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PubMed1986

Diagnostic morphologic and urodynamic antegrade pyelography.

Diagnostic antegrade pyelography, with a thin needle, is basically a simple procedure that can be performed relatively rapidly under local anesthesia with few complications of significance. Its role, however, is frequently crucial to subsequent patient management. During morphologic antegrade examination, aspirated urine can be analyzed for tumor cells (cytologic examination), infection (smear, culture), or other biochemical alterations. The use of antegrade pyelography in the demonstration of internal diversion, ureteral fistula, and the site and cause of obstruction is well established. Dynamic antegrade study is crucial in the assessment of many pyeloureteral units in which the issue of current obstruction is equivocal or uncertain. Absolute renal and bladder pressures are obtained simultaneously; these and the calculated differential pressure provide objective data relative to ureteral resistance to urine flow and renal nephron preservation.

Adult↗
PubMed1985

[Antegrade pyelography].

Percutaneous antegrade pyelography under ultrasonic real-time guidance was performed in 18 cases of obstructive hydronephrosis, which were poorly visualized the renal collecting system on excretory urography and in which or retrograde pyelography could not be performed successfully. This technique was safe, accurate and easy, and provided significant diagnostic information in these cases. With the patient under local anesthesia an 18 gauge spinal needle was inserted into the renal pelvis. Approximately 10-20 ml fluid were withdrawn from the renal pelvis for cytology and culture. After the injection of contrast medium radiograms were obtained in adequate positions. Delayed films were obtained when indicated. In 8 cases pelvic and/or ureter tumor was diagnosed. In two cases congenital anomalies were diagnosed, one had complete obstruction at the ureteropelvic junction and the other had complete obstruction at the ureterovesical junction. In the other three cases ureter ligation and in 5 cases ureter stenosis were diagnosed. The quality of the aspirated urine was dark-red in 6 cases, positive cytology, in 6 cases, all of which had pelvic and/or ureter tumors. No severe complications were observed.

Adult↗
PubMed1981

[Echotomography in nephroblastoma and neuroblastoma of the lumbar fossa in childhood. Comparison with intravenous pyelography and computerized tomography (author's transl)].

The respective values of intravenous pyelography, ultrasound examination and computerized tomography are compared with the findings at surgery and with histological data in 28 children with malignant tumors of the lumbar fossa. Ultrasound proved to be of significant value in assessing the extent of the tumor. At the present time, computerized tomography is only indicated when intravenous pyelography and ultrasound examination fail to provide adequate information.

Angiography↗
PubMed1978

Comparison of arteriography, venography, and pyelography in experimental renal trauma.

Experimentally produced renal injuries are shown by arteriography, venography, and retrograde pyelography using geometric magnification techniques. Arteriography is the most satisfactory modality examined. Venography is technically more difficult and generally less sensitive than arteriography, although extravasation of contrast material was shown with equal frequency. Retrograde pyelography is inferior to arteriography and correlates closely with the venographic findings.

Animals↗
PubMed1981

[Anterograde pyelography to assess morphology (author's transl)].

The use of anterograde pyelography to assess morphological changes revealed the presence of obstruction in the upper urinary tract, previously undetected by urography, in 61 patients studied. The technique, used almost exclusively to expose the pelvis over the last year, is described. Only in very rare cases was there a failure to puncture the renal pelvis, and no complications occurred. The relative indication of anterograde and retrograde pyelography are discussed, as well as the morphological data obtained by each method in different types of obstruction: complete, severe incomplete, and partial. The main indications for this procedure are reviewed as a function of the etiology.

Adult↗
PubMed1980

[Combined intravenous arteriography and pyelography in hypertension. I. -- Technical and diagnostical aspects on the bases of 475 cases (author's transl)].

UNLABELLED: Renal arteriogram can be obtained by a rapid injection (15-22 ml/s) of a venous bolus of 2-3 ml/kg B.W. of contrast media at 38 p. 100 and followed by an excretory pyelography with early films and wash out by furosemide to determine the functional significance of an eventual stenosis in a hypertensive patient. Analysis of 2 000 such radiological examinations, 475 of which done in hypertensive patients, showed that a stenosis could be adequatly detected in 70 p. cent of the cases when only one arteriographic film was taken and in 95 p. 100 of the cases when 6 films were taken with a film changer. With this latter technique the morphological information was comparable to that obtained with the Seldinger technique. This latter was however necessary to confirm the stenosis preoperatively when only one arteriographic film was taken. Tolerance of the examination was good in spite of transitory heat sensation and headache in 66 p. cent of the cases. The examination of 475 hypertensive patients led to discover 55 renal artery stenosis, 12 of which were functionnal, 4 aneurysms (1 of the renal artery, 2 of the aorta, and 1 of the hepatic artery) and one coarctation. IN CONCLUSION: combined intravenous arteriography and pyelography is a valuable technic, as regards, safety and efficiency in the diagnosis of renovascular hypertension. This warrants a comparison of this technique with the classical diagnostic approach of renovascular hypertension as regards its diagnostic efficiency and cost for the community.

Adolescent↗
PubMed1988

Hematuria following blunt abdominal trauma. The utility of intravenous pyelography.

To clarify the indications for intravenous pyelography (IVP) and nephrotomography (NT) in the evaluation of patients with hematuria following blunt thoracoabdominal trauma, we performed a retrospective analysis of patients admitted during a one-year period who had undergone IVP and NT for suspected renal injury. One hundred thirty-four patients were reviewed, and the findings of IVP and NT correlated with the magnitude of hematuria on urinalysis, associated injuries, management, and outcome. Sixty-two (46%) of 134 patients had fewer than ten red blood cells per high-power field (RBCs/HPF) on urinalysis (group 1), 19 (14%) of 134 patients had 10 to 30 RBCs/HPF (group 2), and 53 (40%) of 134 patients had greater than 30 RBCs/HPF (group 3). Twenty-seven patients had renal injuries detected by IVP and NT, two in group 2 and 25 in group 3. We conclude that IVP and NT should be reserved for patients with greater than 30 RBCs/HPF on admission urinalysis.

Abdominal Injuries↗
PubMed1995

Imaging evaluation of blunt renal trauma in children: diagnostic accuracy of intravenous pyelography and ultrasonography.

Forty-six consecutive children with blunt renal injury were evaluated retrospectively to assess the diagnostic accuracy of the different imaging methods, including ultrasonography (US), intravenous pyelography (IVP), and computed tomography (CT), and to determine the optimal radiologic management. Doppler ultrasonography was never performed in an emergency. Classification of the 46 renal injuries was as follows: 25 contusions, 4 lacerations, 11 ruptures, and 6 pedicle injuries. The diagnostic accuracy of IVP (80.8%) was superior to the diagnostic accuracy of US (41%) in all types of renal injuries. IVP should be performed as an emergency procedure when macroscopic hematuria is present, or when an isolated renal injury is clinically suspected. Microscopic hematuria alone is no longer an indication to perform IVP. Asymptomatic patients with microscopic hematuria should have US examination and should be observed with performance of serial urine analyses. Multiply injured and hemodynamically stable children should be evaluated by contrast-enhanced CT. Hemodynamically unstable children should undergo immediate exploratory laparotomy, if it is indicated after assessment by imaging.

Child↗
PubMed1979

The results of isotope renography and intravenous pyelography in 420 patients with carcinoma of the uterine cervix.

A group of women with carcinoma of the cervix was studied by renography and i.v. pyelography. The incidence of renal and urinary tract disorders detected by these tests increased as did the stage of the disease, being 17.1% with Stage I carcinoma of the cervix, 27.8% with Stage II carcinoma of the cervix, 47% with Stage III carcinoma of the cervix, and 83.3% in Stage IV carcinoma of the cervix. In patients with Stage I and Stage II carcinoma of the cervix, those selected for radiotherapy had twice the incidence of abnormal renograms as those selected for surgery. This difference probably reflected a higher incidence of medical disorders affecting renal and urinary tract function in those considered unfit for surgery. We believe that renograms should be used routinely as a screening test in patients with carcinoma of the cervix.

Female↗
PubMed1988

Dominant and recessive polycystic kidney disease in children: classification by intravenous pyelography, ultrasound, and computed tomography.

Both dominant and recessive polycystic kidney disease appear in childhood. We have analyzed findings of intravenous pyelography, ultrasound and computed tomography in genetically classified cases of dominant (13 children) and recessive polycystic kidney disease (5 children) and thus defined criteria by which sporadic cases of childhood polycystic kidney disease can be classified to dominant or recessive polycystic kidney disease.

Child↗
PubMed1975

Urologic complications after operations for anorectal cancer, with an evaluation of preoperative intravenous pyelography.

Urologic complications arose in 23.7 per cent of 569 patients who underwent abdominoperineal or low anterior resection for anorectal cancer. No radomization of the two operations was attempted, low anterior resection being performed whenever resection 5 cm below the tumor was possible. Complications were more frequent after abdominoperineal resection and in men. Preoperative intravenous pyelography was performed in the cases of 541 of the patients, including 60 who underwent palliative colostomy. The pyelograms of 30 per cent of these patients were abnormal. The abnormalities were anatomic variations of the urinary tract in 25 per cent and urologic diseases in 75 per cent. None of the postoperative urologic complications was related to an abnormal preoperative pyelogram. No relation was found between the radicality of abdominoperineal and low anterior resection and the pyelographic signs of tumor involvement.

Anus Neoplasms↗
PubMed1985

Fine-needle antegrade pyelography of transplanted kidneys.

Ureteral obstruction or perforation must be considered as a cause of poorly functioning renal transplants. Sonography and radionuclide scanning will demonstrate outflow obstruction and/or pararenal fluid collection, but do not usually provide sufficient information on the site of the lesion. In these cases we have successfully used fine-needle puncture of the renal pelvis under sonographic guidance, and antegrade pyelography. This technique shows excellent anatomical details of the renal pelvis and ureter.

Graft Rejection↗
PubMed2005

Direct ureteric length measurement from intravenous pyelography: does height represent ureteric length?

Ureteric length is the most important factor for determining the ideal length of a ureteric stent. In most of the literature, ureteric length is estimated according to a patient's height. We investigated the reliability of a patient's height as a measure of ureteric length. We measured the actual length of the ureteric trace (ALUT) and the linear distance (LD) from the ureterorenal junction to the ureterovesical junction by intravenous pyelography (IVP), using a 15 min view. A total of 203 patients (100 men, 103 women, 406 ureters) with normal findings were studied, and ALUT, LD and height were measured. The mean patient height was 164.3 +/- 8.3(SD) cm. Mean ALUTs of the right and left ureters were 23.4 +/- 1.9 cm and 24.4 +/- 2.0 cm, respectively, and the mean LDs of the right and left ureters were 22.1 +/- 1.9 cm and 22.9 +/- 2.0 cm, respectively. Height was significantly correlated with the ALUTs of both sides, but these were not linear (r2 = 0.024 right, 0.059 left). However, LD showed significant linear correlations with the ALUTs of both sides (r2 = 0.879 right, 0.884 left). Two formulas to estimate the ALUT from LD were suggested: right ALUT = 0.94 x right LD + 2.6, left ALUT = 0.96 x left LD + 2.4. Our results demonstrated that patient height does not provide a reliable estimate of ureteric length. LD by IVP is preferable to patient height when estimating the ureteric length.

Adolescent↗
PubMedDate not supplied

MR pyelography in the assessment of hydroureteronephrosis: single-shot thick-slab RARE versus multislice HASTE sequences.

BACKGROUND: We used magnetic resonance (MR) pyelography to compare the value of thick-slab single-shot rapid acquisition with relaxation enhancement (RARE) sequence with that of multislice half-Fourier acquisition single-shot turbo-spin-echo (HASTE) sequence in evaluating the full spectrum of morphologic features in a group of patients with hydronephrosis. METHODS: MR pyelographic images, with the use of thick-slab RARE and multislice HASTE sequences in 90 patients, were evaluated for image quality, presence of hydronephrosis, and level and cause of obstruction. RESULTS: HASTE sequences provided images of better quality than did RARE sequences (p < 0.001). There was no statistically significant difference in demonstrating the presence of hydronephrosis (p = 0.5) and level of obstruction (p = 0.125). Sensitivity, specificity, and accuracy in diagnosing cause of obstruction were 61.7%, 62.5%, and 62%, respectively, for RARE sequences and 80%, 82.5%, and 81%, respectively, for HASTE sequences, with a statistically significant difference (all p < 0.05). CONCLUSION: Multislice HASTE sequence provides better diagnostic information than does thick-slab RARE sequence, particularly in evaluating the cause of obstruction.

Female↗
PubMed1989

Comparison of oral, written and audio-visually based information as preparation for intravenous pyelography.

Four different ways of giving information in advance to patients about to undergo a threatening medical procedure (intravenous pyelography) are compared; oral, written, slide-tape based and film-sound based. The effectiveness of the methods is measured through patients' ability to recall key point topics in the information spectrum and through their estimates of the degree of overlap between the mental images built up from the information and the reality experienced during the examination. The result is that no significant differences were found, except for one case of overlap. The relative merits of the four methods as they emerge from patients' comments are briefly discussed.

Adolescent↗
PubMed1977

Electrocardiographic changes with intravenous pyelography in healthy individuals.

Fifty apparently healthy individuals undergoing intravenous pyelography had electrocardiographic evaluation before, during, and after the examination. No patient had a major electrocardiographic change after contrast injection. Of the 7 patients with abnormal baseline electrocardiograms, all had a striking (greater than 40 beats per minute) rise in rate. The 43 patients with normal electrocardiograms had a small but significant rise in rate. No ischemic changes or major arrhythmias occurred. Although electrocardiographic aberrations were better correlated with baseline electrocardiograms than history or physical evaluation, our experience and a review of the literature confirms the safety of this examination in healthy people.

Adult↗