Intravenous urogram is besides known as endovenous pyelogram. It is a radiology process to see the piss system including kidney, vesica and ureter. Intravenous urogram is approximately scrutiny allows the physician to see constructions like the cerebral mantle, nephritic, calyceal, nephritic pelvic girdle, pyeloureteric junction, vesica and ureteric drainage. Among the jobs that can be examined in this manner is a vesica infection, kidney infection, shed blooding in the piss, tumour, hurt to the urinary piece of land after a terrible external hurts, and several other related diseases. To transport out this scrutiny, particular stuffs required for these constructions can be seen in the x-ray images. Particular stuffs that are the contrast media.
Contrast agent is injected into a vena in the organic structure and it will be distributed throughout the organic structure via the blood stream, before it is eliminated by the kidneys. Often the contrast agent is injected through the average cubital vena, and images of some of the kidney ensuing contrast image synthesis. There are several types of projections used in the test of IVU. Projections are as full length KUB, KUB on your belly, cross-dim scope reduced the nephritic kidney and upper ureter, oblique to the kidneys, vesica anteroposterior angle of 15 grades to forestall vesica covered with pubic symphysis and the vesica oblique. Contrast agents can be viewed straight on the kidney instantly after injection and is known as nephrogram.
This shows the contrast agent by glomerular filtered before making colyceal system. It is of import to analyze the nephritic lineation, and can observe tumours, cysts or cortical scarring. He besides produces initial information about the mark of kidney. After 5 proceedingss of an injection is given, calyces will be filled with contrast agents, which will so travel down the ureter to make full the vesica.
Contraindications that should be known by the radiographers before any process is as nephritic gripes, nephritic concretion, abdominal hurting, abdominal surgery at the latest, after the patient gave birth, and the replacing of the kidney. This contraindication is of import to avoid complications that may happen.
Patient readying before during the scrutiny
Patients are non allowed to imbibe a few hours before urogram scrutiny. Patients are besides asked to take a laxative to do certain everything is clean from the soiled stuff. If the patient is taking any medicines such as blood force per unit area medical specialties, patients can go on taking these drugs unless prohibited by a physician. If the patient is pregnant, the patient should be told radiographers working.
Intravenous urogram was non performed on patients who are pregnant unless certain exigency instances. Patients will be asked to subscribe a papers. This papers is transporting all the hazards, benefits and all the digests that can happen. This allows the patient to understand all the processs of this review. If the patient agrees to presume all hazards and understand the processs established, the patient can subscribe the paperss and processs will be carried out.
Precautions before usage of contrast media in endovenous urogram
The reaction can non be expected to contrast media, and all patients should be cared for and tidy during the process. Of involvement to analyze the patient before executing any process should non be taken lightly. This usher will let the radiographers to transport out the process. Radiographers should cognize the marks of the assorted reactions that occur. There are many stairss that must be taken earlier, during and after the usage of endovenous contrast media. The first, radiographers must cognize the patient ‘s wellness history. Second, if the patient is a patient who had a high hazard, radiographers must utilize low-osmolar contrast media.
Among patients with high hazard of the asthma, epilepsy, diabetes, and others. Following, batch figure and expiry day of the month should be examined in contrast media. In add-on, radiographers must guarantee that the contrast agents in organic structure temperature. Radiographers should besides look into whether or non the bundle has disterile. Prior to this contrast media fringy, they should cognize the right processs, look intoing exigency equipment and cognize how to utilize these tools, and look into the appropriate volume of contrast, the dosage and the right processs.
Intravenous urogram process
Urografi endovenous trial was initiated by inquiring the patient to take vesture and have on a infirmary gown provided. Patients are besides asked to take all jewellery that was found in patients. Then the patient will undergo blood trials to look into whether the patient ‘s kidney map is good or non.
After that, the patient will be laid on stretchers or x-ray tabular array. Then, the radiographers will take an x-ray images before contrast medium injection. Injection of contrast media on the patient through an endovenous. An endovenous cannula ( IV ) is inserted through a vena in the patient ‘s arm or manus. Then, the contrast medium injected.
X raies are taken at the times specified. Several sequences of the movie will be done harmonizing to the trial. X-ray frequences depends on the patient ‘s kidneys to menurus contrast media. Normally, the kidneys would usually filtrate the contrast medium within 5 to 10 proceedingss. Pesalit should stay a remainder between each X ray is taken. Another imagination technique will be used in concurrence with endovenous urogram called kidney tomogram. This is the imaging images of patient kidney in the piece status.
Nurses will help the radiographers to look into the patient ‘s pulsation, respiration and blood force per unit area continuously. Before the last X ray is taken, the patient will be asked to empty their vesica. This is to see patients when the vesica is empty. Intravenous urogram processs completed when all the paths clearly show the urine pictures X ray. The full process takes about one hr.
Procedure during injection
During injection, radiographers must cognize where the Radiologist or a physician may be contacted. In add-on, radiographers must invariably supervise the respiration rate, blood force per unit area, colour and degree of patient consciousness.
Procedure after the injection
Radiographers should stay with the patient non less than 15 proceedingss. when the review was made, look into whether pesalit can return place safely or non. make non let patients to return if there are any complications.
Intravenous urogram trial is one trial that will necessitate to utilize a batch of movie. This is because the process performed and requires much more construction posisisi patient ‘s organic structure to be x-ray. Preliminary movie is the first movie to be taken to the trial. Preliminary movie utilizing a movie of size 14 ten 17 inches ( 43 x 35 centimeter ) . The movie will be placed under the patient. the patient would lie with the projection AP venters to include the symphysis pubic bone and diafgram boundary line. This is to look into the patient ‘s venters was making stock list and to unwrap any instance of calcifications of the nephritic piece of land. X-ray beam was centered in the center of the degree of iliac crest. Extra X ray taken to find any akkan opacities present in the patient ‘s organic structure. 35 grades posterior to the nephritic country. Preliminary aim was to analyze the patient ‘s colon and intestine readying to see patients. It besides seeks to place the nephritic place to find the exposure factors. It is besides to look at jobs in kidney patients.
Then radiographers will take x-ray movie, called immediate. The movie will be taken instantly after injection of contrast media. Film size 10 ten 17 inches ( 24 x 30 centimeter ) was used to movie this immediate. X-ray beam centered between the lower costal border and xiphisternum. Patients will be in a province of AP in the country to see nephritic patients kidneys when contrast is injected. It aims to demo nefrogram, nephritic parenchyma is opacified by contrast medium in patients with nephritic tubules. The purpose is to demo the movie immediate nephritic parenchyma to demo neofrogram stage. It is besides to analyze the size of kidney patients will be expanded from the original size after injection of contrast.
After 5 proceedingss of contrast media injected in patients, radiographers will take an x-ray.X-ray called a 5 minute movie. Size of movie mensurating 14 ten 17 inches ( 35 x 43 centimeter ) used for this movie. Patients in the supine AP and AP projeksinya for nephritic country. After 5 proceedingss of completion of the injection of contrast medium to patients, taking X-rays done full KUB shows the urinary system. Taking images of x-ray taken at this clip to find the patient ‘s intestine motion is symmetrical and does non necessitate to modify the technique for measuring demands. For illustration, another contrast medium should be injected when the kidney is less opacification. The intent of a 5 minute movie is to compare the flow of contrast agent by the two sides of kidney patients. It is besides to see the patient ‘s pelvic girdle system. 5 minute movie is besides to analyze the elimination of symmetricalness in both kidneys.
After that, the movie is taken 15 proceedingss. This movie is so named because the X ray is taken after 15 proceedingss the patient is injected with contrast media. Film size 10 ten 12 inches ( 24 x 30 centimeter ) used for this movie. Taking x-ray done 15 proceedingss after injection ( 10 proceedingss after the movie 5 proceedingss ) . The purpose is to see the nephritic calyx system more clearly, the force per unit area is on this movie series with kolimasi exposure on nephritic kawaswan. Use of force per unit area rings are non needed when the patient shows any indicant of nephritic concretion and in patients after surgery. This is to avoid hurt to the nephritic patient. Perform head-down place when the force per unit area rings are non used.
Then, release movie taken after the 15-minute movie. Size of movie mensurating 14 ten 17 inches ( 43 x 35 centimeter ) used for this movie. Taking x-ray done after opening the force per unit area ring or for patients who do non utilize the force per unit area ring, the patient should be changed from the caput down place to a reclining place. The full urinary system and bladder country should look at this movie series.
The last movie was taken in a trial called the movie station – nothingness / micturate. Size of movie mensurating 14 ten 17 inches ( 43 x 35 centimeter ) used for this movie. Taking x-ray performed after the patient ‘s intestine to empty the urinary vesica. The intent of the movie station – nothingness / micturate was to measure the patient ‘s residuary piss after micturition. It is besides to see the ability to unclutter the patient ‘s ureter vesica. It besides showed no vesica jobs such as tumours and divertikulum.
Hazard of Intravenous urogram scrutiny
Intravenous urogram is ever carried out without any hazards or jobs. This scrutiny is a safe scrutiny. However, to guarantee that all the conditions are truly safe and to avoid any complications, patients should be caring and ever sensitive to side effects. The patient is exposed to radiation. Rate of radiation received by patients was similar to the radiation received by all the environment for 14 months.
If the patient is pregnant, this scrutiny can non be done. This is because the fright of radiation can hold inauspicious side effects on the content. There are besides some possible side effects experienced by patients after the review but it is really hapless. If there are any side effects, patients may experience hot or antsy and uncomfortable in the oral cavity after having an injection of contrast media. It merely felt by the patient for a few proceedingss.
Care for patients after endovenous urogram scrutiny is indispensable. This is due to resuscitate a patient of any effects after the trial. Radiographers should guarantee that patients in stable status. Slowly open the needle and clean the topographic point involved. Give an account to the patient for follow-up attention after proving is completed. Ask patients to alter their apparels after the completion of the trial. Radiographers should besides rede patients to imbibe sufficient H2O to take the contrast media from the patient ‘s organic structure.
Complications may happen during or after the review. Allergic reaction or allergic reaction to contrast media is a major hazard even kidney harm could be one of the complications. If the patient has allergic reactions to iodine, contrast stuff, has a job hives, trouble external respiration, the patient should instantly advise the radiographers. Detailed information and the patient ‘s medical history should be known in order to avoid any complications that may happen.
Clinical diagnostic radiology has been developed non merely in footings of equipment and techniques used, but the contrast media allows ocular construction and internal variety meats can be seen in more item. A dosage of contrast media used in x-ray normally contains 2000 times as much I content of I in the organic structure. However, I contained in the contrast media will be removed in a natural system instantly. Generally no side effects occur. Choice of contrast media has ever been a job, but really it depends on the radiotherapist itself. To do rational determinations about the pick of contrast media have a high apprehension of the rules of physical and physiological needed.
Why contras media is necessary?
The degree of fading of all the patients affected by the atomic figure of factors involved. If there is such a big denseness difference between the bosom musculus and the air in the lungs, the lines of the construction can be seen on radiogram as a natural contrast exists. Similarly, if there are differences in the figure of atoms between two tissues like musculus and bone. Muscles consist of low atomic figure alternatively of bone consists of Ca and has a high atomic figure of lebiih. Line construction can be seen because of the natural contrast. But if the two variety meats that have the denseness and atomic figure is non much difference, it is non possible to separate the construction of the organ in the radiogram because the contrast does non be of course.
So, no manner we could see the blood vass in an organ or internal construction of the kidneys without the usage of other substances or alter the contrast. Two of import factors can be changed is the denseness and atomic figure of an organ construction. Number of atomic construction is hollow as the blood vass can be added or promoted by make fulling the liquid has a higher atomic figure such as I contained in the contrast media.
Type of contrast media
There are several types of contrast media used. Contrast media can be differentiated based on the mode used. Although there are assorted types of contrast media, the type frequently used is based on its x-ray fading and magnetic resonance signals.Contrast media can be divided into two positive contrast media and contrast media is negative. Contrast stuff is used to heighten x-ray fading. Positive contrast media stuffs give the white in the image.
While the media are negative contrast stuff was used to portray the image black.Gadolinium is used in magnetic resonance signal as MRI contrast agents. Gadolinium enhance the quality of MRI scans. There are two types of positive contrast stuff is used in an X ray of Ba and I. There are many types of bing I contrast media with different viscousnesss, osmolariti and I content.
a ) Non-iodine contrast media
Medium contrast stuff is a white pulverization that was indissoluble. The pulverization is assorted with H2O and a few other excess constituents to do a mixture of contrast stuff. This stuff is by and large merely used in the digestive piece of land. Normally this type of contrast medium ingested or given by clyster. Upon scrutiny, this stuff will be removed from the organic structure with soiled stuffs. Non-iodine dimer is the best pick for a low toxic content. However, non-iodine dimer has a higher monetary value.
B ) Iodine contrast media
Materials iodine contrast media is soluble in H2O and is non harmful to the body.Contrast stuffs are widely sold as a solution of clear, colourless liquid. Concentrations are normally expressed in milligram / milliliter. Iodine contrast stuff is used about in every human organic structure. Iodine contrast media is divided into three. Contrast media incorporating iodine oil, I contrast media and water-soluble contrast media are non H2O soluble.
Microbubbles were a contrast agent used to assist sonographic echocardiogram. These bubbles of N and supported by proteins, lipoids or polymers. Decrease in denseness between gas and liquid environing the bubble and will reflect back ultrasound. This procedure causes the resulting image can be seen clearly.
Consequence of contrast media
Contrast media are safe to utilize, but some wellness jobs associated with some of the contrast media. Chemical reactions vary about the danger of decease, with about 0.9 deceases per 100 000 instances. These factors are invited to this unsafe reactions, including a strong allergic reaction, asthma and bosom disease bronchiol. There are many misconceptions that exist among the professionals is the contrast between the media associated with allergic reactions to seafood because they both have the I content in it.
However, few surveies have been made and indicated that while I is a substance frequently used in contrast media, but it was non the cause of the allergic reaction but it is better for patients with a history of other allergic reactions. However, there are besides some patients reactions to contrast media. Examples of such reactions are nausea or emesis, experiencing hot all over the organic structure, while rubing, sneezing, sometimes shortness of breath and hypotension. Actual reactions depending on the patient ‘s ain opposition.
Way of contrast media given
1 ) Through Oral
Contrast media is given by oral cavity by imbibing or swallowing of contrast media. Normally it is barium sulphate. Giving unwritten contrast media will impact where the tummy will look white on x-ray movie. Contrast media incorporating Ba sulphate is non harmful. Barium sulphate is excreted out in a twenty-four hours or two yearss. In all instances, the usage of contrast media is non advised for pregnant adult females because of deficiency of conclusive grounds about how safe contrast media in gestation. However, if this type of scrutiny can salvage lives, the hazards should be weighed once more on a case-by-case.
2 ) Through Anal ( little bowel and big bowel )
Contrast media through the rectum or anal granted. Contrast media is inserted into the rectum with the aid of rectal catheter. Rectal contrast media through which this will impact the big bowel will look white on x-ray movie. In this manner, the assorted variety meats or constructions can be viewed and studied.
3 ) Through intravascular
Contrast media is given by intravascular injection. Often, the stuff used is iodine-based contrast media. Most patients can be detained and given an injection of contrast media rapidly removed from the organic structure without inauspicious side effects. Iodine-based contrast media caused a warm feeling when injected. Sometimes patients may experience ill after having the injections. Therefore, patients are ever advised non to take any nutrient before any radiological scrutinies necessitating contrast media.
Rarely, iodine-based contrast media may do an allergic reaction. Gadolinium contrast media are besides given in the signifier of magnetic resonance imagination during the injection. Contrast medium is working to enable the variety meats that have good blood supply appears white on the MRI images.
4 ) The intra-arterial, spinal cord and intraabdominal.
Choice of contrast media
Radiologist choose the type of contrast media based on experience and cognition. They choose the type of contrast media depends on the patient ‘s status. To do determinations, assorted factors including clinical factors and fiscal factors are besides considered to help in doing a choice. Royal College of Radiologist supply some counsel. Among the patients who are at high hazard of reaction. Among them are kids, the aged, diabetics, patients enduring from asthma, and patients with allergic reactions. In this group, 25 % of patients were recommended for the trial.
How the contrast media used
There are a figure of radiological scrutinies utilizing contrast media. Volume, different types of contrast media for each patient depending on the type of review and the demand Radiologist.
Angiography is the scrutiny carried out to analyze the blood vass. Choice of arteriography and venography depending on what type of blood vass to be inspected. Either vena or arteria.
For arteriography, the contrast media through the catheter used in the arterias. Blood flow will take to the loss of contrast media. With this, the image of the arteria can be seen in variety meats or in other parts division.
For venography, contrast medium injected into the vena and vena travel throughout the organic structure can be seen. The greater the size and figure of venas in the organic structure, the more places that need to be made by radiographers to obtain images of venas throughout the organic structure. Normally venography performed to corroborate the patient has deep vena thrombosis. In the leg, venography was besides performed on the variety meats in the organic structure by infixing the contrast medium into the organ via the venous catheter.
Intravenous urography ( IVU )
Intravenous urography is a cheque for a urinary piece of land. When an endovenous injected, most of the contrast media to be secreted by the kidneys. This review is performed to look into whether there is any kidney rocks or other kidney jobs.
Computer imaging ( ICT )
An electronic, ICT has a better contrast sensitiveness. But it can non make a contrast which does non be of course. A sum of 43 % of CT processs utilizing contrast media. CT is widely used in the organic structure but are frequently used for scrutiny of nerve cells as the encephalon and spinal cord. It is besides used for analyzing the thorax, venters, and pelvic girdle. It is besides utile for analyzing the tumour.
Spinal cord and major nervousnesss can non be displayed by X ray without the usage of contrast media. Spinal cord and other nervousnesss can be displayed utilizing MRI. Images can be produced if the contrast medium injected into the cerebrospinal fluid environing the spinal cord. Contrast media have been created specifically for this scrutiny. The bulk of myelography made to analyze the lumbar to corroborate any clinical jobs such as intervertebral phonograph record out of the place. However, CT and MRI now has replaced myelography as the research lumbar. Myelography with CT scan was used to look into spinal cord and cervical countries.
Inspection of other
There are several other scrutinies in which contrast media are needed. As an illustration of the contrast medium is introduced to the construction of such articulations to analyze the anatomy and pathology. Iodine incorporating contrast media when given orally, it can be used to analyze variety meats such as the little bowels.
Duties of radiographers
Radiographers should be sensitive to the demands of patients are willing to assist and should hold a responsible attitude. Always willing to assist the province to face and trade with an exigency process, particularly when contrast media. Clearly and accurately depict the process of contrast media utilizing linguistic communication easy understood by patients. Cooperation of the two parties to bring forth a successful process.
In decision, much needed in the media kontas green goodss images that are clearer and brighter because it has the belongingss of radio-opect lupus erythematosus penetrated by X ray. It will besides be a unsafe to the patient if the radiographers to take it easy patient safety.