BNO-IVP

Delviana M.

BNO

Nier, Overzicht,
Blass

Kidney, Ureter,
Bladder

Foto Polos
Ginjal, Ureter,
Kandung Kemih

IVP

Intravenou
s
Pyelogram

Pielografi
Intravena

IVP
Untuk melihat struktur ginjal, ureter, kandung kemih

Batu

Tumor

Urinary Tract Infection

Back or Flank Pain

Trauma

Menggunakan kontras
Resiko alergi dan toxic

Kontraindikasi BNO-IVP

Riwayat alergi, kontras (Iodine)

Hamil

Menyusui (setelah 2 hari dapat kembali menyusui)

Intrauterine Device

Gangguan fungsi ginjal

Kreatinin (N=0.5-1.2 mg/dL)

Blood Urea Nitrogen (N =10-20 mg/dL)

BUN : kreatinin ratio (N=6-25)

Diabetes (metformin asidosis laktat)

Penyakit jantung

Aritmia

Tahapan Pembacaan IVP

Menit Ke 0

Menit Ke 5

Kontras sudah mengisi ureter dan buli-buli

Menit Ke 30

Melihat fungsi ekskresi ginjal. N = sistem pelvikaliseal sudah tampak

Menit Ke 15

Foto polos perut

Foto dalam keadaan berdiri untuk menilai kemungkinan terdapat perubahan posisi ginjal (ren mobilis)

Menit Ke 60

Melihat keseluruhan anatomi saluran kemih, antara lain filling defectI, hidronefrosis, double system

Pada buli-buli diperhatikan adanya identasi prostat, trabekulasi, penebalan otot detrusor, dan sakulasi

Paska Miksi

Menilai sisa kontras (residu urin) dan dibvertikel pad buli

Normal

A
normal
intravenous
urography
(IVU)
with the following
films
Scout
Nephrogram
Serial shoots at
5 min interval up
to 15 mins of
injection
of
contrast
Prone
Obliques
Full bladder

Significant
variation between
two normal renal
pelves,
demonstrated by
excretory
urography
A.Large,
extrarenal pelvis
B.Narrow,
completely
intrarenal
pelvis,
barely
larger in caliber
than the ureter

Nephrolithiasis

CASE
Presentation
Left Flank Pain
25/M
Scout
film
(1st)
shows
large
left
renal calculus
15 min film (2nd)
shows
abnormal
deviation
of
the
ureter
Normally
bilateral
renal function
Case of large renal
pelvis calculus with
normal function

CASE
Presentation
Patient came for
a
routine
IVP
study
for
suspected
right
renal calculus.
F
On IVP, the left
kidney was found
in
the
pelvic
fossa with normal
function.
Pelvic
often
found
of the

kidenys are
incidentally
on imaging
abdomen.

Hydronephrosis
Dilatation of the urinary collecting system of the kidney (the
calyces, infundibula, pelvic)

CASE
Presentation
This patient presented
with right flank pain for
the past 1 month. The
patient was advised for
an USG which revealed
right
sided
hydronephrosis. A mid
ureteric calculus was
suspected
30/M
1st image is a scout film
which
revealed
no
calculus
2nd film is a radiograph
taken after 10 mins of
injection of contrast. In
this we see a dilated
renal pelvis due to kink
in the ureter at the
level of L3 vertebra.
Case

of

ureteric

kink

Hydroureteronephrosis
Dilatation of the urinary collecting system of the kidney
(the calyces, infundibula, pelvic) and ureter

CASE
Presentation
Left sided flank pain, USG
showed 2 cm calculus in left
lower ureter.
30/F
IVP shows a left lower
ureteric calculus on control
film most likely at the
vesicoureteric
junction
(VUJ). The contrast study
shows a moderately dilated
ureter and the calculus is
seen to move up and down.
The left ureter has an
abrupt
narrowing
with
dilation of the proximal
part.
The
is
a
stricturous
narrowing of the left lower
ureter adjacent to the left
VUJ causing stasis of urine
and thereby predisposing to
calculus formation.

Ureterolithiasis

CASE
IVP
demonstrating
dilation of the
right
renal
collecting
system
and
right
ureter
consistent with
right
ureterovesical
stone

CASE
Presentation
Right
flank
pain,
ultrasound
shows
proximal hydroureter and
mild hydronephrosis.
30/M
Arrows points to a low
density calculus
Scout : apparently normal
with
no
evidence
of
calculus
10 min film : right sided
proximal hydroureter and
mild dilatation of PCS
15 min film : findings are
persistent and a filling
defect is noted at the L3L4 level
Case
of
right
sided
midureteric calculus (low
density).

CASE
Non
contrast
helical
CT
scan of the
abdomen
demostratin
g at stone
at the right
ureterovesi
cal junction

CASE
Presentation
Mild
right
hydronephosis
on
ultrasound study.
61/F
There
are
calculus
projected on the right
transverse process of
L4.
After
contrast
injection there is a cut
off at the level of the
calculus that do not
cause
completer
obstruction,
but
it
causes
a
mild
dilatation
of
upper
ureter.
This

case

illustrates

Renal cyst
Pelvicaliectasia

SE 57y/F. Right renal cyst and minimal pelvicaliectasia

Nephroptosis (Floating Kidney)

CASE
Intravenous excretory urogram (IVU) in 40 yo female witth the complain on mobile
mass in the right lower quadrant with standing associated with bilateral flank and
back pain that resolved in supine position
A. Supine IVU shows kidneys in the normal position, with normal ureters and
proximal collecting system
B. Standing film shows significat displacement of both kidneys with the right
kidney moving onto the pelvis as described by the patient

Bladder stones

Sumber
Webmd.com
Radioopedia.org
Sudoyo dkk. Buku ajar Ilmu Penyakit Dalam Edisi V,
Jilid II
David Sutton. Textbook of radiology and imaging Vol 2.
Sagung Seto. Buku bedah urologi
Campbell-Walsh Urology 10th edition

Terima Kasih