BASIC PRINCIP OF BASIC PRINCIP OF GENITOURINARY TRACT GENITOURINARY TRACT

IMAGINGIMAGING

BASIC PRINCIP OF BASIC PRINCIP OF GENITOURINARY TRACT GENITOURINARY TRACT

IMAGINGIMAGING

Bagaswoto PoedjomartonoBagaswoto Poedjomartono

Department of Radiology Faculty of Medicine Department of Radiology Faculty of Medicine GMU / Dr. Sardjito GHGMU / Dr. Sardjito GH

JogjakartaJogjakarta

X-RAY MACHINEFOR ABDOMINAL AND URINARY

TRACT

Point of view:Regio hypochondriumRegio epigastricumRegio lumbalisRegio umbilicalisRegio iliacaRegio hypogastricum

ABDOMEN

CONGENITAL ANOMALY OF KIDNEY

• Failure of development

• Aplasia• Hypoplasia• Hypertrophy• Simple ectopia

• Fusion of the kidney

• Crossed ectopia• Malrotasi• Cystic disease

KIDNEY EXAMINATION1. Plain photo2. IVP3. Retrograd Pyelography4. Antegrad Pyelography5. CT6. USG7. MRI8. SPECT9. Hybrid CT/MRI/PET/SPECT10. Angiography

INTRAVENAPYELOGRAPHY

1. Administered iodine solution ionik/non-ionik i.v dosage 20-50 ml.

2. Image on 5 minute AP position after contrast injection to evaluate the kidney and pelvicaliceal system.

3. Image on15 minute after contrast injection to evaluate the ureter flow.

4. Image on30 minute after contrast injection prone position to evaluate ureter and bladder filling.

5. Upright image AP position, if needed to evaluate kidney movement.

6. After voiding AP position to evaluate bladder empty.

INTRAVENAPYELOGRAPHY

TRACT URINARIUSINTRAVENA PYELOGRAPHY

TRACT URINARIUSINTRAVENA PYELOGRAPHY

Staaghorn stone at theRight and Left kidneys

ANTEGRAD PYELOGRAPHY

Indication:Non function kidneyHidronephrosisKidney decompressionUrinary 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

Renal angiography

USG

Scintigraphy

CT AND USG KIDNEY

Cystic disease

Hydronephrosis

KIDNEY CT USING CONTRAST MEDIA

MSCT CONTRAST OF KIDNEY

coronarSagital/lateral

RENAL TRAUMAURGENCY:

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 SIGN1. Extra passage / leakage2. Bulging / haematoma perirenal /

subcapsular3. Defect / rupture / tear4. Obstructed5. Pelviectasis / hydronephrosis6. Arterial / venous defect / rupture

BLADDER TRAUMAThe 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: TUR3. Injuries:

1. Penetrating or non penetrating2. Direct or indirect

4. Complication of bladder trauma: Fistulae bladder: vagina, uterus, rectum / bowel, peritoneum, cutaneous.

URETHROCYSTOGRAPHY

RADIOLOGY IN BLADDER TRAUMA

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

RADIOLOGICAL SIGNS1. Penetrating of radiopaque foreign

body2. Leakage / extra passage of

contrast media3. Direct penetration fragment

fracture from pelvic / pubic bone

Prostatic Gland

HYSTEROSALPHYNGOGRAPHY1. Pemeriksaan saluran reproduksi wanita2. HSG set3. Kanul HSG dimasukkan kedalam cervix uteri dan

difiksasi4. Kontras sol iodine 10-15 ml5. Evaluasi cavum uteri6. Evaluasi Tuba Fallopii7. Evaluasi spill kontras8. Evaluasi organ sekitarnya

HysterosalphyngographyNormal

Point of view:Cavum uteriTuba uterinaSpill 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