INTRAVENOUS UROGRAM OR INTRAVENOUS PYELOGRAMThis presentation covers in detail about the anatomy, patient preparation, procedure and pathologies. It contains lots of images and timings for imaging. you can look into this presentation for more ideas about IVU/ IVP. -THANK YOU-

1. INTRAVENOUS UROGRAM
YAKESH.V
SRI RAMACHANDRA UNIVERSITY
PORUR, CHENNAI - 116

2. INTRAVENOUS UROGRAM
• Intravenous means the mode of
injecting contrast media through
vein.
• Urogram is the study of visualizing
kidney , ureters, bladder etc by
introducing contrast material.

3. HISTORY
• He developed a technique
in which a contrast
medium, UROSELECTAN
was injected into the
blood stream to see
kidneys, ureters and
bladder.
Dr. Moses Swick, American physician
and professor of urology.

4. What is Contrast media ??
• Radiographic contrast media are a type of contrast
material used to improve the visibility of internal
structures.
• Radiographic contrast medium are typically iodine or
barium.

5. KIDNEY ANATOMY
• The kidneys are paired retroperitoneal
structures.
• That are normally located between
T12-L3 vertebrae.
• Left kidney typically superior in
position than the right.
• The upper poles are normally oriented
more medially and posteriorly than the
lower poles.

6. ANATOMY
Renal pyramids
Renal artery
Renal vein
Renal hilum
Renal pelvis
Minor calyx
Major calyx
Capsule
Infundibulum

7. INDICATIONS
• Loin pain.
• Haematuria.
• Renal stones
• Abdominal trauma
• Suspected Congenital problems.
• Physiological abnormalities in kidney.

8. CONTRAINDICATION
ABSOLUTE CONTRA-INDICATION
• Pregnancy
• RFT creatinine value
above 1.3 mg/dl.
RELATIVE CONTRA-INDICATION
• Generalized allergic
conditions
• Previous allergy to the
contrast agent/iodine
• Multiple myeloma
• Hepato renal syndrome
• Infancy

9. CONTRAST
ADULT DOSE
1.2 ml/kg
CHILD DOSE
1.5ml/kg

10. MATERIALS REQUIRED
STERILE ALCOHOL SWABS
10ml & 20 ml SYRINGE10ml EXTENSION TUBE
IOHEXOL
VENFLON

11. EQUIPMENT
SHIMADZU FLEXAVISION
1000mA
SIEMENS FLUOROVISION 3000
800m A

12. EQUIPMENT
Normal X-ray unit can be used

13. PATIENT PREPARATION
• Bowel should be prepared with help of
laxatives and gas absorbers.
• Lab report values should be checked
before giving appointment.
• Clinical complaints should be asked.

14. PROCEDURE
POINTS FOR CONSIDERATION
• 1. Urinary bag to be clamped in catheterized patients..
• 2. Vaginal pack to be given for women with VUF before
injecting contrast.

15. PROCEDURE
• Informed Consent is to be obtained
• Procedure should be clearly explained to
the patient.
• Patient is asked to void before starting the
procedure.
• IV puncture is given using venflon
(18G-24G).
• Abdomen KUB scout film is taken in supine.

16. KUB-SCOUT

17. PROCEDURE
• Check the patency of the line by
flushing 10ml normal saline to
check the flow.
• Slowly the Contrast should be
injected to the patient.
• The patient should be frequently
asked for any allergic response or
any discomforts.

18. PROCEDURE
• A 5 mins film is taken in supine
after giving contrast.

19. PROCEDURE
• A 5 mins film is taken in supine
after giving contrast.
• Then following 10,15,20 mins
films are taken in same supine
position.

20. PROCEDURE
• A 5 mins film is taken in supine
after giving contrast.
• Then following 10,15,20 mins
films are taken in same supine
position.

21. PROCEDURE
• A 5 mins film is taken in supine
after giving contrast.
• Then following 10,15,20 mins
films are taken in same supine
position.
• 30 mins film is taken in prone
position.

22. PROCEDURE
• A 5 mins film is taken in supine
after giving contrast.
• Then following 10,15,20 mins
films are taken in same supine
position.
• 30 mins film is taken in prone
position.
• Then a full bladder is taken.

23. PROCEDURE
• Following post void is taken to
see the residual urine in the
bladder.
• Delayed film has to be taken
by upto 24 hrs incase of
obstructive uropathy.

24. FILM FORMAT
• To concise we take
• Scout AP
• 5 mins film
• 10 mins film SUPINE
• 20 mins film
• 30 mins film – Prone
• If necessary oblique views.

25. PATHOLOGY !!!

26. POST VOID RESIDUE
Normal Image showing PVR

27. POST VOID RESIDUE
Normal Image showing PVR

28. HORSE SHOE KIDNEY

29. HORSE SHOE KIDNEY

30. PUJ OBSTRUCTION

31. URETEROCOELE

32. NON FUNCTIONING KIDNEY
15 min film showing no
excretion in left kidney
Delayed 24 hrs film showing no
excretion in left kidney

33. DOUBLE MOIETY

34. HERNIATION OF BLADDER INTO
THE RIGHT INGUINAL CANAL

35. GENITOURINARY TUBERCULOSIS

36. AFTER CARE
• Patient is asked to drink lot of water.
• Anti-allergic and antihistaminic drugs are given to the
patient if complains of any allergy.

37. PARAMETERS
VIEW kV mA mAs
AP 80-90 200 20-25
OBLIQUE 85-90 200 30-40
VIEW kV mA mAs
AP 70-80 1-2 2-3
OBLIQUE 85-90 1-2 2-4

38. THANK YOU