lab positioning for gu system ivp & cysto & ercp

Lab Positioning for GU SYSTEM

IVP & Cysto & ERCP 2014 revised

IVU /IVP 2014 FOR SERIES NOTESSCOUT (14 X 17)•Kidney cone down (11x14)

– 1 min or 5 min (upper abd)(KUB with contrast-all 14 X 17)•10 - 15 MIN (AP with contrast)•RPO/LPO (30º rotation)Special IMAGES:•DELAY FILMS (PA /AP/PA)•UPRIGHT (1” below IC)

– Kidneys & bladder drop•POST VOID

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SCOUT14 X 17

KUB

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Kidneys “cone down:

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3 – 5 min film

CONE DOWN 1min & 5 min (KIDNEYS)(some may want 1min, 3min, 6min, 9min)

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1 min blush nephrogram

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5 minute cone down

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10 MINUTES –

BLADDER NOT YET FULL

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RPO/LPO taken between10 – 15 minutes (time marker ?)

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RPO

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15 min fulldone AP or PA

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Additional imaging:Upright – can show mobility ofkidneys and bladder (see cysto for more info)

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RESIDUAL CONTRAST

CHECK WITH RADIOLOGIST

MAY WANT ANOTHER POST VOID

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CYSTOGRAMS & VCUGIndications?

• CHILDREN• ADULT• MALE :

– AP, OBL’s (30º to 40º rotation)– & LAT

• FEMALE – AP, OBL’s (40º to 60º rotation)

• FLUORO OR• OVERHEADS

CYSTOGRAMS (only) : (CONE DOWN ON THE BLADDER)

• FOR FEMALES - 10 X 12 CW – • CR 2" above PS (2" below ASIS) Crosswise • Perpendicular CR only (no angles) - • AP, BOTH OBLIQUES (40-60 degrees) - so just use 40degrees (LATERAL ?)

FOR MALES -10 X 12 LW – AP, BOTH OBLIQUES (30 -40 degrees) • CR centered AT PS • For LATERAL only - CR 2" above PS (2" below ASIS)• (The book was somewhat confusing - the lateral (pg 222) showing a male patient - is shown as the same centering as for

the Female pg 221 - but the male information starts on page 223)

VCUG ONLY :VOIDING CYSTO URETHROGRAMS

• Need to cone down on bladder to include urethra and distal ureters (for reflux)

FOR FEMALES & MALES - 11x14 LW – (BUT - cone down as needed for the SIZE of the patient) see page 223 & 224

• Perpendicular CR only (no angles) - • ONE OBLIQUE (RPO OR LPO) – (40 degrees) • TAKE IMAGE WHILE VOIDING - CR CENTERING JUST ABOVE

THE PS (PUBIC SYMPHYSIS) FOR BOTH MALE AND FEMALE

• (you would never use a 14 x 17 for cystograms, unless the refulux went all the way to the kidneys are you were instructed to do so by the Radiologist)

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MALE CYSTOAP, RPO, LPO, LAT

C/R @PS

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Lateral Cysto

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FEMALE CYSTOAP, RPO, LPO, ? LAT

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Foley balloon seen

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VCUG

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HEPATOBILIARY & the Gall Bladder (GB)

RT 124 rev Sp 2010

37 PA SCOUT 14 X 17 or 11 x 14

RUQ - PA OR AP

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This position will be tested in lab

Taken as a scout and post – contrast filling

For ERCP

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LAO or RPO for RUQ

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Drainage film

RUQ- RPO