Imaging in Genitourinary System.pptx

8/17/2019 Imaging in Genitourinary System.pptx

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Imaging inGenitourinary System


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ANATOMY


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ANATOMY

ale Reproductive System


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ANATOMY


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IMAGING MODALITIES

› Plain abdominal x ray

› BNO-IVP

› Retrograde

uretrography/cystography/urethrocystography

› Bipolar Urethrocystography

› Voiding Cystourethrography

› Ultrasonora!"y

› #T S$an

› M%I

› N&$l'ar Imain

› (yst'rosal!"inora!"y


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Retrograde

uretrography/cystography/urethrocystogra

phy


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%'trorad' Ur't"rora!"y

To ass'ss t"' &r't"ra

T"' $ontrast m'dia is in)'$t'd *rom t"'

distal to t"' !roximal !art o* t"'&r't"ra +r'trorad' or as$'ndin,


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Indi$ation Ur't"ral r&!t&r'

Ur't"ral stri$t&r'

#on'nital anomaly

Ur't"ral st&l'

Ur't"ral di.'rti$l'

#ontraindi$ation A$&t' &rinary tra$t

in*'$tion

Ur't"ral obstr&$tion ('mat&ria

%'$&rr'nt &rinarytra$t in*'$tion

Slo/ &rinary 0o/

Urinary mass


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IMAGING IN %GU

Pr'-$ontrast AP 1ilm %i"t-ant'rior Obli2&' L'*t-ant'rior Obli2&'


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%'trorad' Ur't"rora!"y3 Ur't"ralr&!t&r'


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%'trorad' Ur't"rora!"y3 Ur't"ralstri$t&r' /it" !'ri&r't"ral abs$'ss


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%'trorad' #ystora!"y

To ass'ss t"' &rinary bladd'r

T"' $ontrast m'dia is in)'$t'd t"ro&"

t"' &rinary $at"'t'r into t"' &rinarybladd'r

%'trorad' to t"' &rinary 0o/


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Indi$ation %'$&rr'nt &rinary

tra$t in*'$tion

S&s!i$ion o* &rinarybladd'r r&!t&r'

Ston'

Mass In0ammation

Di.'rti$l'

1ist&l'

In$ontin'ntia

('mat&ria

M'as&r' t"' &rinary.ol&m' !ostmi$t&rition

Ass'ss t"' int'rityo* t"' anastomosisor s&t&r' !osto!'rati.'


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#ontraindi$ation Pr'nan$y

Ur't"ral r&!t&r' +$ontraindi$ation tot"' &rinary $at"'t'r ins'rtion,


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%'trorad'Ur't"ro$ystora!"y

To ass'ss t"' &rinary bladd'r and t"'&r't"ra4

#ombination o* t"' r'trorad'&r't"rora!"y and $ystora!"y4

T"' $ontrast m'dia is in)'$t'd t"ro&"t"' 'xt'rnal &r't"ral ori$i&m to ll t"'&r't"ra and t"'n t"' &rinary bladd'r4


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BipolarUrethrocystography


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Bi!olar Ur't"ro$ystora!"y

To ass'ss t"' &r't"ra *rom t"' !roximaland distal as!'$ts4

%'trorad' *rom t"' distal &r't"ra Ant'rad' *rom t"' $ystostomy

$at"'t'r

Pati'nt is as5'd to .oid so t"at t"'$ontrast m'dia /ill ll t"' !roximal!art o* t"' &r't"ra4


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Bi!olar Ur't"ro$ystora!"y

Indi$ation Ass'ss t"' !roximal and distal marin

o* obstr&$tion +stri$t&r'6 ston'6 mass,in t"' &r't"ra

#ontraindi$ation All'ry to $ontrast m'dia


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VoidingCystourethrogram(VCUG)


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Voidin #ysto&r't"roram+V#UG, To d'monstrat's t"'

lo/'r &rinary tra$t

"'l!s to d't'$t t"'

'xist'n$' o* any.'si$o-&r't'ral r'0&x

to d't'$t bladd'r

!at"oloy

to d't'$t $on'nitalor a$2&ir'd

anomali's o* bladd'ro&t0o/ tra$t

!assin a $at"'t'r t"ro&" t"'&r't"ra into t"' bladd'r llint"' bladd'r /it" $ontrastmat'rial ta5in radiora!"s/"il' t"' !ati'nt .oids4


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Indicat

ions

VC

UG

#"ildr'n

Ad&lts

Urinary tra$t in*'$tion7 Us&ally don'a*t'r som' /''5s o* a$&t' sta' or may

b' don' &nd'r antibioti$ $on.'r'4 .oidin di8$&lti's 3 dys&ria 6 t"in

str'am dribblin6 *r'2&'n$y6 &r'n$y6.'si$o &r't'ri$ r'0&x6 tra&ma4

Bas'lin' st&dy !rior to lo/'r UT s&r'ry4

Tra&ma to &r't"ra6 &r't"ral stri$t&r'6&r't"ral di.'rti$&la 6UTI6

%'0&x n'!"ro!at"y !rior to r'naltrans!lant o* on'9bot" 5idn'ys4


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P%O#EDU%E

Und'r as'!ti$ $onditions6 $at"'t'ri:' t"' &rinarybladd'r /it" !ati'nt in s&!in' !osition4

P&s" t"' dil&t'd $ontrast m'di&m slo/ly &nd'r

0&oros$o!i$ &idan$' As5 t"' !ati'nt to in*orm yo& /"'n "' "as &r' to

mi$t&rat'4

As5 t"' !ati'nt to mi$t&rat' in a &rin' r'$'i.'r in an'r'$t obli2&' !osition4

S!ot ima's ar' ta5'n d&rin mi$t&rition in ri"t andl'*t obli2&' !ro)'$tions and any r'0&x is r'$ord'd4

1inally6 a *&ll-l'nt" .i'/ o* t"' abdom'n is ta5'n tod'monstrat' any &nd't'$t'd r'0&x o* t"' $ontrastm'di&m t"at mi"t "a.' o$$&rr'd in t"' 5idn'ys and tor'$ord t"' !ost mi$t&rition r'sid&'4


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Voidin #ysto&r't"roram+V#UG,

Ad&lt Mal'3

› T"' .oidin st&dy $an b' modi'd by'ttin t"' !ati'nt to .oid aainstr'sistan$' by &sin a !'nil' $lam! or$om!r'ssion o* distill'd !art o* !'nis6/"i$" 'n"an$'s .is&ali:ation o* &r't"ra byt"' arti$ial dist'nsion4

› T"is is 5no/n as chokecystourethrography


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S$o&t 1ilm

T"' rst ima' is a;UB $all'd t"' scoutflm4

On t"is lm on' $anevaluate the spineand pelvis +in)&ry or$on'nital anomaly

s&$" as s!ina bida,and t"' so*t tiss&'s+$al$i$ations6*or'in bodi's6 't$4,4


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illing

!hase

S'.'ral s'$onds a*t'r t"' $ontrast mat'rial b'ins to0o/6 t"' minimally ll'd bladd'r is ima'd in t"'ant'ro!ost'rior !ro)'$tion4

A &r't'ro$'l' or bladd'r t&mor t"at is /'ll s''n d&rin'arly llin may b'$om' obs$&r'd as mor' $ontrastmat'rial 'nt'rs t"' bladd'r4

On $om!l't' llin 6t"' bladd'r s"o&ld a!!'ar smoot"and r'&lar and t"'r' s"o&ld b' no llin d'*'$ts4 T"'

'd's o* t"' bladd'r ima' s"o&ld b' smoot"4


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Voidin P"as'

Ima's $a!t&r'd d&rin .oidin /illd'monstrat' the urethra +stri$t&r's

or obstr&$tion, and the "ladder6 andt"'y /ill do$&m'nt t"' !r's'n$' orabs'n$' o* vesicoureteral re#u$%


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T"is lm s"o/sa normal mal'&r't"ra< t"'r' is

no obstr&$tion4 T"' .ariations''n in t"'diam't'r o* t"'&r't"ra isnormal4

Voidin P"as'

Ind'ntation at t"' &r't"ral

s!"in$t'r +normal,


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Post-.oid 1ilm

T"' !ost-.oid ima'may demonstratere#u$ +$ontrast

s''n in t"' &r't'r or5idn'y, ore$travasation o&urine &rom the

"ladder orurethra +s&$" as*rom a tra&mati$r&!t&r',4

Normal !ost-.oid lm


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Vesicoureteral re#u$(VUR)


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V'si$o&r't'ral r'0&x +VU%,

V'si$o&r't'ri$ r'0&x +VU%, abnormal0o/ o* &rin' *rom t"' bladd'r into t"'

&!!'r &rinary tra$t

yo&n $"ildr'n4 As s&$" t"' dianosis is rst s&s!'$t'd

a*t'r a &rinary tra$t in*'$tion in ayo&n $"ild4


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MCUG T"' !rimary dianosti$!ro$'d&r' *or '.al&ation o*

.'si$o&r't'ri$ r'0&x is a .oidin$ysto&r't"roram +V#UG,

/"'t"'r r'0&x o$$&rs d&rinmi$t&rition or d&rin bladd'r llin


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Grad' I3 r'0&x to &r't'r b&t not to 5idn'y

Grad' II3 r'0&x into &r't'r6 !'l.is6 and

$aly$'s /it"o&t dilatations Grad' III3 r'0&x to $aly$'s /it" mild

dilatation6bl&nt'd *orni$'s

Grad' IV3 to $aly$'s /it" mod'rat'

dilatation6oblit'ration o* *orni$'s Grad' V3 ross dilatation6 tort&o&s

&r't'rs4


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V#UGd'monstratin"ilateral Grade III

vesicoureteralre#u$


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Pr'-.oid $ontrast ll'dbladd'r d'monstrat'dbilat'ral .'si$o-&r't'ral r'0&x /it"mildly tort&o&s andmod'rat'ly dilat'd&r't'rs6 /it" $ontrastr'a$"in bl&nt'd

dilat'd $aly$'s4 1indins ar' 5''!in

/it" bilat'ral type 'vesicoureteral

re#u$4


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Imaging in Genitourinary System.pptx

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