Radio logical investigations of urinary system

Radio logical investigations of urinary system
There are 4 main radiological Ix:
1 —IVU: Intravenous urography.
2- U/S
3-CT scan
4-Radioisotope scan.
Others (not frequently used): MRI, arteriography, antegrade or retrograde pyelogram.
I-IVU STUDY
OBJECTIVES
Indication
Advantages
Disadvantage
Procedure
Examples
INDICATIONS
1-Renal colic to visualize stones or obstructions
2-Heamaturia
Recurrent UTI to assess congenital anomalies strictures or urothelial lesions 3-
Renal obstruction e.g. renal mass
4-assessment of renal outline pylocalyceal system ureters bladder urothelium
Others e.g.
5- Prostatitis
6-Neurogenic bladder
7-Trauma
IVU is not indicated in
Pylonephritis
Renal failure
Renal parenchymal disease
Allergy to contrast
ADVANTAGE
Widely available
Excellent to identify uroepithelium
Can visualize the whole length of ureters


Can quantify the degree urinary tact obstruction
DISADVANTAGE
Need for patient preparation
Risk of radiation
Contrast media problems such as allergy
May get suboptimal results due to
1. Patient movement
Overlying bowel gas 2.
Poor concentration media due to poor renal function
.
PATIENT PREPRATION
1. Laxatives is taken 24 hr before the examination
Nil by mouth for 4-6 hr before the examination 2.
3.The patient should be ambulant as long as possible to decrease air swallowing
4.Certain measures is taken to certain group of patients e.g. DM and children
Note ; in renal failure patient we give double dose of contrast 6oomg \kg
Contrast is non ionic low osmolar water soluble contrast