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CT IVP (Intravenous Pyelogram)

Last Updated: 2026-01-01 Author:

  • 1. Clinical Summary

    Series Phase Coverage
    Non-Contrast (optional) Non-contrast Top kidneys to Pubic symphysis
    Early Portal Venous Contrast (60 sec from 1st injection) Top kidneys to Iliac crests
    Excretory Phase Contrast (90-120 sec from 2nd injection) Top kidneys to Pubic symphysis
    • Hematuria
    • Urothelial carcinoma
    • Collecting system evaluation
    • Hydronephrosis

  • 2. Patient Prep

    • Position: Supine with arms raised
    • NPO Status: NPO 4 hours

  • 3. IV Contrast & Injection

    Parameter Value
    Agent Isovue 370
    Volume Split bolus: 1st injection 1.1 mL/kg + 2nd injection 0.4 mL/kg
    Flow Rate 4 mL/s
    Duration 18-20s + 5-10s
    Timing Split bolus technique

    Full dose if eGFR > 30. Split bolus for combined nephrographic and excretory phases

  • 4. Special Notes

    • COMPLEX protocol: 1) NC (optional stone protocol) 2) 1st contrast injection 3) Early PV 60s after 1st 4) WAIT 5-7 min 5) 2nd injection + saline 6) Excretory/IVP 90-120s after 2nd
    • Additional Recons: MIP urogram coronal and sagittal. Curved MPR of ureters. 3D urogram
    • 18-20G IV. Split bolus technique. May give Lasix 10-20mg IV for better opacification

    Safety First

    • Renal Function: Verify eGFR > 30
    • Allergy: Check allergy history
    • NC optional: detect stones. Early PV: renal parenchyma. Excretory: collecting system ureters bladder for urothelial lesions
    • Split bolus critical for opacification. Lasix may help. Prone imaging optional for ureters
Series Name Start Location End Location Delay Slice Thickness Notes
Scout Top kidneys Pubic symphysis N/A N/A AP
Non-Contrast (optional) Top kidneys Pubic symphysis N/A 2 mm Optional stone detection
Early Portal Venous Top kidneys Iliac crests 60 sec from 1st 2.5 mm Nephrographic phase
Excretory Phase Top kidneys Pubic symphysis 90-120 sec from 2nd 1.25 mm Collecting system opacification
Plane Acquisition FOV Thickness/Increment Kernel IR Strength Notes
Axial Non-contrast KUB 2 mm/2 mm Standard 3 Stone detection if done
Axial Portal venous Kidneys 2.5 mm/2.5 mm Standard 3 Renal parenchyma
Axial Excretory Full urinary tract 2 mm/2 mm Standard 3 Urothelial surfaces
Coronal Excretory Full urinary tract 2.5 mm/2.5 mm Standard 3 MIP urogram