A gas pyelogram is a pyelogram in which the kidneys, renal pelvis and ureters are filled with gas, and have a radiolucent appearance. This gas is produced by some gas producing micro organisms which infect most upper parts of urinary system.1- Wein, Kavoussi, Novick, Partin, Peters, Campbell-Walsh Urology, 9th edition, 2007.2- Emil A, Tnagho, Jack W. McAninch, Smith’s General Urology, 17th edition, 2008, Lange Medical Book, New York.
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Retrograde pyelography is generally done when an intravenous excretory study (intravenous pyelogram or contrast CT scan) cannot be done because of renal disease or allergy to intravenous contrast. Relative contraindications include the presence of infected urine, pregnancy (because of radiation), or allergy to the contrast. Because a pyelogram involves cystoscopy, it may cause sepsis, infection or bleeding, and may also cause nausea and vomiting. The dye may also be toxic to the kidneys.
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Small lesions can be removed under local anesthesia as well. Additional evaluation may include a chest X-ray, an intravenous pyelogram, cystoscopy or proctoscopy, as well as blood counts and metabolic assessment.
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An intravenous pyelogram (IVP), also called an intravenous urogram (IVU), is a radiological procedure used to visualize abnormalities of the urinary system, including the kidneys, ureters, and bladder. Unlike a kidneys, ureters, and bladder x-ray (KUB), which is a plain (that is, noncontrast) radiograph, an IVP uses contrast to highlight the urinary tract. In IVP, the contrast agent is given through a vein (intravenously), allowed to be cleared by the kidneys and excreted through the urinary tract as part of the urine. If this is contraindicated for some reason, a retrograde pyelogram, with the contrast flowing upstream, can be done instead.
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One alternative is a magnetic resonance (MR) urography with and without intravenous contrast. Another alternative is a retrograde pyelogram paired with either magnetic resonance imaging of the upper urinary tracts (MRI) or a renal ultrasound (US). This imaging assessment is capable of excluding upper tract malignancies.
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A retrograde pyelogram is a medical imaging procedure in which a radiocontrast agent is injected into the ureter in order to visualize the ureter, bladder, and kidneys with fluoroscopy or radiography, using plain X-rays. The flow of contrast (up from the bladder to the kidney) is opposite the usual outbound flow of urine, hence the retrograde ("moving backwards") name. A retrograde pyelogram my be performed to find the cause of blood in the urine, or to locate the position of a stone or narrowing, tumour or clot, as an adjunct during the placement of ureteral stents. It can also be used ureteroscopy, or to delineate renal anatomy in preparation for surgery.
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Leonard George Rowntree (1883–1959) was a Canadian physician and medical researcher who was credited with founding the research tradition at the Mayo Clinic. He is most well known for pioneering kidney research including the Rowntree test for kidney function; dialysis; the intravenous pyelogram and plasmapheresis. Rowntree was awarded the Medal for Merit in 1946.
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A retrograde pyelogram is done to locate the stone in the kidney. With a small 1 centimeter incision in the loin, the percutaneous nephrolithotomy (PCN) needle is passed into the pelvis of the kidney. The position of the needle is confirmed by fluoroscopy. A guide wire is passed through the needle into the pelvis.
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Large jackstone in the bladder of a 60-year-old Middle Eastern man. Stone was removed by open cystolithotomy. The diagnosis of bladder stone includes urinalysis, ultrasonography, x rays or cystoscopy (inserting a small thin camera into the urethra and viewing the bladder). The intravenous pyelogram can also be used to assess the presence of kidney stones.
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Cloacal exstrophy (EC) is a severe birth defect wherein much of the abdominal organs (the bladder and intestines) are exposed. It often causes the splitting of the bladder, genitalia, and the anus. It is sometimes called OEIS complex. Diagnostic tests can include ultrasound, voiding Cystourethrogram (VCUG),MRI, intravenous Pyelogram (IVP), nuclear renogram, computerized axial tomography (CAT Scan), and magnetic resonance imaging (MRI).
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Intravenous pyelogram (IVP) is a useful procedure in detecting the presence of abnormal renal mass in the urinary tract. This procedure involves the injection of a contrasting dye into the arm of the patient. The dye travels from the blood stream and into the kidneys which in time, passes into the kidneys and bladder. This test is not necessary if a CT or MRI scan has been conducted.
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This test involves injecting a radiocontrast agent which is passed into the urinary system. X-ray images are then obtained every few minutes to determine if there is any obstruction to the contrast as it is excreted into the bladder. Today, intravenous pyelogram has been replaced at many health centers by CT scans. CT scans are more sensitive and can identify very small stones not seen by other tests.
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Although hematometra can often be diagnosed based purely on the patient's history of amenorrhea and cyclic abdominal pain, as well as a palpable pelvic mass on examination, the diagnosis can be confirmed by ultrasound, which will show blood pooled in the uterus and an enlargement of the uterine cavity. A pyelogram or laparoscopy may assist in diagnosing any congenital disorder that is suspected to be the underlying cause of the hematometra.
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The main imaging tests performed in order to identify renal cell carcinoma are pelvic and abdominal CT scans, ultrasound tests of the kidneys (ultrasonography), MRI scans, intravenous pyelogram (IVP) or renal angiography. Among these main diagnostic tests, other radiologic tests such as excretory urography, positron-emission tomography (PET) scanning, ultrasonography, arteriography, venography, and bone scanning can also be used to aid in the evaluation of staging renal masses and to differentiate non-malignant tumours from malignant tumours.
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Currently genotyping is not available in the United States but might be available in Spain, Italy, UK, Germany and Russia (by private companies in Germany and Russia). Regular X-rays often fail to show the cystine stones, however they can be visualized in the diagnostic procedure that is called intravenous pyelogram (IVP). Stones may show up on XR with a fuzzy gray appearance. They are radioopaque due to sulfur content, though more difficult to visualize than calcium oxalate stones.
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Dosing can vary; is recommended for thyroid imaging and for total body while an uptake test may use . There is a study that indicates a given dose can effectively result in effects of an otherwise higher dose, due to impurities in the preparation. The dose of radioiodine 123I is typically tolerated by individuals who cannot tolerate contrast mediums containing larger concentration of stable iodine such as used in CT scan, intravenous pyelogram (IVP) and similar imaging diagnostic procedures. Iodine is not an allergen.
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To confirm the diagnosis, a CT angiogram can be performed, which would track the vascular path over the kidney, showing that a vessel is obstructing the superior calyces. Alternatively, a physician may perform a cystoscopy with a retrograde pyelogram, which would demonstrate the level of the obstruction and rule out nephrolithiasis. For those individuals that do not present with any symptoms, hematuria may be found on an urinalysis when coming in for a routine physical. Since hematuria, to any degree, is an abnormal finding, this would lead to further imaging to diagnose its cause.
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It is often supplemented by an upright PA view of the chest (to rule out air under the diaphragm or thoracic etiologies presenting as abdominal complaints) and a standing view of the abdomen (to differentiate obstruction from ileus by examining gastrointestinal air/water levels). Despite its name, a KUB is not typically used to investigate pathology of the kidneys, ureters, or bladder, since these structures are difficult to assess (for example, the kidneys may not be visible due to overlying bowel gas.) In order to assess these structures radiographically, a technique called an intravenous pyelogram was historically utilized, and today at many institutions CT urography is the technique of choice.Paul Schmitz, MD, et al. Medscape. Kidneys, ureters, and bladder imaging: plain films of the abdomen.
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In 1920, Rowntree was made Head of Section and Professor of Medicine of the Mayo Foundation. He recruited what became known as the "Rowntree group" to the Mayo Clinic including Norman Keith of Toronto, Samuel Amberg of Chicago, and Reginald Fitz of Boston, all of whom had been collaborators with his at Hopkins, and later Henry Helmholtz, George Brown, Walter Alvarez, Russell Wilder, Stanley McVicar, Albert M. Snell, Jay Bargen, Carl Greene, Philip Hench, Bayard Horton. During his 12 years at the clinic, he published more than 100 articles, primarily in the fields of endocrine disease, water metabolism, and hepatology including the treatment of Addison's disease with adrenal extractsRowntree, LG, Snell, AM. A Clinical Study of Addison's Disease. WB Saunders Co, Philadelphia, Pa; 1931 and the radiological technique to xray the kidneys known as the intravenous pyelogram Rowntree left the Mayo clinic in 1932 to continue his illustrious career in medicine as director of the Philadelphia Institute for Medical Research.
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This test procedure typically involves two tests performed in connection with each other: an iodine uptake test and a scan (imaging) with a gamma camera. The uptake test involves administering a dose of radioactive iodine (radioiodine), traditionally iodine-131 (131I), and more recently iodine-123 (123I). Iodine-123 may be the preferred radionuclide in some clinics due to its more favorable radiation dosimetry (i.e. less radiation dose to the person per unit administered radioactivity) and a gamma photon energy more amenable to imaging with the gamma camera. For the imaging scan, I-123 is considered an almost ideal isotope of iodine for imaging thyroid tissue and thyroid cancer metastasis. Typical administration involves a pill or liquid containing sodium iodide (NaI) taken orally, which contains a small amount of iodine-131, amounting to perhaps less than a grain of salt. A 2-hour fast of no food prior to and for 1 hour after ingesting the pill is required. This low dose of radioiodine is typically tolerated by individuals otherwise allergic to iodine (such as those unable to tolerate contrast mediums containing larger doses of iodine such as used in CT scan, intravenous pyelogram (IVP), and similar imaging diagnostic procedures).
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