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PubMed1991

Comparison of excretory urography, angiography, ultrasound and computed tomography for T category staging of renal cell carcinoma.

The diagnostic significance of excretory urography, renal angiography, ultrasound and computed tomography for predicting the stage of tumours was evaluated by comparing their results with peroperative and histopathological findings. Thirty-nine out of 178 patients operated on for renal cell carcinoma from 1981 to 1988 were subjected to all four diagnostic procedures. The T stage was determined correctly by computed tomography in 80% of the cases, by ultrasound in 74.5%, by renal angiography in 64% and by excretory urography in 56.5%. Excretory urography did not give any significant additional information on the T category compared with the other imaging methods. Angiography is still of value in that it gives preoperative information on the collateral circulation and the number of renal arteries and their location.

Adult↗
PubMed1990

Intravenous urography versus ultrasonography in evaluation of women with recurrent urinary tract infection.

Intravenous urography and ultrasonography were compared prospectively in 120 women with recurrent urinary tract infection. The median age was 44 years (range 15-85). There was good correlation between the two methods in detecting hydronephrosis, calculi greater than or equal to 5 mm, and major post-pyelonephritic scarring. Urography was superior in detecting small cortical scars, slight caliceal dilatation, and less than or equal to 4 mm calculi. Based on the good results, low cost, and absence of radiation hazards or contrast media reactions, we conclude that ultrasonography may replace urography when a radiological screening of the upper urinary tract is deemed necessary in women with recurrent urinary tract infection.

Adolescent↗
PubMed2001

The value of cystoscopy and intravenous urography after magnetic resonance imaging or computed tomography in the staging of cervical carcinoma.

The clinical staging system for cervical carcinoma presently recommended by the International Federation of Gynecology and Obstetrics (FIGO) does not include MRI or CT findings and thus suffers limited accuracy. Recently however, the positive contributions of MRI and CT to preoperative staging have been reported. This study involves a determination of the value of routine cystoscopy and intravenous urography, in the detection of bladder invasion or hydronephrosis resulting from cervical carcinoma, among patients who had undergone MRI or CT. Among a total 296 patients with cervical carcinoma, 271 patients (92%) had undergone MRI and 25 (8%) CT. Bladder invasion was identified pathologically by cystoscopic biopsy in 8 (57%) of the 14 patients with suspected bladder invasion on MRI or CT. There was no bladder invasion in any of the other cases lacking in bladder invasion evidence on MRI or CT. Hydronephrosis was identified by intravenous urography in 18 patients, as it also was in all of these cases on MRI or CT, confirming a negative predictive value for MRI or CT, in detecting bladder invasion or hydronephrosis from cervical carcinoma, of 100%. Therefore, although MRI or CT cannot totally replace cystoscopy, the latter is unnecessary in the absence of bladder invasion evidence on MRI or CT. Intravenous urography, however, can be safely omitted whenever MRI or CT is performed.

Adult↗
PubMed1975

Acute renal failure after excretory urography in diabetic patients.

Currently used contrast media for excretory urography are generally considered safe even in the presence of renal insufficiency. Isolated reports of acute oliguric renal failure in diabetic patients after excretory urography have been documented. We describe eight such patients who developed this complication. The approximate incidence of recognized acute oliguric renal failure in diabetics undergoing excretory urography was 2 in 1000 as compared with none in more than 100 000 procedures done in nondiabetic patients. Six of the diabetic patients with acute renal failure recovered; two required hemodialysis, never regaining self-sustaining renal function. If detected early, acute renal failure in this setting can often be managed conservatively. Attempts to induce diuresis have been discouraging.

Acute Kidney Injury↗
PubMed1999

[Comparison of spiral computed tomography without contrast media and intravenous urography in the diagnosis of renal colic].

OBJECTIVES: This prospective study was designed to determine the reliability of noncontrast spiral CT scan, compared to that of intravenous urography (IVU), in the diagnostic assessment of acute renal colic. MATERIAL AND METHODS: 53 patients, admitted with an empirical diagnosis of renal colic after initial assessment, were included and underwent spiral CT scan without contrast agent injection, immediately followed by IVU. These examinations were performed according to a blind protocol by two different radiologists. We initially looked for the presence of stones and/or urinary tract obstruction. Patients with a stone and/or obstruction (urinary tract dilatation) visible on CT scan were then examined for the presence of CT signs associated with stone disease (infiltration of the perirenal and periureteric fat, oedema of the ureteric wall and loss of sinus fat). We calculated the statistical correlation between the presence or absence of obstruction and these accessory signs. RESULTS: 45 stones were recovered (in 36 cases before the two examinations). 36 stones were identified on CT versus only 24 on urography. Urinary tract dilatation was demonstrated in 26 out of 53 cases by both urography and CT. The frequency of accessory signs visible on CT in the presence of stones (n = 36) was 66% for infiltration of periureteric fat, 36% for infiltration of perirenal fat and 75% for oedema of the ureteric wall. In the presence of urinary tract dilatation, these frequencies were 92%, 84% and 60% respectively. CONCLUSION: Noncontrast spiral CT is a reliable and rapid diagnostic modality for the detection of urinary stones, providing a morphological study equivalent to that of IVU and able to guide appropriate treatment. It should replace IVU in the diagnostic assessment of renal colic.

Acute Disease↗
PubMed2002

[Retirement plan for a 70-year-old. Intravenous urography disembarks from uroradiology].

Over the last 70 years, intravenous urography (IVU) has played a major role in the work-up of diseases in the kidneys and the upper urinary tract. However, modern cross-sectional modalities have shown that IVU does not fulfill current requirements. Patients with renal colic are better examined by non-enhanced CT scanning, as it finds more stones (60 versus 100%). Furthermore, a disease outside the upper urinary tract is found in about 15% of patients with renal colic, and in 3% another kidney or upper urinary tract disease is found. For patients with haematuria, CT urography is a better alternative, as it combines the advantages of CT with those of IVU. IVU misses about 15% of renal tumours above 3 cm in diameter and almost all below 3 cm. MR urography is the newest way of imaging the upper urinary tract; its exact role is still undetermined, but it is recommended for children, young persons, and pregnant women. After 70 years of good performance, it is time for IVU to retire.

Contrast Media↗
PubMed1992

[Preclinical evaluation of iotrolan as a contrast medium for angiography and urography].

Efficacy and tolerability of iotrolan, a nonionic isotonic dimer, as a contrast medium for angiography and urography were investigated in animals. In the arteriography of rabbit femur, the efficacy of iotrolan 280 mgI/ml was as good as iopamidol 300 mgI/ml and better than meglumine diatrizoate 306 mgI/ml. In rat urography, the efficacy of iotrolan 280 mgI/ml was better than both iopamidol 370 mgI/ml and iohexol 350 mgI/ml. Vascular pain was less with iotrolan 280 mgI/ml than with iohexol 300 mgI/ml in rats. Effect of iotrolan on the pulmo-cardiovascular parameters, arterial pO2, hematocrit and plasma osmolality was less than iopamidol and diatrizoate in rabbits. Iotrolan induced no renal dysfunction and diuresis where iopamidol induced diuresis in rats. Effect of iotrolan on the blood coagulation was similar to nonionic monomers and less than diatrizoate in rabbits. Because of its isotonicity, iotrolan induced little water shift in the blood vessel and urinary tract, which would result in good efficacy and tolerability. These results suggest that iotrolan is superior to ionic and nonionic monomers for angiography and urography.

Angiography↗
PubMed2004

Assessment of CT urography in the diagnosis of urinary tract abnormalities.

BACKGROUND: To evaluate the accuracy of helical computerized tomography urography (CTU) in diagnosing urinary tract disease. METHODS: We collected 102 patients who underwent CTU from March 2001 to September 2002. The clinical symptoms of these patients included: flank pain or hematuria, which were clinically suggestive of urinary system disorders. All patients received CT scan with or without intravenous contrast medium administration, except patients who had allergy history or poor renal function. Reformatted CT urography was performed and the accuracy of imaging diagnosis was evaluated. RESULTS: Of these 102 patients, 40 cases were proved to have urolithiasis, 24 cases were with renal or ureteral tumors, and there were 38 cases of other urinary system disorders (including inflammation, ureteral stricture and congenital anomalies). Precontrast CTU correctly diagnosed 39 of 40 urolithiasis cases (97.5%). Precontrast and contrast-enhanced CTU were performed in the non-urolithiasis group and correctly diagnosed 23 cases of renal or ureteral tumors, 4 cases of congenital disorder (2 duplications, 1 congenital renal agenesis due to VATER syndrome and 1 retrocaval ureter). Five of 34 patients with chronic inflammatory process of urinary tract or ureteral stricture were indistinct from malignancies according to the imaging of CT urography. CONCLUSIONS: CTU is good modality for demonstration of urinary tract disorders. It is better in showing radiolucent stones and non-opacified urinary system. CTU demonstrates more soft tissue information than IVU in the patients with urinary tract tumors. CTU may be an alternative modality for patients with deterioration of renal function or allergic history of contrast medium.

Adolescent↗
PubMed1992

[Comparative study on nephrotoxicity of ionic and non-ionic contrast agents for drip infused urography].

The effects on renal function of an ionic and hyperosmolaric contrast agent (diatrizoate) and a non-ionic and slightly hypertonic agent (iohexol) for drip infused urography were compared on 60 patients with normal renal function. Urine samples were collected before and 30 minutes after drip infusion of contrast agent, and analyzed for albumin (ALB), gamma-glutamyl transpeptidase (gamma-GTP), N-acetyl-beta-glucosaminidase (NAG), beta 2 microglobulin (beta 2MG) and creatinine (CRE). The urinary excretion of proteins and enzymes was compared with urinary CRE. gamma-GTP, NAG and beta 2MG increased significantly after infusion of diatrizoate. gamma-GTP and beta 2MG increased significantly after infusion of iohexol. Excretion of ALB, gamma-GTP, NAG and beta 2MG was significantly higher after infusion of diatrizoate than after iohexol. The urinary concentration of CRE was significantly lower after infusion of diatrizoate than after iohexol. The degree of renal damage after urography was no related to the appearance of allergy to the contrast agent or age of patient. Therefore, the non-ionic and slightly hyperosmolaric iohexol may be less toxic to the kidneys than the ionic and hypertonic diatrizoate. This nephrotoxicity after drip infused urography is thought to be related mainly to the osmolarity of contrast agent.

Adult↗
PubMed1990

[Intravenous urography in acute pyelonephritis].

Intravenous urography, systematically performed in 50 consecutive acute pyelonephritis patients, revealed abnormalities in 17 of them: in 12 cases (24%), treatment and follow-up were modified; in the other 5 cases (10%), the anomalies were insignificant. The nephrogram was normal for 33 patients (66%). The frequency of significant abnormalities was higher in patients over 50 years of age (46.2%) than in those under 50 (16.2%) (p less than 0.05), and was also higher in patients remaining febrile for 3 days after the onset of an appropriate antibiotic therapy (66.6%) than in responsive patients (14.4%) (p less than 0.01). Among the significant lesions, 10 were detectable by echography and another by abdominal X-ray. Thus, a population of women under 50 years of age with acute pyelonephritis can be selected for urography, as shown by these results, however, they must be confirmed before changing the systematic practice of urography.

Acute Disease↗
PubMed1990

[Clinical study of iohexol in excretory urography].

Excretory urography was performed using iohexol (Omnipaque 300 and Omnipaque 350) on 388 patients requiring urography in the Department of Urology, Nagoya University School of Medicine and 10 affiliated hospitals. Adverse reactions were observed in 3 cases (0.8%), but they were all mild. Good image efficacy was obtained in more than 95% of the patients injected 20 ml, 40 ml, and 100 ml of Omnipaque 300 and 40 ml of Omnipaque 350. There was no difference in the results of image efficacy between 40 ml (Omnipaque 300) and 100 ml (Omnipaque 300) groups. Therefore, the use of 40 ml of Omnipaque 300 for excretory urography was considered to be a very useful screening method for the urinary tract.

Adolescent↗
PubMed1988

Ultrasonography should replace intravenous urography in the pre-operative evaluation of prostatism.

In 48 patients referred for radiological evaluation as part of an investigation for benign prostatism both intravenous urography and ultrasonography were used. Ultrasonography combined with a plain abdominal radiograph was shown to be a better investigation than intravenous urography. Ultrasound was equally sensitive in detecting changes in the upper tracts and post-micturition residual volume and was more accurate in estimating prostate size. Intravenous urography was slightly more sensitive in detecting bladder wall changes, but this was not of clinical significance.

Aged↗
PubMed1989

Renal parenchymal scars in adults. Split function and extent of scars at urography and DMSA scintigraphy.

In 13 adult patients the occurrence of renal scars was evaluated, and the split function was determined at both intravenous urography and 99mTc DMSA scintigraphy. The split function was also measured by the gold standard - hippuran renography. DMSA scintigraphy turned out to be as good as intravenous urography for evaluation of established scars and better for determination of split function. Thus, scintigraphy may replace intravenous urography in adults with symptoms or signs of renal scars.

Adolescent↗
PubMedDate not supplied

Influence of urography on renal function in children. A double blind study with metrizoate and iohexol.

Thirty-two children were given either metrizoate or iohexol for urography in a double blind study. Mild to moderate adverse reactions were observed in all patients receiving metrizoate (15/15) and in 4 receiving iohexol (4/17). Alkaline phosphatase in urine was significantly increased 4 hours after the injection of both media, but had returned to pre-injection levels 16 hours later. The excretion of beta 2-microglobulin and albumin was not altered. In 9 children in the metrizoate group and 11 in the iohexol group the glomerular filtration rate (GFR) was determined before urography by the single injection 99Tcm-DTPA-technique and 3 to 4 hours after urography by measuring the plasma disappearance of the contrast medium with the x-ray fluorescence technique. No reduction of GFR was observed.

Adolescent↗
PubMed1989

Evaluation of contrast dose reduction for excretory urography using computed radiography.

We prospectively investigated whether performing excretory urography by computed radiography (CR) - with CR's broader dynamic range and potential for post-processing - would permit lower contrast dose while maintaining usual image quality. The rationale for this experiment was to evaluate whether CR had potential in reducing the risks and costs associated with urography. Sixty sequential patients were randomly assigned to undergo computed urography with either our full (282 mg I/kg body weight) or half our usual dose (141 mg I/kg body weight) of intravenous 60% diatrizoate meglumine. Three blinded observers judged automatically post-processed full dose tomograms and KUBs as qualitatively superior to both automatically post-processed and individually, interactively post-processed half dose images. Thus, post-acquisition image manipulation could not fully compensate for diminished image quality due to contrast dose reduction.

Diatrizoate Meglumine↗
PubMed1988

The changing scene of radiology: value of urography as initial examination in infectious and hypertensive disease, hematuria and malignant disease.

Four to 20% positive findings were found in a review of 1913 excretory urographics. Possibly relevant findings were 20% in patients referred for infectious disease, 10% in hypertensive disease, 6% in hematuria and 4% in neoplasms. Urography influenced treatment mainly in the 2 groups with few positive findings. The costs for positive findings may be acceptable in patients with hematuria or suspicion of neoplasms, but are too high in the other groups. Until ultrasonography can replace intravenous urography as the first screening method in upper urinary tract disease, the patient selection for urography in infectious and hypertensive disease should be improved.

Adult↗
PubMed1983

Iohexol in urography. Survey and present state.

A review of the available clinical documentation on the use of iohexol in urography reveals good radiographic properties and patient tolerability with less adverse reactions than several of the conventional ionic contrast media under comparison. Iohexol has clearly been shown to be well suited for urography in adults and may be the contrast medium of choice in pediatric urography.

Adult↗
PubMedDate not supplied

Noninvasive estimation of kidney function by x-ray fluorescence analysis. Elimination rate and clearance of contrast media injected for urography in man.

A noninvasive method for the estimation of kidney function is described. The use of radioactive tracers and the sampling of plasma and urine are omitted. The method has been used in patients referred for urography and who had therefore been injected with routine amounts of iodine-containing urographic contrast medium. After urography, the elimination rates of urographic contrast medium from both serum and finger tissue were determined and compared during a 2-hour period that began two hours after injection of contrast medium. The elimination of iodine in finger tissue was measured noninvasively using x-ray fluorescence analysis. A strong degree of correlation was found between the elimination rates from serum and finger tissue and between the total clearances calculated from the serum and finger measurements. Thus, after urography estimation of kidney function may be obtained as a fringe benefit by x-ray fluorescence measurements of the elimination rate of an iodine-containing contrast medium from tissue or from serum.

Adolescent↗