Urinary system 1

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Urinary system 1

  1. 1. Advance Radiographic Technique
  2. 2. Urinary tract investigations I.V.U/ 1 Retrograde pyelogram/ 2 Antegrade/ 3 Cystogram/ 4 Urethrogram/ 5 MCUG/ 6 Angiography/ 7
  3. 3. Anatomy of the urinary system two kidneys/ 1 two ureters/ 2 urinary bladder + urethra/ 3
  4. 4. Anatomy of the urinary system
  5. 5. Anatomy of the urinary system
  6. 6. (Intravenous urography (IVU Contrast examination for urinary tract
  7. 7. Indications a. Congenital b. Acquired
  8. 8. Contra indication a. Absolute contra indication b. Relative contra indication
  9. 9. Contrast media Urographin/ 1 Omnipaque/ 2 Others/ 3
  10. 10. Patient preparation Caster oil/ 1 Disflyteal/ 2 Eucarbon/ 3 light diet/ 4 patient fasting at least 4hrs before the / 5 procedure
  11. 11. Before to start the procedure Check the ultrasound/ 1 report Check the blood/ 2 urea
  12. 12. Before to start the procedure The patient should void just before the :examination for the following two reasons a bladder that is too full could rupture, / 1 especially if compression is applied early .in the exam urine already present in the bladder / 2 .dilutes the contrast medium
  13. 13. Procedure of routine normal :IVU plain film/ 1
  14. 14. Procedure of routine normal :IVU Insertion of butter fly* Injection of contrast* media
  15. 15. Procedure of routine normal :IVU Immediate film/ 2 ((nephrogram film
  16. 16. Procedure of routine normal :IVU Early excretion film (5/ 3 (min
  17. 17. Procedure of routine normal :IVU Compression*
  18. 18. Procedure of routine normal :IVU :Compression is contraindicated After recent abdominal surgery. After renal trauma. If there is a large abdominal mass. When the 5 min film shows already. distended calyces Patient with IVC filter.
  19. 19. Procedure of routine normal :IVU min film for p.c.s & 10/ 4 upper ureter
  20. 20. Procedure of routine normal :IVU Release film to show/ 5 the whole urinary tract including the full bladder
  21. 21. Procedure of routine normal :IVU full bladder film/ 6
  22. 22. Procedure of routine normal :IVU post micturition film/ 7
  23. 23. IVU with less films which means less radiation (IVU in pregnancy (not early pregnancy / 1 IVU in follow up/ 2 IVU in emergency/ 3 Some time in children
  24. 24. IVU with less films which means less radiation Plain film* min film 20 – 15* No compression. No compression and no preparation in . .pregnancy and emergency
  25. 25. Extra films/ extra radiation .IVU in renal hypertension/ 1 obstruction or stricture ( we take delayed films) / 2 :after 1/2hr 1hr 2hrs 6hrs 12hrs . If no function we take retrograde pyelography
  26. 26. Retrograde pyelograpgy If the IVU fails to show P.C.S and upper .ureter
  27. 27. Retrograde pyelograpgy Contra indication .Infection of the lower UT. 1 .Large vesical or urethral stone . 2
  28. 28. Retrograde pyelograpgy Contrast media Diluted water soluble CM
  29. 29. Retrograde pyelograpgy Procedure :The Pt comes with catheter Plain KUB to show the position of the . 1 .catheter and radiopaque calcification (injection of the CM (under screening * .Pt supine head down to fill the PCS . 2 Raised Pt head and take radiograph for . 3 .ureter and pulling the catheter out
  30. 30. Retrograde pyelograpgy
  31. 31. Retrograde pyelograpgy
  32. 32. CASES

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