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PubMed1995

Diagnostic imaging in children with urinary tract infection: the role of intravenous urography.

Ninety children referred to hospital with urinary tract infection (UTI) were investigated by iv urography (IVU), ultrasonography (US) and 99mTc dimercaptosuccinic acid scan (DMSA). Fifty-eight children also underwent micturating cystourethrography (MCUG). In 36 (40%) of the children, at least one result was abnormal. Abnormal findings were found in 29 children with IVU, in 10 with US and in 16 with DMSA. Six of the 58 children had vesicoureteric reflux (VUR) in 8 kidneys. In 16 children, IVU was the only examination with an abnormal result, and in 10 of these the findings were considered important for treatment or prognosis. IVU is an important supplement to US and DMSA in investigation programs for children with UTI. IVU should be performed in cases of renal scars, dilatations or in children with recurrent infections.

Adolescent↗
PubMed1978

Computed tomography in diagnosis of abdominal masses in infancy and childhood. Comparison with excretory urography.

Computed tomography (CT) of the abdomen and pelvis was performed in 26 instances of suspected mass in 24 infants and children. The information obtained was compared to that of standard abdominal radiography and excretory urography (IVP). Results were analyzed prospectively. CT was able to detect and define masses more precisely than abdominal radiography and IVP. The information obtained by CT, in a single noninvasive examination emitting minimal ionising radiation, seems comparable to that offered by a combination of multiple radiological and other imaging procedures. It is conceivable that with accumulating experience and further technological improvement CT may become an excellent screening procedure in the investigation of abdominal and pelvic masses. The high cost of CT scanning may be offset by the benefits cited.

Abdominal Neoplasms↗
PubMed1969

Acute urography: a method for general use.

A new method of acute urography suitable for use in any general hospital is described. It takes only 30 minutes and can be performed by the duty radiographer.The method has proved invaluable in the diagnosis and differentiation of renal colic. With radiation safeguards, it may be of value in pregnancy. It has been found useful in renal trauma and in the differential diagnosis of haematuria.

Adult↗
PubMed1969

Urography in myelomatosis.

To investigate whether urographic contrast media might precipitate Bence Jones protein in the renal tubules and lead to renal failure in patients with myelomatosis, the reaction between the media and myeloma urine was studied in vitro. Appreciable precipitation was found only in urine at or below pH 4.5, and its occurrence did not correlate with the type or concentration of protein present. It is concluded that the risk of urography in myelomatosis is very small.

Acute Kidney Injury↗
PubMed1973

Excretion urography in acute renal failure.

High-dose excretion urography has been carried out in 32 patients presenting with non-obstructive acute oliguric or non-oliguric renal failure. An early, dense, persisting nephrogram has been observed in all patients with acute uncomplicated tubular necrosis and in patients with acute oliguric pyelonephritis. This appearance is modified by the presence of pre-existing renal disease. Different patterns have been observed in patients with acute glomerular disease, severe renal ischaemia, and chronic glomerular disease. The study demonstrates that careful analysis of the evolution of the nephrogram in patients with acute renal failure provides valuable information as to the nature of the parenchymal disease.

Acute Kidney Injury↗
PubMed1974

Use of intravenous urography.

Studies on 1,476 intravenous urographic examinations done in a 15-month period showed that the proportion of abnormal results varied widely-from 20% in patients with abdominal pain other than renal colic to 92% of those in prostatism. Patients with the strongest clinical evidence of haematuria were the most likely to have abnormal urograms, and to undergo cystoscopy with abnormal findings on this examination. All six patients with renal hypertension showed abnormalities other than on the urogram. Prior use of other tests may increase the effectiveness of urography.

Abdomen, Acute↗
PubMed1988

Fatal Stevens-Johnson syndrome following urography with iopamidol in systemic lupus erythematosus.

A 46 year old white woman with active systemic lupus erythematosus developed a skin rash 8 hours after intravenous urography with the non-ionic contrast medium iopamidol. Severe Stevens-Johnson syndrome with erythema multiforme, intrahepatic cholestasis, pulmonary infiltrates and acute renal failure ensued, leading to her death. Although non-ionic contrast media are generally less toxic than traditional ionic agents, their use in patients with immunological disease may be hazardous.

Female↗
PubMed1976

Predicting tomographic levels for urography.

Based on a retrospective and prospective analysis of more than 200 consecutive patients undergoing excretory urography, the authors formulated a chart for determing optimum tomographic levels using the anteroposterior abdominal distance as a criterion. the renal contour was visualized satisfactorily in 93% of cases.

Humans↗
PubMed1976

Fluid restriction before excretory urography.

Despite a lack of hard evidence, many radiologists continue to support the use of fluid restriction before urography. Based on increasing the urinary contrast medium concentration, this has been shown to be a poor index for renal opacification. The usual overnight restriction produces no significant change in urine osmolality or opacification. Effective fluid restriction may produce a just detectable increase in pyelographic density but the nephrogram in unaffected, even by active hydration. Fluid restriction may occasionally result in inadvertent dehydration with serious or fatal reactions. Since it is ineffectual in improving the urogram and potentially hazardous, it should be abandoned.

Contrast Media↗
PubMed1977

Visualization of the gallbladder wall at excretory urography: implication for infusion tomography of the gallbladder.

Visualization of the gallbladder wall during intravenous infusion of diatrizoate has been equated with cholecystopathy. However, a large control group of patients without biliary tract symptoms has not been studied. The authors examined a group of 2,867 such patients who underwent excretory urography; the results suggest that visualization of the normal gallbladder wall occurs frequently enough to severely limit the usefulness of infusion tomography of the gallbladder in the diagnosis of cholecystopathy.

Cholecystography↗
PubMed1979

The selection of patients for excretory urography.

Symptoms, signs, and laboratory findings that indicated excretory urography in 1,622 patients, were compared with the radiographs. The chance that an indication would be associated with demonstrable disease was calculated. No "low-likelihood" indications could be identified. Elimination of the urograms obtained for any of the indications would not have been possible without simultaneously precluding detection of many diseased patients. The monetary cost of case-finding was low, and the efficacy of patient referral high.

Boston↗
PubMed1980

Cytogenetic effects of contrast material in patients undergoing excretory urography.

Acentric chromosome fragments produced in cells by irradiation or other agents give rise to micronuclei in daughter cells. The micronuclei can be counted readily in large numbers of cells which provides a sensitive measure of chromosome aberrations. Previous studies have shown that the presence of contrast material enhances the radiation-induced yield of micronuclei in vitro. This may be due to the dose enhancement effect and the chemical action of contrast media or their derivatives. Micronuclei were scored in peripheral blood lymphocytes obtained from 26 patients before and after excretory urography (ExU). The results show a consistent and significant increase in the counts after ExU amounting to about one third of the counts blood samples before the examination. We have also measured radiation exposures in this group and estimated an average exposure to the circulating lymphocytes of about 0.2R (0.52 X 10(-4) C/kg). We conclude that the contrast medium contributed significantly to the increase in micronuclei.

Adult↗
PubMed1980

Evaluation of the renal outline by excretory urography.

Tomograms and oblique radiographs were compared in 172 adult patients undergoing routine urography to assess the degree of renal outline visualized and to determine the best midpoint for nephrotomography. Tomograms proved better for demonstrating the renal outline (66.3% of patients demonstrating 78.4% of the renal circumference) than oblique views (only 23.2% of patients demonstrating 65.5% of the renal circumference). The combination of tomograms and oblique radiographs proved best, demonstrating 96.5% of the renal outline. Colon cleanliness was a significant factor. The midpoint of tomographic sections is determined by multiplying the anteroposterior diameter of the patient by 0.4.

Humans↗
PubMed1981

Recognition of bladder tumors by excretory urography.

Bladder tumors initially may be diagnosed by excretory urography in patients undergoing the examination because of specific symptoms or unrelated complaints. Among seven strategies tested by six experienced readers, the combination of early, full-bladder, and postvoiding anteroposterior radiographs was most successful in identifying bladder tumors in a series including 20 cases of biopsy-proved bladder tumor and 19 cases of cystoscopically normal bladders. The postvoiding radiograph, when viewed alone, was the single most valuable projection, and resulted in the correct diagnosis of 14 cancers that were not appreciated on any other single radiograph for a given case. The addition of oblique projections to the other three views did not significantly increase diagnostic sensitivity.

Carcinoma, Transitional Cell↗
PubMed1982

Computed tomography as a supplement to urography in the evaluation of suspected neuroblastoma.

Eleven children in whom a retroperitoneal neuroblastoma was suspected on the basis of plain radiographic or urographic findings underwent computed tomography (CT). CT identified and localized a neurogenic tumor in eight patients. Calcifications were demonstrated by CT in six lesions, but by urography in only four. One neuroblastoma detected by CT was not seen on the urogram; in five patients greater extent of the tumor was defined by CT than by conventional radiologic procedures. In three patients CT excluded a neuroblastoma, but diagnosed other disorders (hepatic tumor, pancreatitis, and retrocaval ureter). Our results confirm that CT is a simple and accurate method for diagnosis, delineation of extent, or exclusion of neuroblastoma.

Abdominal Neoplasms↗
PubMed1982

Collateral circulation secondary to upper extremity venous thrombosis visualized during excretory urography.

Unsuspected upper extremity venous thrombosis was observed in three patients undergoing excretory urography. Thoraco-abdominal collateral vessels were readily visible following an intravenous bolus injection of contrast material into a vein in the affected extremity. The increased incidence of upper extremity venous thrombosis is probably due to the frequent use of subclavian vein catheterization for parenteral nutrition, central venous monitoring, and cardiac pacing. The collateral pathways are characteristic and can easily be recognized.

Adolescent↗