CT cystography

CT cystography is a variation of the traditional fluoroscopic cystogram. Instead of anterograde opacification of the urinary collecting system (as with CT urography), contrast is instilled retrograde into the patient's bladder, and then the pelvis is imaged with CT.

Indications

• suspected bladder rupture
  • fluoroscopic and CT cystography are considered equivalent for this indication
• postoperative bladder/suspected bladder leak

Procedure

Technique

• urine is drained from the bladder via a Foley catheter or suprapubic catheter
  • remember in a trauma situation with a possible pelvic injury, a retrograde/ascending urethrogram should be performed first to exclude urethral injury
• a bag of dilute water-soluble contrast (e.g. Cystografin) is hung to instill contrast into the bladder under gravity pressure
  • dilution ratio of 1:10 is often used
• similar to conventional cystography, contrast is instilled until the patient feels a strong urge to void (or ≥300 mL has been administered)
• perform CT of the pelvis with thin sections
  • if the entire abdomen is to be performed, then this is performed first and the bladder is filled for CT cystogram afterwards

See also

• bladder rupture

Siehe auch:

• Zystographie

und weiter:

• urinary bladder injury