This document summarizes various advanced radiographic techniques used in urinary tract investigations. It discusses the anatomy of the urinary system and provides details on intravenous urography (IVU) procedures, including patient preparation, the routine procedure involving multiple films, and variations used in specific cases like pregnancy or emergencies. It also covers retrograde pyelography which is used when IVU fails to show parts of the urinary system. The techniques discussed provide radiologists with guidance on visualizing and evaluating the urinary tract through contrast imaging.

1. Advance Radiographic
Technique

2. Urinary tract investigations
I.V.U/ 1
Retrograde pyelogram/ 2
Antegrade/ 3
Cystogram/ 4
Urethrogram/ 5
MCUG/ 6
Angiography/ 7

3. Anatomy of the urinary system
two kidneys/ 1
two ureters/ 2
urinary bladder + urethra/ 3

4. Anatomy of the urinary system

5. Anatomy of the urinary system

6. (Intravenous urography (IVU
Contrast examination for urinary tract

7. Indications
a. Congenital
b. Acquired

8. Contra indication
a. Absolute contra indication
b. Relative contra indication

9. Contrast media
Urographin/ 1
Omnipaque/ 2
Others/ 3

10. Patient preparation
Caster oil/ 1
Disflyteal/ 2
Eucarbon/ 3
light diet/ 4
patient fasting at least 4hrs before the / 5
procedure

11. Before to start the procedure
Check the ultrasound/ 1
report
Check the blood/ 2
urea

13. 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

14. Procedure of routine normal
:IVU
plain film/ 1

15. Procedure of routine normal
:IVU
Insertion of butter fly*
Injection of contrast*
media

16. Procedure of routine normal
:IVU
Immediate film/ 2
((nephrogram film

17. Procedure of routine normal
:IVU
Early excretion film (5/ 3
(min

18. Procedure of routine normal
:IVU
Compression*

19. 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.

20. Procedure of routine normal
:IVU
min film for p.c.s & 10/ 4
upper ureter

21. Procedure of routine normal
:IVU
Release film to show/ 5
the whole urinary
tract including the full
bladder

22. Procedure of routine normal
:IVU
full bladder film/ 6

23. Procedure of routine normal
:IVU
post micturition film/ 7

24. 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

25. 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

26. 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

27. Retrograde pyelograpgy
If the IVU fails to show P.C.S and upper
.ureter

28. Retrograde pyelograpgy
Contra indication
.Infection of the lower UT. 1
.Large vesical or urethral stone . 2

29. Retrograde pyelograpgy
Contrast media
Diluted water soluble CM

30. 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

31. Retrograde pyelograpgy

32. Retrograde pyelograpgy

33. CASES