Types of Cystograms

Nuclear Cystogram

Nuclear Cystogram also known as the retrograde cystogram is used to provide an x-ray view of the bladder, upon the injection of a sterile dye. It identifies disorders of the bladder, such as, urinary tract infection and tumors, among other disorders.

 The procedure for this exam is as follows: The doctors administer anesthesia to the patient after which an instrument, thin and tube like, known as a catheter is then inserted into the bladder. The contrast medium is injected through the tube into the bladder by way of the urethra. X-ray films are then taken at different stages, and at different angles, while the bladder is being filled, in order to get a complete view of the bladder.

Other films are taken afterwards. The procedure takes 1-1 ½ hours, after which the patient has to wait while the film is developed.

Radiographic Cystogram

Radiographic Cystogram is a procedure is via a contrast medium; its aim is to be able to view the outline of the bladder clearly. This type of examination is used frequently in the study of the kidney, ureters, urethra and the bladder. It is quite useful in detecting or diagnosing cysts, tumors or other diseases of the bladder. The extent of the radiological exam required is dependent on the condition of the patient and the size of the affected area.

The procedure for this exam is as follows: Apply pressure to the upper arm while the patient is lying on the scanner table, so that the veins of the arm is distended,

after scrubbing the inner elbow with antiseptic, radioisotope is then injected (small amount) into the vein. The upper arm pressure is then released, so that the radioisotope is able to travel through the bloodstream in a concentrated portion, after which the kidney is then scanned. More than one image is taken, each lasting approximately, 1-2 seconds.

The total scan time is about 30-60 minutes. After the scan, the images are then analyzed, detailed information regarding the kidney is then available. To excrete the radioisotope, a lot of fluids and frequent urination is required.

Comparison to CT Cystography

The similarities between the Computed Tomography (CT) Cystography and Nuclear Cystogram is not very many, as there are no tubular inserts, or injections, but the similarities with the Radiographic Cystogram are many, they are similar procedures, as they both involve lying on a table, being injected with a dye, films being taken as the dye highlights the areas being scanned. The scan times for both procedures are also the same.

The Radiographic Cystogram is a preferred procedure and would in fact, be viewed as the “Gold Standard”, as according to studies conducted by Urologists http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B7XMT-4HJWW9T-36&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&_docanchor=&view=c&_searchStrId=1028713209&_rerunOrigin=google&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=f61090dcb41cbb51d9e7ef2a104fd318

 (“Quantitative nuclear cystography did not predict the outcome in patients followed for primary vesicoureteral reflux at a single institution for 3 years or longer. Intermittent reflux was common. These data suggest that nuclear cystography cannot be used to assess

reliably the prognosis in individuals. Strong consideration should be given to using negative findings on 2 cystograms to confirm reflux resolution in patients at high risk.”)

Both cystograms are used to conduct the same tests, and to draw the same conclusions; however both the procedures are in no way similar, nor is Nuclear Cystogram as effective as Radiographic Cystogram.

Nuclear Cystogram is definitely more invasive than Radiographic Cystogram, as it involves the insertion of tubes into the bladder through the urethra, and the discomfort the patient feels as a result of that process