Urography, shock reaction and repeated urography.
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Humans↗
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[Has the technic of urography by perfusion, in comparison with standard urography, reduced the percentage of complications?].
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Contrast Media↗
[Should complete intravenous urography still be performed systematically in all cases of arterial hypertension? Remarks on 1,500 cases. Diagnostic, economic and dosimetric findings. The value of a simplified method of intravenous urography (author's transl)].
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Adolescent↗
Urography in children: when should it be done? 2. Conditions other than infection.
Conditions that are often associated with an increased incidence of renal anomalies include imperforate anus, congenital vertebral abnormalities, and Fanconi anemia; excretory urography should be done if such a condition is present. Urography is also useful to provide baseline data in conditions associated with later development of urinary problems, such as myelodysplasia, prune-belly syndrome, and exstrophy of the bladder. In addition, urography serves as a periodic check for complications of treatment (hydronephrosis, obstruction) in patients with urinary diversion. Certain signs, eg, dribbling, hematuria after mild trauma, unexplained pneumothorax or pneumomediastinum in a neonate, and neonatal abdominal mass, call for immediate urography. In many conditions that were formerly thought to be associated with major urinary abnormalities, urography is not called for. Such is the case in hypospadias, deformities of the external ear alone, and undescended testes. Dehydration is the only absolute contraindication to urography.
Child↗
Prediction of vesico-ureteral reflux in children from intravenous urography films.
Intravenous urography and voiding urethrocystography were performed on 255 children with urinary tract infection. Eighty-six (34%) of these children had some kind of abnormality of the urinary tract. Vesico-ureteral reflux was observed to 96 ureters (19%) in 69 children (27%). The prediction of vesico-ureteral reflux by two radiologists from urography films only gave 46 (48%) and 51 (53%) false negative results respectively. In cases of clinically important reflux (III--V degrees), however, the rate of false negative predictions was 0/18 and 1/18 (6%) respectively. The rate for false positive predictions were 45/413 (11%) for both radiologists. In view of the number of pathological findings in this series i.v. urography is recommended as a routine in children undergoing urological work-up after their first urinary tract infection. As the clinically important vesico-ureteral reflux seems to be predictable from urography films alone, voiding urethrocystography seems not to be justified in children with negative i.v. urography, and can be postponed and carried out later if the urinary tract infection recurs.
Adolescent↗
The value of routein intravenous urography in acute epididymitis.
The urographies of 106 patients with acute epididymitis are reviewed. In 71 cases the urogrpahy was completely normal, while in the remaining 35 patients abnormalities were found. In 25 patients the findings were consistent with hypertrophy of the prostate. More than half of the patients had known urological diseases and had undergone cystoscopy and/or catheterization prior to the onset of acute epididymitis. All 35 patients had demonstrated symptoms that would otherwise have resulted in intravenous urography independent of the epididymitis. No cases of urogenital tuberculosis were found. The authors conclude that routine urography under the age of 50 is not recommended. Over the age of 50 concomitant urological diseases are so common that urography is often indicated, but acute epidiymitis in itself is only a relative indication.
Acute Disease↗
Metrizamide in urography. II. A comparison of 51Cr-EDTA clearance and metrizamide clearance in man.
In nine subjects undergoing urography with metrizamide measurements of total serum clearance of 51Cr-EDTA have been made before, during, and after the urography. During the urography both total serum clearances and renal clearances were determined for 51Cr-EDTA and metrizamide. The present study in man confirms the previous results from investigations in rabbits, that most of the intravenously injected metrizamide is excreted through the kidneys, that tubular reabsorption of metrizamide occurs and suggests that metrizamide might be used with advantage for urography.
Chromium Radioisotopes↗
The value of provocative and acute urography in patients with intermittent loin pain.
Twenty-two patients with intermittent loin pain thought to be typical of primary pelvic hydronephrosis but with normal appearances at standard excretion urography were subjected to diuretic urography using Frusemide-induced diuresis. If this was normal, acute urography was performed when the patient had pain. Abnormal appearances were shown in only 15 patients. In 4, only the erect films revealed the hydronephrosis. Dilatation occurred in response to a diuretic load in 9 and the abnormality was shown at the time of an attack of pain in 4. The hydronephrosis was shown only during the attack of pain in 2, a diuretic urogram having been normal. In 2 patients the nephrographic signs of acute obstruction were shown to be due to occlusion of the pelvi-ureteric junction at the time of an attack of pain. The importance of sequential examination, the value of erect films and acute urography are stressed.
Diuresis↗
Furosemide-augmented intravenous urography: results in essential hypertension.
Giving an intravenous diuretic during urography (furosemide-augmented urography, vasodilated urography) causes renal swelling which is easily measured. Several investigators have used this observation as the basis of a screening test for renovascular hypertension. They found that normal kidneys enlarge in area by more than 10%, while kidneys with renal artery stenosis show a blunted size response, usually less than 5%. We used the technique in 46 patients with proven essential hypertension in order to further examine its potential usefulness in the hypertensive population. The 92 kidneys showed an average area increase of only 7.0% +/- 3.6% SD, and only 15% of the kidneys enlarged by more than 10%. Based on these observations we doubt that vasodilated urography will be valuable as a screening test for renovascular hypertension because of the high incidence of false positive and indeterminate results in patients without renal artery stenosis.
Adult↗
[Diagnostic value of urography in the study of arterial hypertension].
In spite of the widespread use of intravenous urography and its extensive employment in the study of hypertension, there is still no unanimity of views as to its application in such pathology. 147 urographies belonging to 330 hypertense patients admitted to the Bari Medical Pathology Department between 1-1-1975 and 30-9-1977 have therefore been examined so as to assess its diagnostic value. Thereafter, the percentage of abnormalities found with urography were evaluated and compared with those in the population at large. Results stress on the one hand the higher incidence of renal ptosis and poly-cystic kidneys in the hypertense, and also highlight the possibility of revealing clinically silent diseases with this technique; on the other hand, many urographies (more than 50%) were useless and it is not always possible to diagnose certainly the presence of stenosis of the renal artery owing to the presence of false positives and negatives.
Adult↗
Renal sonography in pediatric patients. A comparative study between sonography and urography.
Renal sonograms of 260 children were compared with the corresponding excretory urograms. Since each kidney was evaluated separately 520 sonographic and urographic findings could be compared. The study is based on single investigations only, serial investigations were not included. 326 kidneys could be classified as being normal, primarily on the basis of the urogram. By sonography only 10 out of these 326 were misinterpretated as being pathological, 2 by urography. 194 kidneys could be classified as being pathological either by urography or- if necess -by other methods. In 16 out of these 194 no evidence for a pathological process could be found in the sonogram (7 cases of destructive pyelonephritis, 3 cases of double kidneys, 2 cases of slight obstruction of urine flow, 2 cases of small kidneys, 2 cases of ureteral buds), in 10 cases no evidence was seen in the urogram (6 cases of glomerulonephritis, 2 cases of polycystic kidneys, 1 case of preversial ureteral buds), in 10 cases no evidence was seen in the urogram (6 cases of glomerulonephritis, 2 cases of polycystic kidneys, 1 case of prevesical ureterolith, 1 case of ureteral bud). In 2 cases pathological alterations of the kidney was found by both methods, however, the diagnosis differed. Nonfunctioning kidneys were found in 15 cases. In all of these the sonogram provided important complementary information. Our results show 1) that by a systematic application of sonography the early diagnosis of urinary tract malformations can be improved 2) that renal sonography provides the basis for a stricter application of excretory urography and 3) that by the combination of both methods the diagnosis of renal diseases can be improved.
Adolescent↗
The value of intravenous urography prior to abdominal hysterectomy for gynecologic disease.
Negligence and failure to "test timely" are the two most common charges in obstetric and gynecologic malpractice suits. Both charges are often made in cases involving urinary tract injury during gynecologic surgery. These injuries occur most commonly during abdominal hysterectomy. This report is a 6 year study of 170 consecutive abdominal hysterectomies to ascertain the value of routine preoperative urography in preventing urinary tract injuries. As a control, 260 consecutive abdominal hysterectomies were performed without preoperative urography. There was one ureteral transection in the control group, but unrecognized urinary tract injuries did not occur in either the study or control group. The risks, costs, and benefits of urography are analyzed.
Adult↗
Enhanced detection of asymptomatic renal masses with routine tomography during excretory urography.
In a prospective study of a diagnositc scheme for evaluating renal masses, it was observed that a significant number of masses (29 per cent) would have been undetected without the aid of routine tomography. The renal masses detected with the aid of tomography are either small or peripheral lesions which cause no impingement upon the renal collecting system. Without specific symptoms referable to a renal mass and without hematuria, many renal masses will be overlooked on standard excretory urography. The general improvement in diagnostic quality, the ease with which this procedure may be added to excretory urography, and the minimal expense involved would be additional factors which should justify the use of routine tomography with excretory urography in any radiology department.
Adult↗
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↗
Liver metastases discovered during high-dose excretory urography.
Liver metastases were discovered in 4 adults during high-dose excretory urography with upper abdominal tomograms. Previous reports in the English literature have noted incidental discovery of hepatic cysts or abscesses during urography, but no documented cases of liver metastases were found. All metastases were visualized as round, lucent, hepatic filling defects during total body opacification. Radiologists performing high dose excretory urography with tomography should routinely scrutinize the hepatogram, because metastases, cysts, or abscesses may be visualized. Final diagnosis of these masses usually depends on additional diagnostic modalities.
Contrast Media↗
Indications for rapid sequence urography after washout (reinjection) in the diagnosis of renovascular hypertension.
38 hypertensive patients suspected of renovascular hypertension were examined with rapid sequence urography, washout, aortography or selective renal arteriography. When discordant results were found between rapid sequence urography and washout, we used a particularly helpful procedure which we define reinjection or rapid sequence urography after washout: washout is followed by the injection of a second 50-cm3 dose of contrast agent and five more roentgenograms at 1-min intervals. In our series, reinjection allowed correct diagnosis in 66% of the cases with discordant results and confirmed diagnosis in 83% of the cases of renovascular hypertension.
Aortography↗
The value of urography following lymphography in malignant diseases.
The need for urography following ascending pedal lymphography in malignant disease has been studied in 298 consecutive patients. Forty per cent of the urograms were abnormal. Urographic abnormalities due to the disease being investigated were heralded by abnormal lymphography except in four patients, three with carcinoma of the bladder and one with carcinoma of the cervix. The majority of abnormalities unrelated to the disease being investigated were of no significance. In a small number there was congenital malposition of the kidney so that it fell within the proposed field of treatment. It is concluded that it is unnecessary to do routine urography with every lymphogram. Indications for urography are abnormality or suspected abnormality of the lymphogram, failure to locate the kidneys on plain films and clinical indications such as carcinoma of the bladder or carcinoma of the cervix.
Adolescent↗
Urography and renography in the follow-up of patients with toxemia of late pregnancy.
We have studied 129 patients with toxemia of pregnancy two months post partum by urography and renography. The same investigations were performed on 17 healthy parturients post partum. 49 patients (38.8%) had an abnormality either in urography or renography. 20 patients (15.5%) had an abnormal urogram and 42 (32.6%) an abnormal renogram. The findings correlated so that 7 patients had an abnormal urogram with a normal renogram and 13 patients had an abnormality in both investigations. 29 patients had only an abnormal renogram. In the control series 3 patients had an abnormal urogram and the same patients also had an abnormal renogram. We divided the studied patients into groups according to the clinical severity of toxemia. Urographic and renographic findings were divided evenly in the series so that abnormalities were no more common in the severe cases. Renography cannot be considered merely as a screening method when compared with urography in the follow-up of toxemic patients, but these investigations are complementary.
Female↗