Tiffany Ly, MPAS, PA-C, presents “Genitourinary Radiology Review: CT Urogram.”
How to cite: Ly, Tiffany. “Genitourinary Radiology Review: CT Urogram.” May 27, 2025. Accessed Jul 2025. https://grandroundsinurology.com/genitourinary-radiology-review-ct-urogram/
Genitourinary Radiology Review: CT Urogram – Summary
Tiffany Ly, MPAS, PA-C, Academic Urology and Urogynecology of Arizona, Phoenix, Arizona, focuses on practical principles for interpreting radiologic imaging in urology. In this 15-minute presentation, she emphasizes the importance of providing detailed clinical indications when ordering a CT urogram to guide radiologists toward relevant findings. Ly advises considering patient factors such as body habitus, claustrophobia, implanted devices, renal function, and contrast allergy when selecting imaging modalities.
Reviewing imaging before receiving a formal report enhances patient care and fosters trust by allowing providers to explain findings to patients visually. Ly notes that overreading studies can uncover overlooked findings and prevent laterality errors that could impact surgical planning. She recommends developing a systematic approach to reviewing axial, coronal, and sagittal views and underscores the value of comparing current images with prior studies to distinguish stable from progressive hydronephrosis.
Ly considers CT urogram the holy grail in urology imaging by combining non-contrast, contrast-enhanced, and delayed phases in a single study. She outlines the four CT urogram phases and their roles in stone detection, tumor characterization, obstruction assessment, and differential enhancement patterns. She shares practical tricks such as using bone and liver windows to distinguish stones from contrast, and illustrates how Hounsfield unit measurements predict stone composition and inform surgical strategy.
Through case examples, Ly demonstrates how direct image review can reveal partial staghorn calculi, renal atrophy, and nonfunctioning kidneys that influence management. She encourages viewers to adopt these radiology skills to improve diagnostic accuracy and invites them to watch the full video for detailed demonstrations.
