Direct and indirect radionuclide cystography

Abstract

Direct radionuclide cystography has proved to be a useful substitute for roentgenological cystography in studying patients with vesicoureteral reflux. Although the initial diagnosis generally is made with x ray, serial follow-up examinations are more feasible with the radionuclide method because of its lower radiation burden. Additional information obtainable from these studies includes determinations of bladder volume at time of reflux, calculation of urine volume that has refluxed as well as residual bladder urine volume, quantification of reflux drainage time from the upper tracts, and visualization of anatomic defects and variants. More recently, indirect nuclear cystography has been evaluated for the detection of reflux. The greater degree of patient cooperation required for this procedure would appear to favor its usefulness in older children. More investigative work, including correlation with direct radionuclide cystography as well as the roentgenologic studies, is needed.