BASIC PRINCIP OF GENITOURINARY TRACT IMAGING

Bagaswoto Poedjomartono Department of Radiology Faculty of Medicine GMU / Dr. Sardjito GH Jogjakarta

FOR ABDOMINAL AND URINARY TRACT

X-RAY MACHINE

ABDOMEN

Point of view: Regio hypochondrium Regio epigastricum Regio lumbalis Regio umbilicalis Regio iliaca Regio hypogastricum

CONGENITAL ANOMALY OF KIDNEY

Failure of development Aplasia Hypoplasia Hypertrophy Simple ectopia Fusion of the kidney Crossed ectopia Malrotasi Cystic disease

KIDNEY EXAMINATION
1. 2. 3. 4. 5. 6. 7. 8. 9. 10. Plain photo IVP Retrograd Pyelography Antegrad Pyelography CT USG MRI SPECT Hybrid CT/MRI/PET/SPECT Angiography

INTRAVENAPYELOGRAP HY
1.
2.

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4.

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6.

Administered iodine solution ionik/non-ionik i.v dosage 20-50 ml. Image on 5 minute AP position after contrast injection to evaluate the kidney and pelvicaliceal system. Image on15 minute after contrast injection to evaluate the ureter flow. Image on30 minute after contrast injection prone position to evaluate ureter and bladder filling. Upright image AP position, if needed to evaluate kidney movement. After voiding AP position to evaluate bladder empty.

INTRAVENAPYELOGRAPHY

INTRAVENA PYELOGRAPHY

TRACT URINARIUS

TRACT URINARIUS
INTRAVENA PYELOGRAPHY

Staaghorn stone at the Right and Left kidneys

ANTEGRAD PYELOGRAPHY

Indication: Non function kidney Hidronephrosis Kidney decompression Urinary tract obstruction Etc

RETROGRAD PYELOGRAPHY IS REQUIRED WHEN?

There is inadequate definition of upper urinary tract on an IVP Where there is an obstructive element in the upper tract when the obstructing cause is not clearly defined To define the relationship of doubtful or non-radio opaque calculi to the ureter. An oblique film taken as part of

BLADDER NORMAL AND ABNORMAL

kidney examination
USG

Renal angiography

Scintigraphy

CT AND USG KIDNEY

KIDNEY CT USING CONTRAST MEDIA

Hydronephrosis Cystic disease

MSCT CONTRAST OF KIDNEY

coronar Sagital/lateral

RENAL TRAUMA
URGENCY:
1. To confirm damage to the injured kidney 2. To establish the presence and function of the contralateral kidney in case subsequent surgery requires removal of the damage kidney

RADIOLOGICAL SIGN
1. Extra passage / leakage 2. Bulging / haematoma perirenal / subcapsular 3. Defect / rupture / tear 4. Obstructed 5. Pelviectasis / hydronephrosis 6. Arterial / venous defect / rupture

BLADDER TRAUMA
The way bladder may be damage: 1. In the course of surgery: hysterectomy, surgery of the lower part of the colon and rectum, repair of inguinal and femoral hernia, vaginal repair in prolapse operations. 2. Endoscopic procedures: TUR 3. Injuries: 4. Complication of bladder trauma: Fistulae bladder: vagina, uterus, rectum / bowel, peritoneum, cutaneous.
1. 2. Penetrating or non penetrating Direct or indirect

URETHROCYSTOGRAPHY

RADIOLOGY IN BLADDER TRAUMA

Plain photo IVP and cystography USG Fistulography if bladder fistula is faound

RADIOLOGICAL SIGNS
1. Penetrating of radiopaque foreign body 2. Leakage / extra passage of contrast media 3. Direct penetration fragment fracture from pelvic / pubic bone

Prostatic Gland

HYSTEROSALPHYNGOGRAPHY
1. 2. 3. 4. 5. 6. 7. 8. Pemeriksaan saluran reproduksi wanita HSG set Kanul HSG dimasukkan kedalam cervix uteri dan difiksasi Kontras sol iodine 10-15 ml Evaluasi cavum uteri Evaluasi Tuba Fallopii Evaluasi spill kontras Evaluasi organ sekitarnya

Hysterosalphyngography Normal Point of view: Cavum uteri Tuba uterina Spill kontras

HYSTEROSALPHYNGOGRAPHY NORMAL

UTERUS DUPLEKS

ABNORMALITY OF THE UTERUS

HYDROSALPHYNX DUPLEX

Enlargement of the Tuba Fallopii No spill in the Douglas cavity

Uterine lipoma

TRIMA KASIH