Function and anatomy in one study
Images at the 7th, 15th and 25th minutes reflect the nephrographic and excretory phases: a delay in contrast indicates a decrease in kidney function, a “break” of contrast in the ureter indicates the level of blockage by a stone or stricture, expansion of the collecting system indicates the degree of hydronephrosis; duplication, horseshoe kidney, and ureterocele are also visible. Compared to CT urography, the dose is lower, and the functional dynamics are more clear; in complex cases and suspected tumor, MSCT is prescribed. Delayed images are performed if necessary, up to 1–2 hours.
Indications
- urolithiasis - overview image to control X-ray positive stones;
- hydronephrosis, anomalies of the kidneys and ureters - excretory urography;
- urethral stricture, urethral trauma - urethrography;
- vesicoureteral reflux, diverticula, neurogenic bladder - cystography;
- control of drainage and patency after operations (antegrade pyelography, fistulography).
Place of x-ray for diseases of the urinary system
Although MSCT has largely replaced classical urography, X-ray techniques remain indispensable where a functional and “dynamic” picture is needed with a lower dose: monitoring the passage of stones using a survey image, assessing the urethra during urination (voice cystourethrography is the only way to see reflux and the posterior urethra), checking drainages and anastomoses with contrast. The studies are performed by a urologist and a radiologist at the clinic in conjunction, so the images are immediately interpreted in the context of treatment.
