Methods of diagnosis. Intravenous urography

Intravenous urography is a method of X-ray examination of the urinary tract and kidney. In this case, an X-ray contrast substance is introduced into the patient's body. Intravenous urography makes it possible to obtain information about the functional and morphological state of the urinary tract in sufficient detail. At the same time, several X-ray photographs are performed, allowing one to assess the excretion of the injected substance with the kidneys, the operation of the renal system by its accumulation, and its passage to the urinary bladder through the urinary canals. An X-ray contrast substance is then excreted in the urine.

The dose of X-ray contrast substance is determined in accordance with the age, body weight of the patient, as well as the functional state of the liver and kidneys.

Intravenous urography, as a rule, begins with a general picture of all the ureter pathways (radiography of the abdominal cavity). The patient is in a horizontal position. The overall survey captures the area between the tenth-eleventh thoracic vertebra and the lower edge of the pubic articulation. The survey radiograph is made in a straight and a lateral projection. During this study, the presence of foreign bodies, kidney stones and urinary tract can be detected. A review photograph allows you to evaluate the contours and location of the kidneys in relation to the bones of the skeleton, as well as the degree of localization of stones to the kidneys. A review photograph is taken before the introduction of X-ray contrast substance into the body. After its introduction, after some time, several X-ray photographs are performed, with the help of which the level of X-ray contrast distribution along the ureter pathways is detected and evaluated.

Intravenous urography is indicated for abnormalities in the development of the kidneys and urinary canals, with stones in the ureters and kidneys, hematuria of unclear etiology, renal tumor, hydronephrosis, pyelonephritis, kidney tuberculosis, kidney trauma,

Complications in patients after the study (anaphylactic shock, laryngospasm) are quite rare.

Children under the age of three take pictures at intervals of one to three to ten to twenty and forty minutes. In older children, one and a half to fifteen to thirty and sixty minutes.

With reduced excretory and concentration function of the kidneys (at an early stage of development of renal failure) infusion urography (intravenous dropper) is used. In this case, the X-ray contrast substance is administered at a relatively higher dose with a significantly reduced drug concentration. At the same time, more intensive and prolonged contrast of urinary canals and kidneys is provided. For drip administration, use two milliliters of radiopaque substance per kilogram of the total body weight of the patient, with the addition of the same amount of a five percent glucose solution. Drip introduction is carried out within ten to fifteen minutes. In this study, the shots are performed in accordance with a visual assessment. To obtain more clear images and a more complete assessment of the urinary system, the patient is administered intravenously in combination with a tomography or other diagnostic method.

Intravenous urography: preparation of the patient for the study begins 2-3 days before the procedure. A special diet is prescribed for the patient. The diet excludes black bread, sweet and fruit. Twelve hours before the procedure, fluid and food are completely discontinued. In the evening in the previous study day and in the morning on the day of the procedure for two hours, a cleansing enema with the use of chamomile infusion is performed. With meteorism, a decoction of chamomile with carboline is prescribed. Immediately before the beginning of urograph, the bladder empties.