDOMEN AND PELVIS WITH AND WITHOUT IV CONTRAST
There are a variety of scan protocols for the abdomen and pelvis to acquire information for the urologist. The urologist will order the appropriate scan to be performed.  The scan is started at the bottom portion of the lung fields and goes through the pelvis girdle to include the bladder. All anatomy is reviewed and reported by a radiologist. The first portion is without contrast media.  This allows the viewing of kidney stones, cyst(s) on the kidneys and liver along with diverticular disease in the colon. The second scan includes the actual IV contrast injection into the arm.  This may cause a warm flush through your body and a sensation of the need to urinate. This is a quick feeling that will pass immediately.

The need for the contrast media is to identify any tumors, cancers, complicated cyst(s) and abscesses of the abdomen and pelvis. The final scan will be delayed approximately 5 minutes from the injection time to allow your renal system to filter the contrast media through the kidneys and ureter and fill the bladder.  You will be asked to drink plenty of fluids to flush the contrast out in your urine.  It is the normal color of your urine.

CT CHEST
There are several protocols for imaging the thoracic chest with the CT scanner. Your urologist will order the most appropriate scan. For pulmonary nodules in either lung, most often we can scan without contrast media. This takes 10 minutes. If you have had any type of cancerous disease in your body, there will be a need to use IV contrast media to rule out metastatic disease to the lungs and hilum area of the chest. This test will take 30 minutes. The images will be reviewed by a radiologist and reported back to your urologist. You will be instructed to drink fluids to flush the contrast through your renal system.

IN-OFFICE IAC AND ACR ACCREDITED PROGRAM IN COMPUTED TOMOGRAPHY (CT)

 

In May of 2019, we achieved a three year accreditation from the American College of Radiology (ACR) and have maintained it since that time. To achieve the ACR Gold Standard of Accreditation, our facility’s personnel qualifications, equipment requirements, quality assurance, and quality control procedures have gone through a rigorous review process and have met specific qualifications.