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Nephrogram phase

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The nephrogram is that part of the IVU during which contrast is in the glomeruli and proximal tubules. It occurs 1-3 minutes after injection.

It enables the assessment of:

  • presence - are there bilateral functioning kidneys
  • size - normal range is approximately the height of three vertebral bodies. Bilateral, enlarged kidneys suggest polycystic disease, acute pyelonephritis or glomerulonephritis. Bilateral, shrunken kidneys imply chronic disease.
  • shape - cysts and tumours may cause distortion. The two are often indistinguishable, however, tumours opacify to a variable extent, and may show a characteristic "vascular blush."
  • orientation - disorientation may be intrinsic, for example, a horseshoe kidney, or extrinsic i.e. the effects of pressure from other organs.

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