Normal KUB-IVP

GUT Viewbox
Ma. Mercedes Victoria M. Tanchuling
 What is it?
Intravenous Pyelogram
• Assessment of the urinary tract through the
injection of a radio-opaque dye, after which a
series of films are taken over a span of 15-20
minutes
• Gives excellent anatomical images of the
pelvicalyceal systems and an indication of
renal function
 Indications & Preparation
• Lumbar pain, hypertension, palpable abdominal mass,
hematuria (>10 RBC/hpf)
• Prior to IVP, the patient must be:
– NPO 8 hours prior to the study
– Laxatives for cleansing
• BUN/Crea must be checked to make sure patient can
clear the contrast media
• Check for history of asthma and allergies must be
verified in order to avoid possible allergic reaction
with the contrast media
 Types of Contrast
• Ionic
– more allergenic
– hyperosmolar
– cheaper (~P400)
• Non-ionic
– hypoallergenic
– less osmolar
– more expensive (~P1500)
 Patient Preparation
• Night before the exam:
– Very light supper
– At 7PM, let patient take in 4 Dulcolax tablets and 60cc
castor oil.
– From 7PM onwards, NPO but patient can still drink 1
glass of water per hour until 12 midnight.
– At 5AM, rectal suppository
• Patient should empty bladder before the procedure
• All films should be taken at deep expiration
 Procedure
• Contrast media is injected into the arm
intravenously, excreted by the glomerular
filtration
• X-ray films are taken at the following intervals:
– 3 minutes (supine)
– 5 minutes (supine)
– 10-15 minutes (prone)  COMPRESSION APPLIED
– Post-void(upright)
BONES VISCERA
VISCERA COLLECTING
COLLECTINGSYSTEM
SYSTEM

URETERS
KIDNEYS
BLADDER
•Regular
Normally
Psoas
Bean
May hard
Shaped,
Line
show smooth to see!
: obliterated?
smooth
Retroperitoneal
outline
appearance
mets and mass
complete
•voiding
8mm diameter,
cortical thinningvertical
descent
 10-15
•Liver parallel
degenerative cm to vertebra
changes
long, 5cm
•Smooth across, 2.5cmovoid
mucosa; thick
•Pelvis
3 areas
 T12-L3of narrowing:
•1.
•Spleen
Ureteropelvic
 Left > Rightjunction
Dome
Vertebrae is round inbymales,
0.5cm–
mostcommon place
Right lower
flatofinobstruction
females (duethan
to Left
uterus) by 2cm
2. Ureterovesical junction
 Calyces are cupped,
3. Bifurcation
not splayed of the iliac
vessels
Inject contrast material
3 minutes

• More or less an
kidneys and of
opacification
theupper
intrarenal
collecting
collecting
system
system
visualized
5 minutes

contrastisisseen
contrast seen
passingthrough
passing through
thecalices
the calicesandand
pelvispelvis
5 Minutes
 5 Minutes

Pelvis and ureters opacifying

10 Minutes
10 Minutes, oblique view

Ureteral filling

Check for
stones!
 1.full bladder has very smooth borders
2.“dapat bilog na”

20 minutes
full bladder
has very
smooth
borders
Post-void

to check urinary
retention

<50 cc

you can still see

some degree of
contrast in
various areas of
the GU system
 References
Adam, Dixon. Diagnostic Radiology: A Textbook of Medical
Imaging. 5th ed.

Brant and Helm. Fundamentals of Diagnostic Radiology. 3rd ed.

Dyer, RB et al. Intravenous Urography: Technique and

Interpretation. Journal of Radiographics, Volume 4:21, August
2001.