How does retrograde pyelogram differ from a urogram

How does retrograde pyelogram differ from a urogram

A urogram (via intravenous urography [IVU] or computed tomographic urography [CTU]) requires intravenous administration of contrast material, after which imaging of the renal parenchyma is performed in the earlier nephrographic phase of enhancement and of the collecting system in the excretory phase of enhancement. A urogram provides physiologic information about the function of the kidneys, in addition to depicting the anatomy of the renal parenchyma and collecting systems. A retrograde pyelogram provides only anatomic information about the lumen of the collecting system and ureter, but the depiction of mucosal abnormalities is superior to that seen with urography. For performing a retrograde pyelogram, cystoscopy is initially performed by a surgeon, most commonly a urologist, and a catheter is placed through the ureterovesical junction into the renal pelvis under direct vision with a cystoscope. The patient is then transferred to the radiology department where contrast material is injected through this catheter under fluoroscopic guidance to evaluate the lumen of the pyelocalyceal system and ureter for mucosal abnormalities such as urothelial carcinoma. An alternative to placing a catheter into the collecting system is to inject contrast material directly into the ureterovesical junction through the cystoscope and obtain images in the operating room; this technique is useful if the ureter alone has to be evaluated for urothelial abnormalities but is unsuitable for complete evaluation of the collecting system


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