CONTRAST RADIOGRAPHY TECHNIQUES OF URINARY SYSTEM

BY M.SIVA BVN 07055

INTRODUCTION
Contrast radiography of upper and lower urinary system are excellent for evaluation of the kidneys,ureters,bladder and urethra. Three techniques Excretary urography Cystography Urethrography

Excretary urography
Study for evaluation of kidney structure and collection system after intravenous introduction of a positive contrast medium.

Technique
Keep the animal off feed for 36h and off water for 12h. Select either a bolus(low volume rapid infusion ) or drip technique(high volume drip infusion) to administer water soluble iodine based contrast agents,sodium triiodinated organic compounds, sodium iothalates are used.

Dose
Small ruminants-2 to 3ml/kg bwt Large ruminants-0.5ml/kg bwt Dog should not contain more than 35 gm of iodine

Bolus technique
Inject i/v total calculated dose as a bolus

Drip technique
Dissolve the agent in normal saline to make a conc. of 23%. Inject entire volume i/v over a period of about 10 min Obtain standing right lateral radiographs Dog, sheep and calves ventrodorsal radiography

Intravenous pyelogram

Injected contrast draining from kidney to bladder

Adverse reactions
Dogs and cats are vomiting, defecation, urination and hypotension with or without collapse

Cystography
Introduction of contrast media into the bladder via a urinary catheter to diagnose structural abnormalities and diseases of the bladder. Positive, negative and double contrast can be used .

Indication; Animal exhibiting clinical signs such as hematuria, crystaluria, bacturia, dysuria, anuria. CONTRAST MEDIUM Tri-iodinated contrast agents Barium sulfate and sodium iodides are contraindication

Technique
keep the animal off feed for 36h and off water for 12h Sedate the animal and restrain in lateral recumbency Insert lubricated radiopaque catheter into the urethra Advance the catheter into the bladder in the female In male catheter positioned at the neck of bladder, empty the bladder by abdominal compression Infuse 2% lignocaine solution into the bladder

Double contrasted bladder showing uric acid stone

Contrast radiography showing a mass in a dog's bladder

Introduce water soluble iodine (sodium iothalamate) or negative contrast (room air, oxygen, carbon dioxide ) Dose; Small ruminants 80 to 120 ml Dogs- 6 to 12 ml / kg bwt double contrast study; Introduce 15 to 20 ml of positive contrast, roll the animal and introduce negative contrast to fill the bladder. Obtain recumbent right lateral and ventrodorsal projections

URETHROGRAPHY

Consists of filling the urethra with contrast medium to detect urethral trauma, stricture, obstruction and pathological disturbances . Contrast media; Water soluble iodinated contrast agent or air, carbon dioxide or nitrous oxide Retrograde urethrogram, anti grade urethrogram contrast medium can be used

Technique
keep the animal off feed for 36h and off water for 12h Sedate the animal Lubricate a catheter of appropriate diameter with lignocaine gel Insert into urethra for a short distance through urethral opening Infuse 5 to 10 ml of 2% lignocaine into urethra to desensitise urethral mucosa Introduce Diluted water soluble iodine based contrast agent obtain a lateral radiograph during the last phase of infusion of the contrast agent

Ascending urethrography