Lab Positioning for GU SYSTEM IVP & Cysto & ERCP 2014 revised IVU /IVP 2014 FOR SERIES NOTES SCOUT (14 X 17) Kidney cone down (11x14) 1 min or 5 min (upper abd) (KUB with contrast-all 14 X 17) MIN (AP with contrast) RPO/LPO (30 rotation) Special IMAGES: DELAY FILMS (PA /AP/PA) UPRIGHT (1 below IC) Kidneys & bladder drop POST VOID 2 3 SCOUT 14 X 17 KUB 4 Kidneys cone down: 5 3 5 min film CONE DOWN 1min & 5 min (KIDNEYS) (some may want 1min, 3min, 6min, 9min) 6 1 min blush nephrogram 7 5 minute cone down 8 10 MINUTES BLADDER NOT YET FULL 9 RPO/LPO taken between 10 15 minutes (time marker ?) 10 11 RPO 12 13 14 15 min full done AP or PA 15 Additional imaging: Upright can show mobility of kidneys and bladder (see cysto for more info) 16 17 RESIDUAL CONTRAST CHECK WITH RADIOLOGIST MAY WANT ANOTHER POST VOID 18 CYSTOGRAMS & VCUG Indications? CHILDREN ADULT MALE : AP, OBLs (30 to 40 rotation) & LAT FEMALE AP, OBLs (40 to 60 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 ( 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 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) 21 22 MALE CYSTO AP, RPO, LPO, LAT 23 24 Lateral Cysto 25 26 27 FEMALE CYSTO AP, RPO, LPO, ? LAT 28 29 30 31 Foley balloon seen 32 VCUG 33 34 35 36 HEPATOBILIARY & the Gall Bladder (GB) RT 124 rev Sp 2010 37 PA SCOUT 14 X 17 or 11 x 14 RUQ - PA OR AP 38 This position will be tested in lab Taken as a scout and post contrast filling For ERCP 39 40 LAO or RPO for RUQ 42 Drainage film RUQ- RPO