Modern methods of diagnostics gradually are replacing the outdated and routine procedures that are less informative or are complex in their implementation. However, x-ray examination is still widely popular and available in all fields of medical activities.
Review urography is always preceded by other specific methods of research of organs of the urinary tract. Sometimes, you just have this diagnostic procedure to determine the diagnosis of the patient and to begin the necessary treatment.
Main features overview urography
The main purpose of the method is the detection of stones at different levels of urinary system (bladder, kidneys or a ureter). However, to visualize all kinds of rocks, and only urate or oxalate of origin, at the time, as the phosphate concretions are almost invisible in the pictures.
Review urography is indispensable for early diagnosis of urate stones
In addition, the procedure helps the doctor indirectly to judge other pathological processes in the body, based on the following data:
- Visualization of the renal shadow gives information on the size of the body, its anatomical location and configuration.
- On the state of the tissue that surrounds each kidney, can be seen in the contour of lumbar muscle, located on both sides.
- Evaluated bone structure (the lumbosacral spine, hip joints, pelvic bones, the lower edge of the ribs), which are well visualized on the images.
- Well visible on this image of dense formations (e.g., hydatid cyst or tubercular lesions in the tissues of the kidney).
How to do the?
To the resulting x-ray image was most informative and helped the specialist in the diagnosis of the pathological process, must adhere to the following rules:
- You should never be limited to x-rays of only one anatomical region (for example, to make only the left or right kidney). Often there are situations when the pain of not found no changes, while in the opposite there are on certain violations.
- The image should encompass all the structures of the urinary system: two kidneys and their ureters, and bladder.
- Definitely in the need to sign the contours of 11-12 ribs and the upper edge of the symphysis, then only the procedure will be done correctly. It uses film with parameters 30×40 cm
Technique of the procedure
Review urography is quite straightforward and does not require much time. At the time of the study the patient is on her back, his head fit the pillow (he is in a very convenient position).
As before any procedure, the doctor said the condition of the subject, if he had any unpleasant feelings or Express discomfort. Also better to check what drugs he takes.
The x-ray beam is directed at a few centimeters below the xiphoid process, its movement strictly perpendicular to the surface of the body.
In a period where images are produced, the patient is asked to hold your breath. This is necessary in order to avoid a false “double” Cup-pelvis-plating system or existing stones.
The picture was taken immediately after the patient entered the x-ray room (thus minimizing his stay there). Previously, the patient is asked to remove all jewelry and metal objects.
Before the examination the patient should not be afraid, because the procedure is absolutely painless and takes a short period of time
If you don’t first prepare the patient for the upcoming study, the results may be unreliable. For example, swollen loops of intestine interfere with the normal visualization of the processes occurring in the organs of the urinary tract.
Of particular importance is paid to cleaning of the intestine from accumulated in the lumen of feces.
All patients a few days before the study must adhere to the following principles of special training:
- complete elimination of food that can cause flatulence process (white bread, cereals and pulses, potatoes, fruits and dairy products);
- dinner before the procedure should be “easy” and not later than 17.00-18.00 and on the morning urography, it is better not to eat Breakfast;
- it is recommended to clean the bowel of special sorbents (e.g., activated carbon), and in the morning to do an enema “to clean water”;
- you cannot consume plenty of fluids, it is best to drink a glass of unsweetened tea.
Very often the correct diagnosis and visualization of the urinary prevent swollen intestinal loop, so special attention is paid to training examined
Indications and contraindications
For the review urography kidney, ureter and bladder there are the following indications:
- Hydronephrosis of one or both kidneys (congenital or acquired nature).
- The stones at different levels of the urinary tract (in the tissues of the kidneys, ureters, bladder).
- Foreign bodies in the urethra or in the lumen of the bladder.
- Injury to the lumbar region (including muscle tears back).
- Tumor proliferation or other pathological lesions (cysts, abscesses, etc.).
- Abnormalities of the kidneys (for example, doubling) or in position (nephroptosis congenital or acquired nature).
As with any x-ray examination, for review urography has its contraindications:
- Pregnancy or conception.
- The different stages of radiation sickness in a patient.
- The absence of one of the kidneys and functional disorders of another.
It is advisable not to send to urography in the patients, which soon held the upper GI with barium suspension, as remaining in the body contrast dye can worsen the process of visualizing the urinary tract. This does not mean that this study will have to be abandoned. Wait a few days until suspension of barium is completely removed from the body of the subject.
Algorithm of the description of the resulting image
First and foremost, the doctor proceeds to describe the condition of the bone system, which is associated with the indirect influence of pathological processes in the organs of the urinary system on its condition. For example, prolonged existence of diseases of the kidney, compensatory scoliosis of the spine in a healthy way.
If the patient is well prepared for the procedure, the photographs clearly visualized the shadows of the kidneys. Normally, they are placed in the following anatomical boundaries: the left – at the level of XII thoracic and to the II lumbar vertebral bodies, and the right – from I to III of the lumbar vertebral bodies. Finding the right kidney below the left due to the pressure from the liver.
Describing the shadow of both kidneys, the specialist clarifies their shape, size and condition of the circuit. And also noteworthy the density of the tissue throughout its length.
Next, the doctor examines the lumbar muscles, their contour and symmetry of arrangement on both sides. If there are any modifications, then this indicates the beginning of the inflammatory process, or tumor lesions in space located behind the peritoneum (also known as “effacement” of the contours of the muscles may indicate the presence of large hematomas).
Normal ureters should not be visualized as they are hollow on. However, if you have them in the clearance of inflammation or stones in the pictures have the abnormal shadows corresponding to the location of the ureters.
The bladder is determined by the images only if its lumen contains concentrated urine that contains a lot of impurities. In his normal form close to an ellipse.
After the physician describe all the “natural” shade and structure, he proceeds to the examination of the pathological and the incremental shadows generated by different organs of the abdominal cavity or space behind the peritoneum.
Description of the images obtained during the review urography, doesn’t take the doctor long time, so the method is still applied in the prehospital phase, when the question of the future conduct of the patient
Despite the variety of modern methods of diagnosis both invasive and non-invasive nature, visual urography has firmly taken its niche in medical practice. This procedure is included in the standards of research among all patients suffering from diseases in the organs of the urinary tract.