Radionuclide Cystography Overview
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Questions and Answers

What primary purpose does radionuclide cystography serve?

  • Evaluate vesicoureteral reflux. (correct)
  • Assess bladder capacity during fluid retention.
  • Monitor bladder wall thickness changes.
  • Detect kidney stones before surgical procedure.

    • What complication can result from untreated vesicoureteral reflux?

  • Formation of bladder tumors.
  • Recurrent urinary tract infections and potential kidney damage. (correct)
  • Temporary incontinence during voiding.
  • Increased bladder wall elasticity.

    • Which step is NOT part of the direct method in radionuclide cystography?

  • Catheterize the patient.
  • Encourage the patient to void into a bed pan.
  • Administer a functional renal agent intravenously. (correct)
  • Obtain multiple sequential images as the bladder fills.

    • During the direct method of radionuclide cystography, how is the saline infused?

    <p>Through a catheter inserted directly into the bladder.</p> Signup and view all the answers

    What characterizes a normal exam result in radionuclide cystography?

    <p>Increasing bladder activity without reflux into the ureters.</p> Signup and view all the answers

    What is the primary method of radionuclide cystography used for evaluating vesicoureteral reflux?

    <p>Direct method with catheterization and saline infusion</p> Signup and view all the answers

    Which step is crucial before starting the direct method of radionuclide cystography?

    <p>Catheterizing the patient</p> Signup and view all the answers

    What imaging characteristic indicates an abnormal exam during radionuclide cystography?

    <p>Presence of ureteral reflux during urination</p> Signup and view all the answers

    What is the typical volume of ‘Tc-pertechnetate’ used in the saline for a direct radionuclide cystography?

    <p>1 mCi (37 MBq)</p> Signup and view all the answers

    In which position should the patient be placed during the voiding phase of the procedure?

    <p>Seated position with back to the imaging camera</p> Signup and view all the answers

    What is a potential complication of vesicoureteral reflux if left untreated?

    <p>Recurrent urinary tract infections</p> Signup and view all the answers

    During the direct method, what type of images are obtained after the bladder has reached capacity?

    <p>Post-void images of the upper urinary tracts</p> Signup and view all the answers

    How is the degree of reflux quantified during radionuclide cystography?

    <p>Calculating reflux bladder volume and volume of reflux into the kidney</p> Signup and view all the answers

    What is the most common population for which radionuclide cystography is used?

    <p>Infants and children</p> Signup and view all the answers

    What is a characteristic finding during a normal radionuclide cystography exam?

    <p>Consistent volume increase without reflux into ureters</p> Signup and view all the answers

    Study Notes

    Radionuclide Cystography

    • Purpose: Evaluate vesicoureteral reflux (VUR), a condition where urine flows backward from the bladder to the ureters. Commonly used in children.
    • Cause of VUR: Often due to a congenital (present at birth) malformation in the ureters' connection to the bladder.
    • Complications: Can lead to recurrent urinary tract infections (UTIs) and potential kidney damage.

    Radionuclide Cystography Methods

    • Two methods: Indirect and direct.
    • Indirect Method: Administer a functional renal agent intravenously then image during voiding to observe reflux.
    • Direct Method Steps:
      • Patient voids before the study.
      • Patient is catheterized.
      • Catheter is connected to normal saline infused with 1 mCi (37 MBq) of Tc-pertechnetate.
      • Patient is positioned supine on the imaging table, ensuring bladder visibility within the imaging field's lower portion.
      • Multiple sequential images are taken as the bladder fills with radioactive saline.
      • Saline infusion stops when bladder capacity is reached. A posterior pre-void image is taken, capturing the entire bladder and upper urinary tracts.
      • Voiding images are obtained with the patient seated, camera against the back. The catheter is removed, and the patient voids into a bedpan/urinal.
      • A post-void image is taken, including the entire bladder and upper urinary tracts.

    Image Findings

    • Normal: Increasing bladder activity without reflux into the ureters.
    • Abnormal: Ureteral reflux, particularly during urination, with reflux increasing as the study progresses.
    • Quantitative: Reflux bladder volume and the volume of reflux into the kidney can be calculated.

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    Description

    This quiz explores the methods and purpose of radionuclide cystography, primarily used to evaluate vesicoureteral reflux (VUR) in children. It covers both indirect and direct methods of imaging, as well as underlying causes and complications. Test your knowledge on this important diagnostic procedure and its implications.

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