RAD.CONT. PREFI

G3-4 TOPICS (IVPS-HEPATOBILIARY SYSTEM)

IVP (Intravenous Pyelography)

A contrast exam where iodinated contrast is injected IV and excreted by kidneys

Indications of IVP

Detect stones obstruction hematuria hydronephrosis

Contraindications of IVP

Iodine allergy renal failure pregnancy severe dehydration

Patient Prep for IVP

NPO 8 hours bowel cleansing void before exam

Nephrogram

1-minute film showing renal parenchyma enhancement

Nephrotomography

Tomographic slices of kidneys during early contrast phase

Purpose of Nephrotomography

Detect small renal masses or cysts

Percutaneous Renal Puncture

Direct needle insertion into renal pelvis for contrast or drainage

Indications of Renal Puncture

Obstruction or when IVP/retrograde studies fail

Contraindications of Renal Puncture

Bleeding disorders infection uncontrolled hypertension

Hypertensive Pyelography

Rapid-sequence IVP for renal-origin hypertension evaluation

Purpose of Hypertensive Pyelography

Identify renal artery stenosis or delayed enhancement

Retrograde Pyelography

Contrast injected upward into ureters via cystoscope

Indications of Retrograde Pyelography

Ureteric strictures obstruction hematuria

Contraindications of Retrograde Pyelography

Active UTI or urethral trauma

Cystography

Bladder imaging using contrast instilled through catheter

Indications of Cystography

Bladder rupture reflux tumors trauma

Contrast for Cystography

Water-soluble iodinated contrast only

Post-Void Film Purpose

Detect small leaks and vesicoureteral reflux

IVP Contrast Used

Non-ionic iodinated contrast such as Omnipaque or Isovue

Oral Cholecystography

Oral iodine tablets absorbed by liver and stored in gallbladder

Indications of OCG

Gallstones cholecystitis nonfunctional gallbladder

Prep for OCG

NPO after midnight low-fat dinner contrast tablets 14 hours before

Intravenous Cholecystocholangiography (IVC)

IV contrast excreted by liver to opacify bile ducts

Indications of IVC

Detect duct obstruction stones duct anatomy

Contraindications of IVC

Liver failure iodine allergy pregnancy

Intraoperative Cholangiography

Contrast injected via cystic duct during gallbladder surgery

Purpose of IOC

Identify duct anatomy detect CBD stones

Percutaneous Transhepatic Cholangiography

Needle inserted through liver into bile ducts

Indications of PTC

High obstruction dilated ducts tumors strictures

Contraindications of PTC

Bleeding disorders ascites infection

Risks of PTC

Bleeding bile leak peritonitis

ERCP

Endoscope delivers contrast retrograde into bile and pancreatic ducts

Indications of ERCP

Stones strictures tumors jaundice

Therapeutic ERCP

Allows stone removal stent placement dilation

Contraindications of ERCP

Acute pancreatitis severe cardiopulmonary disease

Risks of ERCP

Pancreatitis perforation bleeding

T-Tube Cholangiography

Post-operative contrast exam through T-tube

Purpose of T-Tube Study

Detect residual stones duct patency leaks

Prep for T-Tube Study

Clamp tube 24 hrs prior and NPO 6–8 hrs