Following injection of contrast, spot films are taken of the pelvi-calyceal system and ureter down to the level of any obstruction. In some instances, dynamic fluouroscopic imaging can provide more pertinent information compared to a delayed review of hard copies. Images can be taken in the anterior or oblique position. Usually, nephrostomy imaging provides excellent quality images due to the lack of contrast dilution and the relatively small volume of the system under scrutiny.

• Intraluminal lesions are usually seen as filling defects. Filling defects with a smooth profile are more likely to represent stones, while irregular lesions are suggestive of malignancy

• Position and extent of strictured areas are clearly demonstrated. Smooth contours are indicative of extrinsic compression. Stricture formation secondary to intraluminal pathologies such as ureteric TCC are more liable to appear irregular in outline

• Obstruction can occur at any level within the upper urinary tract and is confirmed by proximal pooling of contrast with little or no distal flow

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