Gastrointestinal Radiology > Procedures > Urography > Adults


Basic Excretory Urography (IVP) Protocol for Adults

  1. Scout Radiographs:
    1. 1. Coned KUB - inferior margin below the pubic symphysis; cone lateral margins just lateral to the renal outlines; superior margin above the kidneys.

    2. 2. Scout tomogram coned to the kidneys; cut 1/3 of the patient's AP diameter from the table top.

      NOTE: Scout films should be checked for positioning and coning; coning is essential to reduce scatter and improve spatial and contrast resolution. Patient should have his skin marked for centering and coning. All subsequent radiographs should reproduce scout film positioning and coning.

  2. Inject contrast media, 100 ml (150 ml for patients weighing more than 250 lbs) rapid IV bolus.

  3. Three immediate nephrotomograms coned to kidneys (same as scout) at estimated central level + 1 cm posterior + 1 cm anterior.

  4. 5 minute coned KUB.

  5. Apply abdominal compression tightly. Mid-level of the compression device should be centered over the posterior iliac crest (by palpation). Do not apply compression if recent trauma, acute ureteral obstruction, or probability of aortic aneurysm.

  6. Two zonograms coned to kidneys at levels to optimally demonstrate collecting structures (as determined from earlier nephrotomograms)

  7. Release compression and immediately expose KUB. 

  8. Optional coned full bladder and post-void bladder views depending on patient history and evaluation of urogram to this point.