Hysterosalpingogram :

The two main indications for this examination are infertility and recurrent abortion. Watertight cannulation of the cervix is performed and aqueous contrast medium is injected to outline the uterus and uterine tubes. Some authorities use oil-based contrast, but granuloma formation and a flare-up of any pelvic infection may result. The narrowest point of the Fallopian or uterine tube is at the entrance to the uterine cavity. The widest point is at the abdominal end, the infundibulum, before it opens into the peritoneal cavity. Free spillage of contrast into the pelvic cavity is an important sign and should be distinguished from loculated spill due to pelvic inflammatory disease. When possible, this examination should be performed 7-10 days following menstruation as earlier in the cycle, venous intravasation may result, and later on in the cycle, accidental fetal irradiation may occur.

   Subtraction Macrodacryocystogram :

The inferior canaliculus is cannulated, having first dilated the punctum. The superior punctum is normally outlined by reflux of contrast, but can be injected separately if necessary. Oil-based contrast medium is used and 2 ml usually suffices to show the whole duct system. The two canaliculi join to form the common canaliculus before entering the lacrimal sac. The sac is approximately 12 mm long and shows a slight constriction at its lower end which is said to be due to the orbicularis oculi muscle. This corresponds to the valve of Krause. The lacrimal duct extends downwards to open into the nasal cavity in the inferior meatus. The anatomists describe a second constriction in the intraosseous part of the duct and this is caused by a fold of mucosa (valve of Taillefer). At the site of opening into the inferior meatus, there is a slightly expanded orifice with another valve of mucous membrane called the lacrimal fold (valve of Hasner). Indications for this technique include obstruction, either partial or complete, diverticulae, sinuses, fistulae, polyps and tumours.

   Antero-posterior Tomogram of the Larynx :

The tomogram of the larynx is taken in phonation 'EE' to show the stretching and adduction of the vocal cords. If one or both cords are paralysed, abduction will not take place. The commonest site for a laryngeal carcinoma is the anterior part of the vocal cords and most small lesions here should be readily visible. Look for upward and downward extension of the tumour.

   Subtracted Lumbar Venogram :

Since the advent of CT and MR imaging techniques, lumbar venography is rarely performed. However, the anatomy of the vertebral veins is optimally demonstrated by this technique. Venous drainage of the spinal cord is longitudinally arranged via plexi, which anastomose freely with the internal and external vertebral venous plexi, which also communicate. Note how the internal veins bend laterally at the level of the disc interspace and medially at the level of pedicles, where they unite via a connecting vein.

   Male Urethrogram :

Indications for male urethrography include demonstration of urethral strictures, false passages, injuries or fistulae. Contrast medium is injected in a retrograde direction outlining the urethra. Anatomically it is divided into three parts: the prostatic urethra; the membranous urethra, which is the site of the external sphincter; and the penile urethra. Injection is made under screen control, taking films at different angles so that short strictures are not missed.