Urography is not to be performed following a standard procedure. However, some key-films can be defined which are to be routinely employed. If needed, additional radiographs can be performed. We tried to optimize the urographic technique combining low X-ray exposure and adequate diagnostic assessment with the injection of 17.5 gI of a non-ionic agent. Two groups of 50 patients each were investigated. In the former, the technique we currently employ in our Institute was used: plain film, 2 nephrotomograms (1'), full-length view (7'), kidney view with ureteral compression (15'), and full-length or bladder view (20'). In the latter group, a more simplified technique was used: plain film, 2 nephrotomograms (1'), kidney view (7'), and full-length view (15'). A compression device was positioned immediately before contrast medium injection and released immediately before the 15-minute exposure. Both urographic techniques allowed high scores to be reached (after the Kelsey Fry method), with no significant differences among the evaluated parameters. Thus, the technique employed on the second group is to be preferred, because it shortens examination time and reduces X-ray exposure. However, a simplified technique increases the radiologist's responsibility: it is thus essential for an experienced uroradiologist to accurately supervise the procedure and immediately decide what to do next.
