Basic Princip of Urinary Tract Imaging
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BASIC PRINCIP OF BASIC PRINCIP OF GENITOURINARY TRACT GENITOURINARY TRACT
IMAGINGIMAGING
BASIC PRINCIP OF BASIC PRINCIP OF GENITOURINARY TRACT GENITOURINARY TRACT
IMAGINGIMAGING
Bagaswoto PoedjomartonoBagaswoto Poedjomartono
Department of Radiology Faculty of Medicine Department of Radiology Faculty of Medicine GMU / Dr. Sardjito GHGMU / Dr. Sardjito GH
JogjakartaJogjakarta
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X-RAY MACHINEFOR ABDOMINAL AND URINARY
TRACT
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Point of view:Regio hypochondriumRegio epigastricumRegio lumbalisRegio umbilicalisRegio iliacaRegio hypogastricum
ABDOMEN
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CONGENITAL ANOMALY OF KIDNEY
• Failure of development
• Aplasia• Hypoplasia• Hypertrophy• Simple ectopia
• Fusion of the kidney
• Crossed ectopia• Malrotasi• Cystic disease
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KIDNEY EXAMINATION1. Plain photo2. IVP3. Retrograd Pyelography4. Antegrad Pyelography5. CT6. USG7. MRI8. SPECT9. Hybrid CT/MRI/PET/SPECT10. Angiography
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INTRAVENAPYELOGRAPHY
1. Administered iodine solution ionik/non-ionik i.v dosage 20-50 ml.
2. Image on 5 minute AP position after contrast injection to evaluate the kidney and pelvicaliceal system.
3. Image on15 minute after contrast injection to evaluate the ureter flow.
4. Image on30 minute after contrast injection prone position to evaluate ureter and bladder filling.
5. Upright image AP position, if needed to evaluate kidney movement.
6. After voiding AP position to evaluate bladder empty.
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INTRAVENAPYELOGRAPHY
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TRACT URINARIUSINTRAVENA PYELOGRAPHY
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TRACT URINARIUSINTRAVENA PYELOGRAPHY
Staaghorn stone at theRight and Left kidneys
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ANTEGRAD PYELOGRAPHY
Indication:Non function kidneyHidronephrosisKidney decompressionUrinary tract obstruction Etc
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RETROGRAD PYELOGRAPHY IS
REQUIRED WHEN?• There is inadequate definition of upper
urinary tract on an IVP• Where there is an obstructive element
in the upper tract when the obstructing cause is not clearly defined
• To define the relationship of doubtful or non-radio opaque calculi to the ureter. An oblique film taken as part of
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BLADDER NORMAL AND ABNORMAL
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kidney examination
Renal angiography
USG
Scintigraphy
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CT AND USG KIDNEY
Cystic disease
Hydronephrosis
KIDNEY CT USING CONTRAST MEDIA
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MSCT CONTRAST OF KIDNEY
coronarSagital/lateral
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RENAL TRAUMAURGENCY:
1. To confirm damage to the injured kidney
2. To establish the presence and function of the contralateral kidney in case subsequent surgery requires removal of the damage kidney
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RADIOLOGICAL SIGN1. Extra passage / leakage2. Bulging / haematoma perirenal /
subcapsular3. Defect / rupture / tear4. Obstructed5. Pelviectasis / hydronephrosis6. Arterial / venous defect / rupture
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BLADDER TRAUMAThe way bladder may be damage:1. In the course of surgery: hysterectomy,
surgery of the lower part of the colon and rectum, repair of inguinal and femoral hernia, vaginal repair in prolapse operations.
2. Endoscopic procedures: TUR3. Injuries:
1. Penetrating or non penetrating2. Direct or indirect
4. Complication of bladder trauma: Fistulae bladder: vagina, uterus, rectum / bowel, peritoneum, cutaneous.
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URETHROCYSTOGRAPHY
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RADIOLOGY IN BLADDER TRAUMA
• Plain photo• IVP and cystography• USG• Fistulography if bladder fistula is faound
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RADIOLOGICAL SIGNS1. Penetrating of radiopaque foreign
body2. Leakage / extra passage of
contrast media3. Direct penetration fragment
fracture from pelvic / pubic bone
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Prostatic Gland
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HYSTEROSALPHYNGOGRAPHY1. Pemeriksaan saluran reproduksi wanita2. HSG set3. Kanul HSG dimasukkan kedalam cervix uteri dan
difiksasi4. Kontras sol iodine 10-15 ml5. Evaluasi cavum uteri6. Evaluasi Tuba Fallopii7. Evaluasi spill kontras8. Evaluasi organ sekitarnya
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HysterosalphyngographyNormal
Point of view:Cavum uteriTuba uterinaSpill kontras
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HYSTEROSALPHYNGOGRAPHY NORMAL
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UTERUS DUPLEKS
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ABNORMALITY OF THE UTERUS
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HYDROSALPHYNX DUPLEX
•Enlargement of the Tuba Fallopii•No spill in the Douglas cavity
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Uterine lipoma
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TRIMA KASIH