An intravenous pyelogram is performed by injecting iodinated contrast material into a vein. As the contrast is excreted by the kidney, x-rays are obtained. An IVP is a useful test to determine both anatomy and function. It provides high resolution images so that the renal pelvis, calyces and ureter are all well seen. One can detect absence of function or perfusion to a kidney when no contrast is excreted.
Usefullness. An IVP is useful in patients with hematuria, hydronephrosis, or abdominal pain thought to be related to the kidneys.
Limitations: An IVP is an invasive test. It requires placement of an intravenous line. Because significant renal function is required to concentrate and excrete the contrast material, IVP's are not useful in patients with renal dysfunction. Newborns rarely have sufficient renal concentrating ability to allow the kidneys to be seen on an x-ray. An IVP will detect renal function, but it is not very sensitive in comparing the function of two kidneys. Nuclear renograms are the best G/U imaging study to measure renal function.
Indications: An IVP may be useful in evaluating children with urine infections, suspected kidney stones, hematuria, or urinary tract obstruction. If you suspect a renal tumor an ultrasound would be a better study.
Examples: IVP of normal kidneys. IVP showing hydronephrosis.
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©David A. Hatch, M.D., 1996