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PubMedDate not supplied

Detection of renal and renal pelvic tumours with urography and ultrasonography.

Urography and ultrasonography of the urinary tract were compared prospectively and blindly in 1306 patients. The patients were a non-selected group referred for urography over 1 year. Renal cell carcinomas were detected in seven patients and carcinomas of the renal pelvis in four patients. Urography detected carcinomas in 10 patients (sensitivity 91%) and falsely suggested malignancy in 52 (specificity 96%). Ultrasonography detected carcinomas in 10 patients (sensitivity 91%) and falsely suggested malignancy in 13 (specificity 99%). No difference between the two methods in detecting renal and renal pelvic tumours was observed in the studied population.

Adolescent↗
PubMed1987

The role of routine intravenous urography in patients with primary hyperparathyroidism.

The plain abdominal radiographs and intravenous urograms of 72 patients with primary hyperparathyroidism were reviewed. Renal tract calcification was detected on plain abdominal radiographs in 27 patients (38%), and intravenous urography revealed no calculi not detected on the plain radiographs. Intravenous urography did, however, show abnormalities not detected on plain abdominal radiographs in 22 patients (37%), but these findings influenced clinical management in only five patients (7%). In these five patients there were indications other than primary hyperparathyroidism for performing an intravenous urogram. Intravenous urography incurs a small risk and should not be performed as a routine investigation in primary hyperparathyroidism.

Adult↗
PubMed1988

Ventilatory function during urography: a comparison of iopamidol and sodium iothalamate.

The effects on respiratory function during intravenous urography of the ionic contrast medium sodium iothalamate and the non-ionic contrast medium iopamidol were compared. Forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) were recorded in 37 non-atopic patients referred for intravenous urography. Nineteen patients received iopamidol and 18 patients received sodium iothalamate. Both the sodium iothalamate and the iopamidol groups showed a significant fall in FEV1 and FVC (P less than 0.001). The reductions in FEV1 and FVC were comparable and were not symptomatic. The differences in the percentage changes of the FEV1 and FVC in the iopamidol and the sodium iothalamate groups were not statistically significant (P greater than 0.5 and P greater than 0.1 respectively). No significant change in the ratio of the FEV1 and the FVC was demonstrated in either the iopamidol or the sodium iothalamate groups. Both the ionic and the non-ionic contrast media produced a measurable but asymptomatic and biologically insignificant fall in static ventilatory function. Bronchospasm does not appear to be an important contrast-induced effect in non-atopic individuals. Iopamidol offers no advantage over sodium iothalamate with respect to ventilatory effects in non-atopic patients undergoing intravenous urography.

Adult↗
PubMed1989

99mtechnetium-dimercapto-succinic acid renal scanning and excretory urography in diagnosis of renal scars in children.

We compared the ability of excretory urography (without tomography) and 99mtechnetium-dimercapto-succinic acid renal scanning to detect renal scars in 32 children with primary vesicoureteral reflux. These children did not have hydronephrosis, renal failure or urinary tract obstruction. In all cases both studies were conducted within a 10-month period. The findings from both modalities were in agreement for 51 of the 64 renal units evaluated (80 per cent). Evaluation of the excretory urogram indicated 6 cases of diffuse and 2 of focal scarring that were not detected by evaluation of the renal scan. The sensitivity of excretory urography to detect renal scars was 84 per cent and the specificity was 83 per cent. The 99mtechnetium-dimercapto-succinic acid renal scan showed 5 cases of focal renal scarring not detected by excretory urography. The sensitivity of the renal scan to detect renal scars was 77 per cent and the specificity was 75 per cent. We conclude that neither study alone could effectively replace the other for the detection of renal scars, and recommend that both be included in the initial evaluation and followup of patients with renal scars.

Adolescent↗
PubMed1988

Ultrasound diagnosis of ureteral stones: its usefulness with subsequent excretory urography.

The diagnostic accuracy of ultrasound scanning and excretory urography was compared in 157 patients with ureteral stones. Over-all, the diagnostic accuracy rates were 78.3 per cent for ultrasound scanning and 81.5 per cent for excretory urography. These rates were 83.2 and 85.0 per cent, respectively, in 107 cases of upper ureteral calculi, and 68.0 and 74.0 per cent, respectively, in 50 cases of lower ureteral stones. When the studies were combined the diagnostic accuracy rates increased to 98.1, 94.0 and 96.8 per cent for upper, lower and all stones, respectively. Ultrasound scanning is useful in the diagnosis of ureteral stones, especially in patients with ureteral colic. However, ultrasound combined with subsequent excretory urography is the most reliable method for the diagnosis of ureteral calculi. Bladder filling is a useful diagnostic aid for ultrasound scanning of lower ureteral calculi.

Adult↗
PubMed1987

The value of retrograde pyelography for fractionally visualized upper tracts on excretory urography in the evaluation of hematuria.

A 5-year retrospective study of 131 hematuria patients (23 with gross and 108 with microscopic hematuria) undergoing retrograde pyelography solely for fractional visualization of the upper tracts on excretory urography revealed no tumors or other significant pathological condition in the 187 renal units (56 bilateral cases) studied. A review of our cases of upper tract urothelial cancer since 1955 revealed 36 patients with complete records of the urological evaluations. None of the cases was diagnosed by retrograde pyelography for fractionally visualized excretory urography and 3 were within 9 months of a previously normal excretory urogram alone or with retrograde pyelography. We believe that retrograde pyelography done solely to evaluate a fractionally visualized upper tract may miss subtle lesions and it should not terminate the evaluation. We recommend that excretory urography, cystoscopy and voided urine cytology studies be performed initially and, if normal, they should be repeated in 6 and 12 months before upper tract urothelial tumors are ruled out.

Adult↗
PubMed1984

Unilateral nonvisualization on excretory urography after external trauma.

Unilateral nonvisualization on excretory urography after external trauma indicates serious consequences for the kidney, since traumatic main renal artery occlusion has been the most common cause of this finding. We evaluated 53 patients with unilateral nonvisualization on excretory urography following blunt (47) and penetrating (6) trauma. All but 1 patient had multiple injuries from severe external trauma. The renal injury causing the nonvisualization was contusion in 8 patients, laceration in 12, rupture in 12 and renal pedicle in 21. Further investigations required to diagnose the type of renal injury consisted of repeat excretory urography in 2 patients, renal arteriography in 14, renal exploration in 36 and autopsy in 1. Early diagnosis was mandatory if the kidney was to be salvaged by surgical repair of the main artery occlusion or if the appropriate management was to be used for the lesser degrees of renal injury, such as rupture, laceration and contusion.

Adult↗
PubMed1998

Efficacy of prone positioning during intravenous urography in patients with hematuria or urothelial tumor but no obstruction.

RATIONALE AND OBJECTIVES: The authors prospectively explored the efficacy of using prone positioning during intravenous urography to improve diagnostic visualization and eliminate the need for retrograde pyeloureterography in patients with no obstruction but with hematuria, history of urothelial tumor, or abnormal results of urine cytology. MATERIALS AND METHODS: Prone radiography was added to the usual intravenous urography protocol in 510 patients (347 men, 163 women) without urinary tract obstruction. Interpretations of intravenous urograms and recommendations for retrograde pyeloureterography were made before and after evaluation of the prone image. RESULTS: Confidence in the urographic interpretation was improved with acquisition of the prone radiograph in 100 of 510 patients (19.6%) (95% confidence interval, 82.1, 118). Retrograde pyeloureterography was obviated in 46 of 510 patients (9.0%) (95% confidence interval, 33.1, 58.9). The prone image was most helpful in evaluating the distal ureters (sacral and pelvic segments). CONCLUSION: Prone patient positioning during intravenous urography is useful when complete visualization of the upper urinary tract is desirable. Obtaining the additional image is cost-effective, even when only a few retrograde pyeloureterography studies are obviated.

Adult↗
PubMed2005

Excretory urography.

Excretory urography is a type of contrast study used to verify and localize upper urinary tract disease. In some instances, information regarding renal function and disease pathophysiology can also be obtained. With the recent advances in small animal ultrasonagraphy, excretory urography has become an underutilized procedure. This article will help explain why excretory urography remains, and will remain, a ubiquitous test that gives excellent detail of the entire urinary tract, and remains an essential tool for the assessment of the renal pelves and especially the ureters. Specifically, this article will focus on technique and interpretation of a properly performed excretory urogram.

Animals↗
PubMed2004

[Functional-anatomic evaluation of dilated uropathies in children using combined MR-nephrography and MR-urography compared to renal scintigraphy].

PURPOSE: To evaluate MR-tomographic assessment of split renal function and degree of obstruction compared to diuretic renal scintigraphy, and pathoanatomic imaging of the urinary tract as all in one exam. PATIENTS AND METHODS: In a prospective study 62 children, aged 1 month to 9.5 years, mean 2.8 years, underwent diuretic renal scintigraphy and dynamic MR-Nephrography at the same day except for 7 patients with a time interval of 1 day. In all patients we did T2w (water-technique MR-Urography) additionally. RESULTS: Comparing split renal function we found a very close correlation in 54 out of 62 patients (correlation coefficient = 0.95). Due to technical failures 8 cases couldn't be calculated. Comparing degrees of obstruction there was an agreement in 57 out of 62 patients, 3 studies were gradually over-, 2 underestimated. All but one morphologic diagnoses in advance obtained by ultrasound and completed by other imaging modalities later on were confirmed MR-urographically. Though correctly imaged the functionless upper moiety in a renal duplication with ureterocele was misinterpreted at a first glance. CONCLUSIONS: Combined MR-Nephrography and MR- Urography allows reliable assessment of split renal function and urinary excretion in children with obstructive uropathies compared to renal scintigraphy. T(2)w MR-Urography provides excellent depiction of dilated urinary tract. In near future MR-tomographic techniques will reduce or even replace scintigraphic and radiographic modalities in patients with urinary tract anomalies.

Child↗
PubMed1993

[Diagnosis and staging of blunt kidney trauma. A comparison of urinalysis, i.v. urography, sonography and computed tomography].

In a retrospective study of 1230 patients with blunt abdominal or flank trauma, the results of microscopic urinalysis, urography, sonography, and computed tomography in the diagnosis and staging of renal injuries were compared. Haematuria was present in 98% of renal lacerations and in all pedicle injuries, whereas among 1038 patients without haematuria only one small laceration was found. The degree of haematuria showed no correlation with the severity of renal injury. 92 renal injuries were diagnosed radiologically, including 58 lacerations, 31 contusions, and three pedicle injuries. Computed tomography was performed in 39 lacerations and six contusions, and allowed correct diagnosis and staging in all cases. Urography established the correct diagnosis in 72%, and sonography in 85%. Sensitivity in the diagnosis of clinically relevant injuries (lacerations and pedicle injuries) was 98% (specificity: 99%), when both modalities were combined. Based on the results of our study, we suggest the use of sonography as a screening modality in blunt abdominal or flank trauma, and additional urography in case of haematuria. Computed tomography is the method of choice for exact staging of suspected renal injury.

Adolescent↗
PubMed1980

[Sodium or methyl glucamine salts as contrast media for urography (author's transl)].

A double blind trial was carried out comparing 15 g sodium amidotrizoate and 15.3 methyl glucamine amidotrizoate for urography. The sodium preparation resulted in significantly better visualisation of the urinary tract, both in normal patients and in those with renal insufficiency. For routine urography in the given dose there was no difference as regards demonstration of the parenchyma and filling of the urinary tract. Similarly, there was no difference in tolerance after the intravenous administration of the two substances. The sodium salt should be avoided in patients with cardiac failure, whereas these are better tolerated than methyl glucamine salts by asthmatics. Judging by our results, the sodium salts are to be preferred for routine urography in a dose of 50 ml., particularly for patients with mild to moderate renal insufficiency.

Adolescent↗
PubMed2003

Magnetic resonance urography in pediatric urology.

OBJECTIVE: To evaluate the efficiency of magnetic resonance urography (MRU) in pediatric urology. MATERIAL AND METHODS: We report retrospectively on 12 children who underwent MRU between January 1999 and November 2001. MRU was performed to accurately evaluate the entire urinary tract because of megaureter, ectopic ureter, vesicoureteral reflux, Y-inverted duplication and hydronephrosis because of pyeloureteral stenosis. T1- and T2-weighted images were obtained in the coronal, sagittal and axial planes. The mean age of the children (8 females, 4 males) investigated was 36 months (range 2-140 months). RESULTS: An accurate anatomical picture of the entire urinary tract could be obtained in all children. The obstructive nature of megaureter could be differentiated. The distal orifice of ectopic ureter could be identified in the vagina. Vesicoureteral reflux into the blind-ending ureteral bud of a duplicated system was accurately identified. Hydronephrosis was demonstrated to be the result of pyeloureteral stenosis. The location of stenoses was easily identified in the sagittal and coronal planes. CONCLUSIONS: MRU is an excellent imaging modality for accurately depicting the urinary tract. MRU is superior to conventional intravenous urography because it does not use ionizing radiation, the gadolinium contrast medium used is not nephrotoxic and the imaging quality is excellent, reproducible and not interfered with by gas superposition. Considering the high costs and diagnostic benefit of MRU compared to intravenous urography, MRU should be performed in patients with impaired renal function, in those with an allergy to contrast medium and if anatomic relationships are not clear prior to reconstructive surgery.

Age Factors↗
PubMed1986

Urography with a low osmolality contrast agent. Comparison of Hexabrix with Conray 325.

A double-blind, parallel group comparison study of Hexabrix and Conray 325 for adult intravenous urography was performed. Sixty patients with a mean age of 54 years were included. Doses of contrast ranged from 0.5-1.1 ml/kg for both groups with a mean of 0.7 ml/kg. Hematology, urinary and biochemical laboratory tests were performed prior to the study in all patients and at 24 hours afterward in nearly half the group. Biochemical laboratory tests were done at 72 to 96 hours in approximately one third of the patients. Hexabrix proved satisfactory for standard urography at a chosen dose of 16 g of iodine (50 ml). There were no statistically significant differences in the diagnostic quality of the urogram in the two groups except for bladder filling. The decreased osmotic diuresis associated with Hexabrix necessitated delayed bladder filming for optimal evaluation. Excellent patient tolerance was achieved with less pain on injection with Hexabrix. There was one death in the Hexabrix group in a patient with multiple medical problems. Although the patient's medical problems appeared well controlled and did not meet specific rejection criteria, they almost certainly played a role in his death. Hexabrix may be useful for adult urography at a lower dose range, eg, 16 g iodine, than is typically used, which also may be cost effective (competitive) given the higher projected cost of the new low osmolar agents.

Adolescent↗
PubMed1990

Cytogenic effects of diatrizoate and ioxaglate on patients undergoing excretory urography.

Possible cytogenic alterations due to radiologic contrast medium in patients undergoing a common radiologic examination is studied. Two groups of 20 patients each were used. Group I consisted of patients undergoing excretory urography, using sodium and meglumine diatrizoate as contrast. A different agent, sodium and meglumine ioxaglate, was used with group II. Three blood samples were taken from each patient before urography, immediately after urography, and 1 week later. The frequency of sister chromatid exchanges (SCE) and chromosomal aberrations (CA) were found to increase significantly in the B samples from both groups, that of group I being higher (P less than .01 compared with P less than .05). Furthermore, these alterations were found to persist in the C samples from group I. No modification of the Proliferating Rate Index (PRI) was found. The osmolarity or other components of the contrast media studied could be involved in the process. The results indicate that ioxaglate produces less cytogenic damage than diatrizoate.

Adult↗
PubMed2003

Use of additives to contrast media to improve imaging in plain film and computed tomography urography.

RATIONALE AND OBJECTIVES: To investigate the effects of additives to iodinated radiograph contrast agents on image quality in plain film and CT urography. MATERIALS AND METHODS: Urea (52 mg/mL), iloprost (10, 20, 50, and 100 ng/mL), nifedipine (0.02 mg/mL), papaverine (0.625 mg/mL) and sodium nitroprusside (0.05 microg/mL) were added to commercial iopromide (300 mg/mL) and iotrolan preparations (280 mg/mL) and plain film urograms were obtained at different time points after contrast injection in rabbits and dogs at iodine doses of 300 or 600 mg/kg body weight. The experiments were repeated in rabbits using CT imaging and iopromide or iotrolan plus urea (52 mg/mL) or iloprost (20 ng/mL) and iodine doses of 50 mg/kg body weight. RESULTS: Urea and iloprost at low concentrations (10 and 20 ng/mL) increased image quality both in plain film and in CT urography. Iloprost at high concentrations (50 and 100 ng/mL), nifedipine, papaverine and sodium nitroprusside decreased image quality. An increase in image quality was accompanied by faster renal elimination of the contrast agent. CONCLUSION: Image quality in plain film and CT urography might be improved by additives to the contrast medium. More data, particularly on dose-response relationships are needed.

Animals↗
PubMed1994

Fluoroscopic evaluation of the ureters during intravenous urography.

In a prospective study, we assessed the usefulness of fluoroscopy in visualizing the ureters during intravenous urography. The percentage of ureter visualized was compared on radiographs acquired with and without fluoroscopic guidance. The length of ureter shown was significantly greater with fluoroscopic spot filming than with traditional urography. We recommend adjunctive fluoroscopy to enhance ureteral visualization during intravenous urography.

Fluoroscopy↗
PubMedDate not supplied

On the use of renal angiography and intravenous urography in the investigation of renovascular hypertension.

The value of renal angiography for revealing renovascular changes has been investigated in 126 patients with hypertension, and in 102 of them a comparison was made with i.v. urography. It was concluded that i.v. urography does not reveal renovascular changes and thus the primary investigation should be renal angiography, in some cases followed by urography in the same session.

Adult↗