Professional Documents
Culture Documents
Terminology
Some prefer the term "urogram" to refer to visualization of the kidney parenchyma, calyces,
and pelvis after intravenous injection of contrast, and reserve the term "pyelogram" to
retrograde studies involving the collecting system. In practice, both terms are often used
interchangeably.
Procedure
Indications
Patient preparation
overnight fasting prior to the date of examination; a laxative would help to achieve a
good preparation
on the day of procedure take a scout/pilot film to check patient preparation and also
for radio-opaque calculi
check serum creatinine level to be within normal range (as per hospital guidelines)
take a history of the patient for any known drug allergies followed by a written
informed consent for the procedure
Technique
Exposures are generally in the 65-75 kV range, mA of 600-1000, with exposure of <0.1 sec.
Higher kV ranges reduce contrast of the renal parenchyma.
There is a wide variation in protocols. One protocol is suggested below, but additional images
should usually be obtained to answer the clinical question:
scout images
nephrogram (1-2 minutes)
early and late images of the upper collecting system (abdominal compression then
applied) (>3 minutes)
tomography may be obtained, if desired
supine, after release of compression, images of the upper collecting system and
proximal ureters (10-15 minutes)
supine image (20 minutes)
prone image (20 minutes)
Emergency medications and emergency equipment must always be available in case the
patient has a reaction to contrast.