Do you have lower back pain, swelling and problems with urination? Pressure rises, but antihypertensive drugs do not help? We strongly recommend checking the condition of the urinary system. In Moscow, you can have an x-ray of the kidneys and pelvic organs at the K+31 multidisciplinary clinic.
X-rays are used in various fields of medicine (including urology). With fluoroscopy, the image is displayed on the screen, and radiography allows you to get a picture of internal structures.
Urography: what is it?
Urography is a non-invasive technique that involves visualization of the structures of the urinary tract using dosed electromagnetic radiation (in the range between gamma rays and ultraviolet).
It weakens as it passes through fabrics of varying densities, allowing you to get a contrast image on a film or monitor screen.
Depending on the indications, a survey or excretory urography of the kidneys is used with a preliminary intravenous injection of a contrast agent.
The pictures show:
- kidneys;
- ureters;
- bladder;
- urethra.
Survey urography helps to see benign and malignant neoplasms (cystic and tumor), calculi (stones), foreign bodies, cavity dilation (hydroureter and hydronephrotic transformation), wrinkling and stretching of the tissues of the genitourinary system, as well as their growth (hyperplasia).
Please note: An x-ray image helps to recognize some helminthiases (for example, echinococcosis).
In intravenous excretory urography, a substance impervious to radiation is introduced into the bloodstream. The method allows assessing the shape and size of structures, the state of the pelvicalyceal segment and functional activity (excretory capacity).
Some time after the introduction of contrast into the systemic circulation, the diagnostician takes a series of images, the analysis of which determines the rate of urine output. Excretory intravenous urography is a study that can be performed according to absolute or relative indications.
Basic (absolute) readings:
- chronic inflammatory process (glomerulo- or pyelonephritis);
- lumbar injury;
- micro or macrohematuria (admixture of blood in the urine);
- suspicion of urolithiasis (kidney stone disease);
- genitourinary system infections;
- nephroptosis (mobility, prolapse of the kidney).
Important: The appearance of blood in the urine may indicate an acute inflammatory process or a cancerous tumor that has already damaged the blood vessels.
Relative indications for intravenous urography of the kidneys are dysuria (urination disorders), suspicion of anomalies (doubling) of the ureter, as well as preparation for surgical intervention on the organs of the urinary system.
Survey urography has practically no contraindications. An x-ray examination is highly undesirable for women who are carrying a child (at any gestational age).
Important: The exception is cases where the pathology poses a clear threat to the health and life of the expectant mother.
Kidney X-ray with contrast cannot be performed in case of renal failure, thyrotoxicosis (hyperthyroidism, hyperthyroidism), during pregnancy and acute conditions accompanied by a febrile reaction (increased overall body temperature, chills, signs of intoxication).
What is retrograde and antegrade urography?
Retrograde (ascending) urography is an X-ray diagnostic method in which liquid or gaseous contrast is injected through the urethral canal through a catheter. The images show pathologies caused by a change in the shape of organs, dysfunction, or obstruction (including obturation, strictures, tumor compression).
Indications:
- chronic inflammation of the renal pelvis (pyelonephritis);
- glomerulonephritis (inflammation of the glomerular apparatus);
- the appearance of blood clots in the urine (gross hematuria);
- difficulty passing urine;
- abdominal and lumbar injuries;
- rehabilitation period after operations on the organs of the urinary system.
In case of colic (intense spasmodic pain) that lasts more than 2 hours, the study is carried out urgently.
With the upward injection of contrast, it is possible to diagnose such pathologies of the bladder as diverticula and prolapse of the organ. The x-ray may show enlargement (hyperplasia) of the prostate.
In antegrade (descending) urography of the kidneys using a contrast agent, a substance impervious to rays is introduced into the pelvicalyceal structures through a puncture (percutaneous puncture) or nephrostomy drainage (catheter).
This method is used when ascending contrast administration or a pronounced decrease in excretory function is impossible. The puncture is performed under local anesthesia with novocaine solution. After taking the images, the contrast is aspirated and antibiotics are injected into the pelvis.
Indications:
- tuberculosis of the kidney;
- Neoplasms and strictures in the ureter, obstruction of the lumen by a calculus;
- urological pathologies leading to dysfunction of the renal parenchyma;
- hydronephrosis;
- control of nephro- or pyelostomy;
- assessment of urine passage after healing of the fistulous tract.
Descending pyelography is not performed if there is a violation of blood clotting, suspicion of oncology or a benign tumor, and paranephritis (an infectious and inflammatory process in the surrounding tissue).
A categorical contraindication to any x-ray of the kidneys with a contrast agent is an individual hypersensitivity to iodine preparations (allergic reactions).
Computed tomography
One of the most informative diagnostic methods is CT, which is also based on the action of X-rays.
A spiral tomograph rotates around a person in a horizontal position and takes a series of images. Images are processed using special software. The diagnostician receives layer-by-layer images (essentially “sections”) of tissue structures.
Important: CT is not performed if the patient's weight exceeds 120 kg (this is the maximum allowable load on the machine table).
