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X-Ray Of The Kidneys With Contrast

X-ray of the kidneys is a radiation research method designed to assess the anatomical structure and functional state of the urinary system. One of the most common methods for examining patients with suspected urolithiasis.

What is it like?

The method is based on the ability of X-rays to pass through body tissues, the degree of darkening (the so-called "shadow") in the finished image depends on the degree of density. Given the harmful effects of ionizing radiation on the body, the intensity of the rays is strictly dosed, and the procedure is carried out by ultrasound clinics only for medical reasons.

X-ray of the kidneys: indications for examination:

  • Urolithiasis or suspicion of it
  • Chronic kidney disease (to monitor and control treatment)
  • Diagnosis of tumors, metastases
  • Pelvic and lumbar injuries
  • Postoperative control
  • Significant deviations in the analysis of urine: hematuria (blood in the urine), proteinuria (protein), pathological changes in the smell, color, density, and transparency of urine
  • Pain of characteristic localization (lumbar region and lower abdomen), renal colic
  • Painful urination
  • Suspected urinary obstruction (obstruction), urinary retention, swelling of the eyelids and face
  • Hypertension
  • Ultrasound Refinement

X-ray (urography) of the kidneys: types of research

A panoramic x-ray of the kidneys- a picture in direct projection without contrast medium; allows you to evaluate the location, shape, and number of kidneys, the condition of the skeletal system of nearby areas, large foci of inflammation, necrosis, tumors, large calcium calculi

Excretory urography- an x-ray of the kidneys with a contrast agent; allows you to evaluate the excretory (excretory) functions of the kidneys: the state of the pyelocaliceal system, the integrity, and patency of the urinary tract; performed in 2 or more projections.

Infusion urography- radiography with an intravenous drip injection of contrast for a detailed study of the kidney parenchyma (body)

Direct pyelography- injection of contrast through a catheter from the lower urinary tract or through a nephropielostomy directly into the kidney; performed in a hospital

Contrast urography

The most informative, simple, and inexpensive research method. It can be performed on an outpatient basis - immediately after the procedure, the patient goes home. The main advantage is the introduction of an iodine-based contrast agent, which, as it is filtered by the glomerular system and excreted through the urinary tract, highlights various areas in the picture.

What does kidney radiography show?

The kidney function test allows you to determine:

  • Anatomical features of the structure of the organ: quantity, location, shape, size, uniformity, integrity
  • Functional features: rate of filtration and excretion of the substance, filling of the pyelocaliceal system inside the kidney, diameter, and patency of the urinary tract
  • Foreign inclusions: the presence of calcifications and stones (stones)- oxalates, carbonates, phosphates, clearly visible in the picture, crystals of salts ("sand"), damaging foreign particles (bone fragments after an injury, fragments)
  • The tumor, its size, prevalence, the presence of metastases, the size of the lymph nodes

How is the procedure going?

The patient is injected with a contrast medium, after which 3 pictures are taken at strictly defined time intervals: the first - 5-7 minutes after administration, the second- 15-17 minutes, and the third- 20-23. In this way, the picture captures the contrast in the pyelocaliceal system, then in the ureter and, finally, in the bladder.

Definition Of Prostate Ultrasonography By Endorectal Approach

The ultrasound is a medical imaging technique based on the use of ultrasound, by which we can "see" inside the body. The ultrasound of the prostate, the gland just below the bladder in men and participating in the production of sperm, can be done in two ways:

For suprapubic: externally, by placing the probe above the pubis

By the endorectal route: internally, by introducing the probe into the rectum

Prostate ultrasound test in Delhi by the endorectal approach is more precise and allows to obtain a better image of the prostate. It also makes it possible to evaluate more precisely the volume of the gland as well as its "texture" and that of the accessory glands (seminal vesicles).

Why have an endorectal ultrasound?

Ultrasonography is a painless, non-invasive examination and is therefore first-line when the doctor suspects an abnormality in the prostate.

This can be the case:

  • After a rectal examination highlighting an abnormality (mass or hypertrophy) of the prostate
  • In case of urinary symptoms (frequent urge and emission of a small amount of urine, pain during urination, urinary tract infection, difficulty urinating, etc.)
  • In case of dosing showing an abnormal value of PSA (prostate antigen)
  • To diagnose Benign Prostatic Hypertrophy (BPH)
  • To guide the doctor when performing a biopsy and to help detect visually suspicious areas to better target specimens

However, endorectal ultrasound has no place in the diagnosis of prostate cancer because it is too inaccurate.

In addition to biopsies, ultrasonography is mainly used to assess prostatic volume, which tends to increase with age, which can lead to urinary discomfort (benign prostatic hypertrophy).

Examination

Ultrasound involves exposing the tissues or organs that one wishes to observe to ultrasonic waves. It does not require any preparation or anesthesia.

For endorectal ultrasound, an elongate (pencil-shaped) probe is used, covered with a condom and lubricated. It is inserted shallow into the anus, the patient lying on his side, knees bent. If a biopsy is performed at the same time, the doctor introduces a needle into the prostate, through the wall of the rectum, guided by ultrasound.

What results can be expected from an endorectal ultrasound of the prostate?

Whether it is to perform biopsies or to evaluate prostate volume, ultrasound clinics helps to diagnose prostate conditions, such as cancer (through biopsies) or benign prostatic hypertrophy. The choice of treatment will depend on the diagnosis but also the age of the patient, different risk factors, etc.

In the case of hypertrophy of the troublesome prostate, several drugs may be prescribed, including alpha-blockers and phytotherapy products (African plum or pygeum, saw palmetto).

Ultrasound Of The Kidneys In Health And Disease

How the kidneys look on ultrasound is normal and how pathology is determined can be found in this article. Here you will find the basic principles that experienced doctors’ use in their work.

A normal view of the kidneys on ultrasound

A complete ultrasound examination having high ultrasound scan cost of the kidneys includes an assessment of the location, orientation, axis, size, and echogenicity of the parenchyma, the contour, the nature of the centrally located echogenic disk and the lack of visualization of the proximal ureter. Normally, the kidneys are located in the retroperitoneal space along with the lumbar muscles and are oriented parallel to their course. They occupy an oblique position, and the upper pole is located dorsal to the lower pole.

The size of the kidney depends on the age; it is measured between the two poles and compared with known nomograms. From the point of view of ultrasound of the kidneys, the most important adjacent organ on the right is the liver, and on the left is the spleen. During the first few months of life, the kidney parenchyma may be iso- or hyperechoic compared with the liver or spleen, and then it becomes hypoechoic.

The cortex can be differentiated from the cerebral bylines, reflecting slight differences in echogenicity. The presence of cortico-medullary differentiation is an indicator of the normal structure of the kidney and the integrity of the parenchyma.

The contour of the kidney in children on ultrasound can be smooth, but often it has a lobed structure. Parenchymal lobules consist of a central pyramid covered with parenchyma of cortical substance and pillars located between the pyramids. With age, the lobed structure disappears, and the contour becomes smooth.

Abnormal development of the kidney on ultrasound

Anomalies or pathology of the kidneys in children can be divided into congenital and acquired, and anatomically- anomalies in the number, localization, vascular, parenchymal and abdominal systems.

One-sided kidney agenesis on ultrasound is often detected. Unilateral agenesis of the kidney is most often determined in children during an ultrasound scan conducted:

  • With urination problems;
  • When screening for related anomalies and
  • About unrelated pathology.

On ultrasound in the renal fossa is not defined as a bean-shaped structure, and it may be located intestines. The surrounding organs are usually not changed. In such cases, it is important to conduct an ultrasound examination of the pelvis to prevent kidney dystopia. In infants, the adrenal glands are visualized in a normal anatomical position.

Kidney dystopia on ultrasonography

The kidneys begin their embryonic development in the large pelvis with the pelvis oriented anteriorly, and then they migrate to the renal fossa and complete the medial rotation by the 6th week of gestation. This process can be interrupted at any stage.

Renal vein thrombosis with an ultrasound scan

Ultrasound done by professional Ultrasound Clinics has a high diagnostic value for suspected renal vein thrombosis. Risk factors include dehydration, birth injury, and sepsis. During the acute phase, marked edema develops, and an ultrasound examines an increase in the kidney with a loss of corticomedullary differentiation. Due to edema at an early stage, the parenchyma looks hypoechoic, but with the progression of fibrosis, it becomes hyperechoic. Thrombi of small vessels look like radiant linear echogenic bands in the parenchyma. Atrophy and calcifications are visualized at a late stage in the thrombus localization zone. When color Doppler on ultrasound, there is a lack of venous blood flow.

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