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Pediatrie urinary infections, vesicoureteral reflux, and voiding dysfunction
Published in J Kellogg Parsons, E James Wright, The Brady Urology Manual, 2019
Intravenous pyelogram (IVP): Shows scars wellDisadvantage: associated with radiation/contrast dosing.
Applications in radiology
Published in Sam Beddar, Luc Beaulieu, Scintillation Dosimetry, 2018
Daniel E. Hyer, Ryan F. Fisher, Maxime Guillemette
Figure 11.9 Fluoroscopy is utilized during orthopedic surgery procedures in order to verify the position of plates and screws in the ankle. (Courtesy of Cleveland Clinic.) Genitourinary exams: Genitourinary procedures involve fluoroscopic imaging of the urinary and genital organs in order to diagnose disease or defect. An intravenous pyelogram (IVP) procedure uses fluoroscopy to observe kidney, bladder, and ureter functionality. An IVP involves injecting an iodine-based contrast agent into a vein in the arm, and then taking a series of fluoroscopic images over a period of time to visualize how the dye is filtered by the kidneys, collected in the bladder, and ultimately expelled through the ureters and urethra.
Proteinuria in Pregnancy
Published in Tony Hollingworth, Differential Diagnosis in Obstetrics and Gynaecology: An A-Z, 2015
Peter Muller, Rachel Wooldridge
Intravenous urogram (IVU) is used less commonly today to evaluate the renal collecting system and renal stones, unless specific information is required prior to surgical intervention. If an intravenous pyelogram (IVP) is required as an adjunct to other imaging modalities in pregnancy, the fetal radiation dose can be minimised with limited scans (including a preliminary plain abdominal X-ray, early and late post-contrast abdominal X-rays only). (See Breathless in pregnancy: respiratory causes.)
Accuracy of transvaginal ultrasound and magnetic resonance imaging for diagnosis of deep endometriosis in bladder and ureter: a meta-analysis
Published in Journal of Obstetrics and Gynaecology, 2022
Zhao Tian, Yi-Chao Zhang, Xian-Hua Sun, Yue Wang, Yan Zhao, Xiao-Hong Chang, Hong-Lan Zhu
UE is usually asymptomatic, making early diagnosis difficult. The condition is often found incidentally as hydroureteronephrosis incidentally on preliminary imaging screening. Several imaging modalities, including CT (Iosca et al. 2013) intravenous pyelogram (IVP), and ultrasonography (Medeiros et al. 2015; Guerriero et al. 2016) have been used for preoperative assessment of extrinsic versus intrinsic ureteral involvement, though all of them failed to ideally characterise the depth of tissue invasion. To help map the disease and plan the optimal surgical approach, UE patients often undergo further investigation using 3D ultrasound or MRI (Sillou et al. 2015; Takeuchi et al. 2015; Guerriero et al. 2016). In this meta-analysis, we found that MRI (with 97% sensitivity and 100% specificity) was not significantly superior to TVS for diagnosing UE (with 87% sensitivity and 100% specificity) which is consistent with the previous Meta-analysis suggesting similar diagnostic performance of TVS and MRI in the detection of DIE, confirming the role of TVS as a cost-effective first-line technique (Guerriero et al. 2018; Noventa et al. 2019). However, some other studies suggested that MRI can also be used to determine the extent of endometriosis outside the pelvic cavity, including sub-peritoneal and upper abdomen localizations that are often undetected on gynecological examination, TVS, or even laparoscopy (Koninckx et al. 2012; Biscaldi et al. 2020). So, we suggest that MRI should also be considered a first-line technique if conditions permit, and if not, highly skilled sonographers were needed to accomplish the diagnosis via TVS.
Contrast-associated acute kidney injury following peripheral angiography
Published in Baylor University Medical Center Proceedings, 2021
Alyssa A. Woltemath, Gabriel Gonzalez, Kristen M. Tecson, Javier Vasquez
Acute kidney injury (AKI) following intravenous contrast administration was first characterized in 1954 when a patient progressed into acute renal failure following an intravenous pyelogram.3 Since then, one of the most significant protections against CA-AKI has been the transition from high-osmolarity contrast to low-osmolar or iso-osmolar contrast media.3 Early contrast media had osmolarities reaching 2200 mOsm/kg, which represents 5 to 8 times the osmolarity of any tissue or fluid in the human body.4 This drastic change in osmolarity can deform red blood cells, cause direct injury to vascular endothelial cells, and result in shifts in the intravascular and extravascular fluid volume.4 Further, it can cause widespread vasodilation and conversely renal artery vasoconstriction.4 Low-osmolar contrast media was developed in 1974 with an osmolarity ranging from 780 to 800 mOsm/kg.4 Although this is hyperosmolar compared to the average serum osmolarity of 300 mOsm/kg, it is still a 64.1% reduction in osmolarity from the previous high osmolarity of contrast media used.4 Luk and colleagues observed more than a threefold protection against nephropathy in patients treated with low-osmolar when compared to high-osmolar contrast agents.3 The low rate of CA-AKI observed in our study may be partly attributable to the avoidance of high-osmolar agents at our center; low-osmolar contrast media is used in most cases and iso-osmolar contrast media is used for high-risk patients.5
Is there still a role of balloon dilatation of benign ureteric strictures in 2019?
Published in Scandinavian Journal of Urology, 2020
Wai Loon Yam, Sey Kiat Terence Lim, Keng Sin Ng, Foo Cheong Ng
After excluding ureteroileal anastomotic strictures and malignant strictures, there are 109 strictures (100 patients) in in our single center retrospective cohort from August 2012 to July 2018. Non-incidental ureteric strictures are diagnosed by imaging such as CT intravenous pyelogram (CT IVP), intravenous urogram (IVU) and/or retrograde/antegrade pyelogram. An incidental stricture is defined as a stricture encountered during ureteroscopy and impassible by a semi-rigid ureteroscopy. A non-incidental stricture is defined as a stricture that can be diagnosed on preoperative imaging. The age of stricture is estimated by the first symptom (e.g. renal colic in a case of ureteric stone causing a stricture formation) or the first imaging (if asymptomatic) to the date of balloon dilatation is performed. Recurrence of stricture is defined as persistence/worsening on follow-up imaging or the need for long term PCN/DJ stent or need for reconstructive surgery.