Zystographie

Cystography is a fluoroscopic study that images the bladder. It is similar to a voiding cystourethrogram (VCUG), and the difference between the studies is primarily one of emphasis; a cystogram focuses on the bladder and a VCUG focuses on the posterior urethra. The study has been adapted to CT as a CT cystogram.

Indications

• dysfunctional voiding
• bladder outlet obstruction
• hematuria
• trauma
  • fluoroscopic and CT cystography are considered equivalent in the emergent setting
• congenital anomalies of the genitourinary tract
• postoperative evaluation of the urinary tract

Procedure

Technique

• insert Foley catheter in bladder, or use an indwelling Foley or suprapubic catheter
• introduce water soluble contrast through the catheter (such as Isovue-300 or Cystografin)
• if looking for a bladder leak after trauma, fill to detrusor contraction or to at least 300 mL
• if looking for a postoperative injury, then fill to a smaller volume (~100-150 mL or until resistance is felt
• avoid overfilling, so as not to blow out an anastomotic suture
• to try to ensure a detrusor contraction, try to have the patient void, if possible

The following projections should be acquired keeping within the ALARA principle:

• AP scout image
• AP early filling images (if injury or postoperative evaluation, focus on those areas)
• AP and steep obliques of the bladder (try to include the area of where the UVJ would be)
• post-void radiograph

A double contrast cystography (pneumocystography) variation on the standard cystogram is possible, but is very uncommonly performed.

Siehe auch:

• Blasenleckage
• Weihnachtsbaumblase
• CT cystogram

und weiter:

• CT cystography