Cystography Pathologies

Question 1

purpose

Answer 1

assess reflux of urine from bladder into ureters (VUR: vesicoureteral reflux)

Question 2

direct method

Answer 2

• tracer instilled into bladder via catheter

Question 3

imaging protocol for direct method

Answer 3

1) dynamic for filling phase (RP infusion)
2) static pre-void
3) dynamic for voiding
4) static post-void

Question 4

indirect method

Answer 4

use of MAG3 or DTPA by IV and performing a renal scan

Question 5

RP and dose
direct method

Answer 5

SC (or DTPA or pert)
18.5-37 MBq

Question 6

RP and dose
indirect method

Answer 6

MAG3 or DTPA

Question 7

imaging protocol by indirect method

Answer 7

wait 2 hours and NO voiding
imaging dynamically while voiding

Question 8

formula to calculate bladder volume

Answer 8

(age + 2) * 30 mL

Question 9

normal appearance for direct method

Answer 9

no tracer in ureters or kidneys during filling or voiding phases

Question 10

normal appearance for indirect method

Answer 10

see kidneys and bladder with no reflux when voiding

Question 11

formula for residual bladder volume

Answer 11

(voided volume (ml) * residual bladder ROI ct)/(pre-void bladder ROI ct - residual bladder ROI ct)

Question 12

symptoms of VUR

Answer 12

• UTIs
• chills, fever
• nausea/vomiting
• dysuria/polyuria/hematuria

Question 13

grade A

Answer 13

ureteral reflux

Question 14

grade B

Answer 14

ureteral and pelvic reflux
(grade 2 and 3 in VCUG)

Question 15

grade C

Answer 15

reflux into pelvis with diffused dilation of pelvis or ureter appreciated

Question 16

false negs

Answer 16

• minimal reflux which can lead to grade 1 being missed
• insufficient instillation which prevents pressures that can cause that reflux

Question 17

false positives

Answer 17

• urine or RP contamination in area