(c)
Post-micturition film of the urinary bladder.
(d) Tomograms are rarely done, but some departments still have the
equipment and perform studies.
(e) When computerized tomography is available, CT studies of the
kidneys are done while the patient still has contrast in their system.
(4) In addition to the regular identification data, lead number markers are
used to indicate the time-interval at which each film was exposed. The time-interval
marker should be so placed that it is easily distinguished on the processed film. Also,
be sure to identify any upright film, if any are taken, with an arrow or other appropriate
marker.
(5) Unless otherwise specified, as soon as each pyelogram is exposed, it is
immediately processed and presented to the radiologist for reading.
(6) To induce urine stasis for the purpose of obtaining the best filling and
thereby greater concentration of the contrast medium in the renal pelvis and calyces,
one of several methods may be used. The two methods most commonly used are
presented below.
NOTE:
Urine stasis is induced only at the request of the responsible medical
authority.
(a) Gravitational method. The patient is placed in the modified
Trendelenburg (20 to 40) position, which induces urine stasis with the aid of gravity.
(b) Compression method. A radiopaque compression device, such as
a suitably shaped block of balsa wood or an inflatable bag, is placed on the lower part of
the patient's abdomen and the proper amount of pressure is applied by an
immobilization band. See figure 2-28. Compression is usually applied before the start of
the injection and released prior to the exposure of the last film. Ureterograms may be
obtained while the ureters are filled with the contrast agent by exposing a film
immediately after compression is released.
MD0959
2-46