Shunt Patency

Question 1

RP
Dose
Admin
TTI

Answer 1

0.5 - 2.0 mCi Tc99m DTPA IV

Image every 15 minutes for 1 hour

Question 2

Indications

Answer 2

Evaluate function of CSF shunt
Evaluate blockage or drainage of CSF shunt
Evaluate hydrocephalus

Question 3

Contraindication

Answer 3

None

Question 4

Patient Prep

Answer 4

Signed consent
Prepare patient for sterile field
Change into gown - betadine stains
Shave area behind ear

Question 5

Positioning

Images

Answer 5

Supine with arms at side
Head first
ANT, ANT marker, LAT, LAT marker, Abdomen

Question 6

Target Organ
Critical Organ
Route of Excretion
Localization

Answer 6

Target: Ventricles, shunt tubing, CSF, abdomen
Critical: Abdomen if draining well, Ventricles if not draining
Excretion: Urinary
Localization: Compartmentalization

Question 7

Procedure

Answer 7

Physician injects into shunt reservoir while occluding the distal end of the shunt. Draw CSF as necessary.
Image abdomen immediately - none is good
Image every 15 minutes for 1 hour

Question 8

Computer Set Up

Answer 8

128 x 128
LEHR
Statics 1 - 2 min or 200 - 500 kCounts
Every 15 minutes for 1 hour

Question 9

Processing

Answer 9

gamma.wustl.edu
CSF shunt scintigraphy
Normal CSF scintigraphy