The application of retrograde pyelography in the diagnosis of traumatic ureteropelvic junction disruption in children / 中华泌尿外科杂志

Objective To explore the application of retrograde pyelography with traumatic ureteropelvic junction disruption in children.Methods A retrospective study was conducted for a total of 26 children with doubt of traumatic UPJ disruption in image from 2009 January to 2017 September.There were 19 males and 7 females with a mean age of 5.4 (1-11) years.And the causes were traffic accident (n =15),fall injury (n =4) and fall damage (n =7).Ultrasound and CT examination indicated different degrees of urinary extravasation in all cases.Enhanced CT delayed imaging had no ureteral enhancement,and could not specify whether UPJ was disrupted.All the patients underwent retrograde pyelography through cystoscope under the general anesthesia.If the retrograde tube entered the renal pelvis smoothly,and the ureter and renal were complete,which was considered to be renal injury.If it was difficult for the tube to reach the UPJ,and the ureteral blind end was shown by contrast angiography,UPJ fracture was considered.Results UPJ was not broken in 9 patients (34.6％),and the peritoneal urine was gradually absorbed after conservative treatment.Retrograde pyelography showed no sign of kidney in 16 cases (61.5％).UPJ disrupture was considered and performed renal exploration.These 16 cases were all confirmed as UPJ disrupture during operation.15 patients underwent ureteropelvic anastomosis,1 patient underwent ureteral anastomosis by using appendix because of long segment defect,and intravenous pyelography after surgery showed that the ureter was unobstructed.Urinoma but not renal was enhanced in 1 patient (3.9％).One case (3.9％) retrograde pyelography showed the perirenal urinary cyst was enhanced,the kidney was not enhanced,and the possibility of UPJ fracture was considered.But this patient was confirmed UPJ not disrupted in the operation and underwent pyeloplasty.Intravenous pyelography showed no contrast agent extravasation after surgery.The sensitivity and specificity of retrograde pyelography in this group were 100％ (16/16) and 90％ (9/10),respectively.Conclusions The sensitivity and specificity of retrograde pyelography were higher,and retrograde pyelography was reliable and irreplaceable in the early diagnosis of UPJ disrupture.

Effect evaluation of different ways of taking magnesium sulfate on bowel preparation prior to performing intravenous pyelography examination / 中国实用护理杂志

Objective To analyze optimal amount of drinking water,ways of drinking water,timelimit of drinking water on the effect of bowel preparation for intravenous pyelography (IVP) examination after oral administration of 50% magnesium sulfate 60 ml. Methods 200 patients who gave their consentfrom June 2009 to February 2010 drank 50% magnesium sulfate 60 ml for IVP check were divided into four groups. Group A: a large amount of graded oral administration of warm water 1200 ml within 1h; Group B: a small amount of oral administration of warm water 1200 ml within 1h;Group C: a large amount of graded oral administration of warm water 2000 ml within 1h; Group D: a medium amount of graded oral administration of warm water 1200 ml within 2 h. And then the bowel preparation effect of the four gro ups were analyzed. Results Through the comparison, group A was much better than the other groups on the aspects of cathartic satisfaction, the effective degree of reading films and flatulence. Conclusions To take a large amount of graded oral administration of warm water 1200 ml within 1h can improve cathartic satisfaction,the effective degree of reading films and flatulence.

Diagnostic Value of MR Urography in Ureteral Obstruction in Children / 实用放射学杂志

Objective To study the diagnostic value of magnetic resonance urography (MRU) in the urinary tract obstruction(UTO) in children.Methods 65 children with UTO underwent intravenous pyelography(IVP),B-ultrasound(BUS) and MR urography(MRU) ,MRU using hearvily T_2-weighted fat suppression turbo echo sequence.MRU features were compared with that of operation.The accurate rate in diagnosis of UTO with MRU was analysed comparatively with that of IVP and BUS.Results The lesions diagnosed with MRU included stricture of ureteropelvic junction in 36 children,and duplication of renal pelvis in 3 children (diagnostic error in 1),primary megaloureter in 9,narrowing of cystic inlet of ureter in 4,cysts of cystic inlet of ureter in 3,solitary kidney in 2,nephrolith in 5,nervous bladder in 2 and congenital renal dysplasia in 1.The accuracy was 98.5% in defining the UTO with MRU(64/65),which was superior to that with IVP and BUS(P＜0.05).Conclusion MRU is of great value in the diagnosis of upper urinary tract obstruction in children.

Percutaneous nephrolithotomy with and without retrograde pyelography: a randomized clinical trial

OBJECTIVE: Since the introduction of percutaneous nephrolithotomy (PCNL), many changes have been added regarding the entrance to pyelocalyceal system such as insertion of the needle pointed to an opaque stone as a guided landmark. We aim at comparing the outcomes of managing renal calculi with and without retrograde pyelography. MATERIALS AND METHODS: In a randomized clinical trial, 55 cases with opaque renal calculi candidates for PCNL with stone in one calyce, in the pelvis or both in one calyce and the pelvis simultaneously were included in a nine-month study. They were randomized into 2 groups, noncatheterized (n = 28) and catheterized (n = 27), called intervention and control groups, respectively. RESULTS: The 2 groups had similar distributions regarding gender, age, duration of operation, length of hospital stay, past history of any surgical procedures on kidney, and stone size. Outcome (residual stone based on aforementioned management) was evaluated with plain X-ray on the morning following the operation. Postoperative hemoglobin decrease was significantly higher in controls than in the intervention group (p < 0.001) (with no clinical significance). No difference in outcome, postoperative fever, duration of surgery, duration of hospital stay and radiation exposure was observed between the 2 groups. CONCLUSION: Our findings showed no differences in major clinical outcomes between the 2 groups (with and without catheter insertion for retrograde pyelography).

The Accuracy of Noncontrast Helical Computerized Tomography Versus Intravenous Pyelography in Patients with Suspected Acute Urolithiasis in the Emergency Department

PURPOSE: This study was performed to compare the accuracy of noncontrast helical computerized tomography (NHCT) with that of intravenous pyelography (IVP) in the evaluation of urolithiasis in the emergency room (ER). METHODS: Between November 2003 and February 2004, a total of 47 consecutive patients presenting to the emergency department with acute flank pain were evaluated with NHCT followed by IVP. The mean of the time interval between NHCT and IVP was less than 5 minutes. All 47 sets of evaluations were later assessed randomly by an independent consulting radiologist for the presence, size, and location of a stone, ureteral dilatation, and secondary signs of ureteral obstruction. RESULTS: Forty-three of the 47 patients were diagnosed with urolithiasis. In 39 of the 43 patients diagnosed with ureteral calculi, the NHCT made the diagnosis. IVP made the diagnosis in 26 of the 43 patients. NHCT had a 90.7% sensitivity, 100% specificity, and 68% accuracy. Compared with IVP, using the McNemar test, NHCT was significantly better able to predict the presence of urolithiasis (p<0.001). CONCLUSIONS: Unnenhanced helical CT is superior to IVP in the demonstration of ureteral calculi in patients with suspected acute urolithiasis in the ER.

Clinical evaluation of IVP,CTU and MRU in the diagnosis of urinary system stones / 医学研究生学报

Objective:To explore the clinical application in urinary system stones of the inspection technologies intravenous pyelography (IVP),computer tomography urography (CTU) and magnetic resonance urography (MRU). Methods:We collected 100 cases of urinary system stones on which 80 were carried out to IVP,60 to CTU and 35 to MRU,25 patients were implemented all 3 examinations. CTU and MRU are reconstructed with multi-level reorganization (MPR),curved projection reproduction (CPR),volume reproduction (VR) and the maximum intensity projection (MIP). Results:Stones were found in 73 patients of the 80 people by IVP,the diagnosis rate is 91.3 %. Stones were found in all the 60 patients except 1 by CTU with images direct and accurate,the diagnosis rate was 98.1 %. By the MRU,stones were found in 20 of the 35 patients at a display rate of 57.1 %,with images displayed in a low stone location signal,filling defect and the hydrocele circs of renal pelvis and ureter. Conclusion:IVP is a simple method,easy-to-patient acceptance and has a high detection rate of stones; CTU has a good image quality and the detection rate is higher than the stone IVP. By combining with the original cross-sectional image,the rate of diagnosis is up to 98%; as a non-invasive and no contrast agent approach,MRU is also very important in the diagnosis of stones.

Comparison of ~(99m)Tc-DTPA Dynamic Renal Imaging and Intravenous Pyelography in Assessing Renal Function / 中国医师杂志

Objective To compare the value of 99m Tc-DTPA dynamic renal imaging and intravenous pyelography(IVP) in assessing renal function. Methods The results of 99m Tc-DTPA dynamic renal imaging and IVP in 117 patients with renal diseases confirmed by clinical examinations, abdominal ultrasonography, CT and blood biochemical markers were analysed retrospectively. Results Out of 234 kidneys,101 were clearly visualized by IVP, which were indicated normal renal uptake by 99m Tc-DTPA dynamic renal imaging, and the GFR value was (60.13?16.85)ml/min. 48 kidneys were poorly visualized by IVP, their uptake detected by dynamic renal imaging was between grade 1 to 3, and the GFR value was (23.06?10.61)ml/min. 85 kidneys were not visualized by IVP, 71.8% of which(61/85kidneys) were indicated uptake of radionuclide by dynamic renal imaging with the (20.39?12.54)ml/min GFR value, and uptake of 8 kidneys among the 61 kidneys was normal. The functional kidneys detected by dynamic renal imaging were more than those detected by IVP(P

The Study on Improvement of the Technology of Intravenous Pyelography under PACS System / 实用放射学杂志

Objective To study the applied value of the improved pyelographic technique under PACS system.Methods The pyelography in 200 cases(including the traditional pyelography in 92,the traditional big dose pyelography in 8 and the improved pyelography in 100) were retrospectively analysed in groups.Results The improved pyelography in comparison with the traditional pyelography,compressing time reduced 9~11 minute during radiography and the contrast medium amount was the same in both.Conclusion The improved pyelography is superior to the traditional or the traditional big dose pyelography.

Imaging Diagnosis of Carcinoma of Renal Pelvis / 实用放射学杂志

Objective To study the diagnostic value of imageology for pyelic carcinoma.Methods The accuracy of qualitative diagnosis and sensitivity were analyzed by comparing various imaging examinations in 19 patients with pathologically proved pyelic carcinomas.Results Irregular filling defect and hydronephrosis were seen in the renal pelvis and calyces on intravenous pyelography(IVP).On CT scan,when the tumor was small,soft tissue mass was in the renal pelvis and the calyces.When the renal parenchyma involved by tumors,the soft tissue masses with unhomogeneous density,liquefaction necrosis in the renal pelvis and the parenchyma were seen.On contrast-enhanced CT scan,enhancement from slight to moderate was found in the lesion.The lesions were detected by IVP in 9/12 cases,by BUS in 10/16 cases,by CT in 18/19 cases and by MRI in 3/3 cases.Conclusion IVP and CT are the first method of choice to diagnose the pyelic carcinoma,BUS can be used as a screening method.While in evaluating the tumor involving the parenchyma of the ren or distant metastasis,CT and MRI are superior to IVP.

The clinical value of IVP in BPH / 대한비뇨기과학회지

Routine use of the IVP in preoperative evaluation of patients with obstructive bladder outlet symptoms has been questioned on the basis of the chance of incidental finding in the upper tract and the implication of such findings to management. We studied 220 patients who underwent intravenous pyelography before prostatectomy at Department of Urology, Sanggye Paik Hospital from Oct. 1989 to Jun 1992. Of 220 patients, 183( 83.2% ) showed normal upper tract with cystogram compatible with benign prostatic hyperplasia. Abnormalities were found in 37( 16.8% ) patients but treatment plan was altered in only 5(2.25% ) cases. Most of these abnormalities could be detected on KUB or cystoscopy. Only one(0.45% ) malignancy would have been missed without routine IVP. We conclude that IVP in our opinion should not be performed as a routine procedure in patients with benign prostatic hypertrophy, but only in selected cases.

Acute pyelonephritis in adult : Characteristics of bacteriologic study and excretory urographic studies / 대한비뇨기과학회지

Acute pyelonephritis is a common disease, the clinical signs and symptoms of which have been well known for many years. Clinical observation was made from 342 cases of adult with acute pyelonephritis in the department of urology and internal medicine, Kyung Hee University Hospital, from March 1986 to February 1992. Intravenous pyelography(I.V.P.) and Voiding cystourethrography(V.C.U.G.) had very little diagnostic value as well as predictive value of prognosis and complication in adult with acute pyelonephritis. But there was screening value in male patients and female patients who had combined urinary tract anomaly or disease. The most common causative organism was E. coli(81.1%). In drug sensitivity test, nearly all Gram negative organisms were resistant to Ampicillin, which previousely was mainly used to acute pyelonephritis. Gentamicin resistant organisms are still being relatively increased. Amikacin and Quinolone derivatives were very sensitive drug to all Gram negative organism.

The Application of Computed Radiography System in Intravenous Pyelography in Children / 实用放射学杂志

Objective To investigate the applied value of computed radiography(CR) system in intravenous pyelography in children.Methods Intravenous pyelography were carried out by CR and traditional intensifying screen/film in 45 children respectively.The diagnostic specificity between CR and traditional intensifying screen/film was compared.Results Urinary system in children could be displayed well by CR,the quality of CR films was ensured.The diagnostic corresponding rate was 86.7% and 59.1% by CR and traditional intensifying screen/film respectively.Conclusion CR is of significance value in diagnosis of urologic diseases in children.

Imaging Diagnosis of Ureter Cyst / 实用放射学杂志

Objective To investigate the imaging diagnostic value of ureter cysts.Methods The intravenous pyelogram(IVP), CT MRI and ultrasonic data of 17 cases of ureter cyst were analysed trtrospectively. Results All patients were correctly diagnosed preoperatively. The application of US and intravenous cystography may aid to improvement of diagnosis.Conclusion The combination of multiimaging modalities was proved to be of great value in diagnosis of ureter cysts.

Characteristics of Upper Urinary Tract Change in Lower Urinary Tract Obstructive Lesions / 대한비뇨기과학회지

Reviewing the radiologic studies of the 402 patients with infravesical obstructive lesions, we studied the pattern of upper urinary tract change in children and adults. The following results were obtained. 1. The upper tract dilatation was shown in 68 patients : 9 of 11 posterior urethral valve patients(82 percent), 22 of 280 benign prostatic hyperplasia patients(7.9 percent), 11 of 57 urethral stricture patients(19 percent), 26 of 54 neurogenic bladder patients(48 per cent). 2. Upper tract dilatation in infravesical obstructive diseases occurred on one side in 32 percent of the cases : 24 percent in children and 38 percent in adults. 3. Of 68 patients with upper tract dilatation, 40 patients had voiding cystourethrography. Vesicoureteral reflux was observed in 30 of 69 dilated kidney units : 25 of 49 kidney units (51 percent) in children and 5 of 20 kidney units(25 percent) in adults. Vesicoureteral reflux was more frequently occurred in children than in adults.

Assessment of Necessary or Adequate Diagnostic Requirement in Urologic Disease -2. Value of Intravenous Pyelography in Benign Prostatic Hyperplasia- / 대한비뇨기과학회지

There have been some pros and cons about the of routine intravenous pyelography in benign prostatic hyperplasia. Herein we analyzed 196 patients who underwent intravenous pyelography before prostatectomy at Dept. of Urology, Seoul National University Hospital from Jan. 1976. to Dec. 1983. Of 196 patients 140 (72%) showed normal upper tract with cystogram compatible with benign prostatic hyperplasia(Group I), 22(11%) dilated upper tract(Group II), 20(10%) incidental upper tract abnormalities including 9 urolithiasis(Group III), and 14(7%) completely normal findings(Group IV). There was a significant relationship between Group II and serum BUN value. Cystoscopy revealed evidence of prostatic enlargement in 14 cases and other abnormal findings including bladder tumor which were not shown on routine IVPs. We conclude that intravenous pyelography is not always necessary in diagnosis of benign prostatic hyperplasia when urine analysis and serum BUN are normal Instead, we recommend KUB to observe renal outline and calculi, and preoperative routine cystoscopy to evaluate prostatic enlargement and bladder neck obstruction.

Clinical Observation on Retrograde Pyelography / 대한비뇨기과학회지

During the period from Jan. 1980 to Dec. 1982, 57 patient were taken RGP and the followings were obtained. 1) RGP was performed 57 patients. 2) Indication was 15 cases (26.3%) of non-visualizing kidney, 17 cases (29.8%) of hydronephrosis, 6 cases (10.5%) of delayed visualization, 13 cases (22.8%) of abnormal findings of calices and pelvis, 2 cases(3.5%) of congenital anomalies of ureter, 1 case (1.8%) of allergy to contrast medium and 3 cases (5.3%) of impaired renal function. 3) Of the 57 patients, 47 patients were defined with RGP and remained 10 patients had been taken other urologic examination for further evaluation.

A Clinical Observation on Retrograde Pyelography / 대한비뇨기과학회지

We reviewed the 46 cases of retrograde pyelography which performed in the Department of Urology, Chosun University Hospital during the period January 1981 to December 1982. And the results were as follows. 1. The cases were consisted of 23males and 23females. The most common age group was 40-49. 2. The common symptoms on admission were flank pain(50%) and gross hematuria(15.3%). 3. The urine findings(before RGP) revealed hematuria in 15 cases, pyuria in 12 cases, proteinuria in 5 cases and AFB positive in urine in 3 cases. 4. The IVP findings that were performed RGP classified into 4 groups as follows, 1) Abnormal changes or poor visualization of calyx, pelvis and ureter: 5 cases(10.8%) 2) Hydronephrosis: 13 cases(28.3%) 3) Delayed visualization: 18 cases(39.1%) 4) Non visualization: 10 cases(21.7%). 5. Of the 46 patients, most patients were defined with RGP and 24 cases had been required other special urologic studies for further evaluation.

Clinical Observation on Retrograde Pyelography / 대한비뇨기과학회지

During the period from January 1978 to December 1980, 46 patients who were taken RGP were analyzed and observed as follows. 1) RGP was performed 46 patients who were not defined exactly on IVP. 2) Undefined findings on IVP that was performed RGP classified into four group as follows. Group I : Abnormal changes or poor visualization of calyx, pelvis and ureter; 17 (32.7%) Group II : Hydronephrosis; 12 cases (23.1%) Group III : Delayed visualization; 9 cases (17.3%) Group IV : Non-visualization; 14 cases (26.9%) 3) Of the 46 patients (52 kidneys), 35 patients (41 kidneys) were defined with RGP and remained 11 patients (11 kidneys) had been required other special urologic studies for further evaluation.

A Clinical Observation on Retrograde Pyelography / 대한비뇨기과학회지

Authors reviewed 110 cases of retrograde pyelography which performed in the Dept. of Urology, Kyung Hee University Hospital during the period from January 1977 to December 1980. And the results were as follows. 1. Indication was 34 cases (31%) of nonvisualizing kidney, 31 cases (28%) of obstructive lesion, 21 cases (19%), of inadequate filling in pelviocalyceal system, 7 cases (6.5%) of impaired renal function. 6 cases (5.5%) of upper tract abnormality, l cases (0.9%) of allergy to contrast media and other 10 cases. 2. On the nonvisualizing kidney, hydronephrosis (23.5%) was most common and normal (20.5%), ureter stone (20.5%) in order. 3. For assessment of obstructive lesion, UPJ stricture (39%) was most common and ureter stone (32%), normal (16%), ureter tumor, UVJ stricture in order. 4. Inadequate filling on excretory urogram revealed normal (24%), renal tumor (19%), renal tuberculosis (9.5%) and chronic pyelonephritis scar (9.5%) etc. 5. The patients who had poor renal function or poor general condition and upper tract abnormality were well defined with retrograde pyelography and available for diagnosis and treatment. 6. Complication were seen in 2 cases (1.8%). One was acute pyelonephritis and the other was pyonephrosis.

Clinical Observation of Antegrade Pyelography / 대한비뇨기과학회지

Clinical observation was made on 30 patients of obstructive uropathy who were performed antegrade pyelography in Department of Urology, Catholic Medical College, during the period from 1971 to 1976. It revealed antegrade pyelography is the most useful diagnostic procedure and accurate to demonstrate the morphology, site and cause of the obstructive lesion, and it leads to adequate procedure of operation. The results were as follows: 1. Non-visualized kidney (10 cases) and hydronephrotic kidney (23 cases) on intravenous pyelography were definitely diagnosed by antegrade pyelography. Non-visualized kidney (10 cases) on intravenous pyelography was distinctly diagnosed as hydronephrosis (7 cases) and hydronephrosis combined with caliceal destruction (3 cases) , and hydronephrotic kidney (23 cases) on intravenous pyelography was diagnosed as hydronephrosis (16 cases) and hydronephrosis associated with caliceal destruction (7 cases) 2. The main cause of obstructive uropathy revealed renal tuberculosis (15 cases), congenital ureteropelvic junction stricture (3 cases) and ureteral stone (3 cases) etc. 3. 32 cases of all 33 cases were noted ureteral obstruction. In these 32 cases, the sites of ureteral obstruction were lower 1/3 of the ureter (20 cases), upper 1/3 of the ureter (8 cases) and multiple ureteral obstruction (4 cases). 4. With definite diagnosis by antegrade pyelography, adequate operation could be performed; nephrectomy (11 cases), ureteral re-implantation (7 cases), nephrostomy (6 cases), cutaneous ureterostomy (5 cases) and pyeloplasty (2 cases).