Comprehensive kidney and urinary tract assessment — CT urogram, renal ultrasound and MRI for haematuria, kidney masses, stones and obstruction.
The kidneys and urinary tract are investigated using a range of imaging modalities, chosen according to the clinical question. Blood in the urine (haematuria), kidney stones, suspected kidney tumours and urinary obstruction all require specialist imaging interpreted by a consultant with urological imaging expertise.
The primary investigation for haematuria (blood in urine). CT urogram images the entire urinary tract — kidneys, ureters and bladder — in multiple phases, detecting stones, tumours and structural abnormalities. It is the most comprehensive single imaging test for the urinary tract.
First-line assessment of kidney size, echogenicity, cysts and masses. Also used for assessment of urinary tract obstruction (hydronephrosis), bladder wall thickening and bladder residual volume. Rapid, radiation-free and widely available.
MRI is superior to CT for characterising complex renal cysts and solid renal masses. It avoids radiation and contrast nephrotoxicity, making it particularly suitable for patients with impaired renal function or indeterminate CT findings.
Low-dose CT is the most sensitive investigation for kidney and ureteric stones. It can detect stones as small as 1mm and identify exactly where stones are lodged in the urinary tract.
Ultrasound assessment of renal artery blood flow — used in investigation of renal artery stenosis in hypertensive patients and post-transplant renal artery assessment.
CT and MRI for suspected bladder tumours, bladder wall thickening and staging of bladder cancer. MRI is particularly important for local staging before cystectomy.
Visible or non-visible blood in the urine requires a structured investigation pathway. CT urogram is the primary investigation for upper tract assessment; cystoscopy assesses the bladder. We produce structured haematuria pathway reports and will clearly indicate which findings require urgent urological follow-up.
Important: Visible haematuria always requires investigation. If you are experiencing blood in your urine, please speak to your GP promptly.
Incidental renal cysts and masses are commonly found on ultrasound or CT. Most cysts are entirely benign, but some require further characterisation with MRI or follow-up CT. Solid renal masses require prompt assessment to exclude renal cell carcinoma. We use the Bosniak classification for renal cysts and provide clear management recommendations.
Low-dose CT is the most sensitive investigation for urinary tract stones. We report stone location, size, density and any associated obstruction — providing the urology team with all the information needed for treatment planning.
Ultrasound and Doppler assessment of transplant kidney function, vascular anatomy and complications. Correlated with clinical and biochemical findings to guide management of transplant dysfunction.