IVP: RAPID

SEQUENCE,INFUSIONS,PYELOGRAPHY,
HIGH DOSE UROGRAPHY

Submitted by: Muhammad Shanu

MIT 4th sem
Submitted to: Khansa Fathima
 DEFINITION
It is the radiographic examination of the
urinary tract including the renal parenchyma,
calyces and pelvis after the intravenous
injection of the contrast media.
Intravenous urography

Use decreased significantly

CT, US, MR, is replacing

Remains primary modality for visualization of

pelvicalyceal system and ureter
 Introduction of excretory urography was
done in 1929, by american urologist

MOSES SWICK .

1937- Berger made several recommendations

 Routine tomography
 High dose of contrast agents
 Ureteral compression
 Terminology
 Urogram

Visualization of Kidney parenchyma, Calyces

and pelvis resulting from IV injection contrast.

 Pyelogram

Describes retrograde studies visualizing only

the collecting system

 So, IVP is misnomer, should be IVU

Cystography
 Describes visualization of the
bladder

Urethrography
 Visualization of urethra

Cystourethrography
 Combined study to visualize
bladder and urethra
 Contrast is what we give intravenously

 Dye is used on clothes and in cooking to

change the color of things – it is not given IV
to patients.
 Indications
American College of Radiology ( ACR) guidelines published
in 2010.

 To evaluate the presence or continuing presence of

suspected congenital anomalies
 To asses the integrity of the urinary tract status post trauma.
 To asses the urinary tract for suspected congenital
anomalies.
 To asses the urinary tract for lesions that may explain
hematuria or infection.
 Investigation of HTN in young adults not controlled.
 Contraindications
No absolute contraindication
Relative contraindication
 Renal failure
 Hepatorenal syndrome
 Previous allergy to the contrast agent/iodine
 Generalized allergic conditions
 Multiple myeloma
 Pregnancy
 Infancy
 Diabetes
 Advantages
 Clear outline of the entire urinary system so can see
even mild hydronephrosis.

 Easier to pick out obstructing stone when there are

multiple pelvic calcifications.

 Can show non-opaque stones as filling defects.

 Demonstrate renal functions and allow for verifications

that the opposite kidney is functioning normally.
 Disadvantage
 Need for IV contrast material

 May provoke an allergic response

 Multiple delayed films ( can take hours as contrast passes quite

slowly into the blocked renal unit and ureter.)

 May not have sufficient opacification to define the anatomy and

point of obstruction.

 Requires a significant amount of radiation exposure and may

not be ideal for young children or pregnant women
THANKH YOU.