Part 2- CONTRAST MEDIA AND GENITO-URINARY upd PDF
Part 2: Contrast Media and Genito-Urinary
Page 1: General Overview
Introduction to contrast media used in genito-urinary imaging.
Page 2: Artifact R
Mention of artifact 'R', further context needed.
Page 3: Anatomy Overview
Anatomic structures include:
Liver
Spleen
Stomach
Right & Left Kidneys
Psoas Muscle
Small Intestine
Ascending & Descending Colon
Rectum
Page 4: Types of Contrast Media: Genito-Urinary
Ionic Contrast Media
Contains iodine as the opacifying element.
Higher osmolality increases chance of reaction.
Upon injection, dissociates into two ions, creating a hypertonic condition in blood plasma.
Common examples: Hypaque, Conray, Renografin.
Page 5: Non-Ionic Contrast Media
Non-Ionic Contrast Media (introduced in 1984)
Also contains iodine but lacks positively charged cations.
Remains intact upon injection, considered safer with fewer reactions.
Common examples: Omnipaque, Isovue, Amipaue, Optiray.
Lower osmolality, reducing the chance of reactions and better tolerated by the body.
Page 6: Common Side Effects of Contrast Media
Temporary hot flash.
Metallic taste in mouth.
Both typically resolve quickly.
Page 7: Patient History Questionnaire
Key questions for patient history include:
Allergies to anything?
History of hay fever, asthma, or hives?
Allergy to drugs or medications?
Allergy to iodine?
Food allergies?
Current medications affecting kidney function (e.g., metformin)?
Previous x-ray examinations with contrast injections?
Page 8: Diagnostic Indicators
Assessment of kidney function through:
BUN (Blood Urea Nitrogen): normal range 8-25 mg/100 mL.
Creatinine: normal levels for adults 0.6 to 1.5 mg/dL.
Elevated levels indicate potential renal failure, tumor, or urinary system conditions.
Page 9: Metformin and Its Risks
Metformin is used to manage non-insulin-dependent diabetes.
Increased risk for acute renal failure and lactic acidosis when using contrast media.
Should be withheld for at least 48 hours after procedures involving contrast.
Page 10: The Urinary System
The system responsible for urine production and elimination.
Page 11: Functions of the Urinary System
Key functions include:
Removal of nitrogenous wastes.
Regulation of water levels.
Maintenance of acid-base balance and electrolyte levels in blood.
Page 12: Components of the Urinary System
Structures involved:
Kidneys
Ureters
Bladder
Sphincter
Urethra
Page 13: Anatomy of the Kidney
Key components include:
Calyces
Renal Pelvis
Renal Artery
Medulla
Renal Vein
Cortex
Page 14: Ureter Anatomy
Structure includes smooth muscle, orifice of ureter, trigone, and prostate.
Page 15: Procedures in Urography
Types of procedures include:
Urography
IVU (Intravenous Urography)
Hypertensive IVU
Percutaneous renal puncture
Retrograde urography
Retrograde cystography
Voiding cystourethrography
Retrograde urethrography
Page 16: General Description of Urography
Urography: radiologic investigations of renal drainage or collecting system.
Page 17: Methods of Urography
Excretory or Intravenous Urography (IVU)
Retrograde Pyelography
Page 18: Excretory Urography
Most frequently employed method with intravenous contrast administration.
Page 19: IVU Overview
IVU: radiographic examination of urinary system; visualizes calyces, renal pelvises, ureters, and bladder after contrast injection.
Page 20: Purpose of IVU
Visualize collecting portion of urinary system.
Assess functional ability of kidneys.
Evaluate for pathology or anatomical anomalies in urinary system.
Page 21: Contraindications for IVU
Hypersensitivity to iodinated contrast media.
Anuria (absence of urine excretion).
Multiple myeloma.
Diabetes mellitus.
Severe hepatic or renal disease.
Congestive heart failure.
Pheochromocytoma.
Sickle cell anemia.
Patients taking metformin or similar medications.
Acute or chronic renal failure.
Page 22-26: Study of IVU Indications
Detailed indications for performing IVU and its relevance.
Page 27: Patient Preparation for IVU
Patient preparation requirements for optimal examination outcome:
Low-residue diet to prevent gas formation.
Light evening meal.
Non-gas forming laxative prior to examination.
NPO after midnight before procedure.
Water intake encouraged before retrograde urography.
Page 28-31: IVU Characteristics
Excretory urography is the common method for urinary system imaging post-contrast.
Page 32-38: Procedures and Timeframes
Describes routine projection times and post-void imaging instructions.
Page 39: Ureteric Compression
Method to enhance filling of pelvicalyceal system and proximal ureters during imaging.
Page 40-42: Ureteral Compression Device
Devices used for ureteral compression and contraindications including ureteric stones and abdominal mass.
Page 43-44: Hypertensive IVU
Special IVU type for patients with hypertension to examine renal implications.
Page 45-46: Percutaneous Renal Puncture and Retrograde Urography
Defines procedures and techniques used to assess renal masses.
Page 47-48: Technique and Positioning
Procedure setup includes positioning the patient and necessary initial imaging.
Page 49-54: Imaging Systems in Cystography
Steps involved in retrograde cystography: indications and positioning for men and women.
Page 55-58: Cystography Procedure Overview
Describes how contrast is instilled and observed during the procedure.
Page 59-60: Voiding Cystourethrography
Explains the study of urethra and urination ability.
Page 61-66: Retrograde Urethrography
Procedures and positioning in examining the male urethra.
Page 67-68: Hysterosalpingography (HSG)
Definitions and purposes of HSG, indications and procedures.
Page 69-73: HSG Techniques
Describes procedure steps, equipment used, and positioning for HSG.
Page 74-84: Patient Preparation for HSG
Patient preparation requirements, technical specifications, and film quality control considerations.
Page 85-94: Intravenous Urography (IVU)
Comprehensive overview of IVU techniques and how they show various renal conditions and pathologies.