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Radiography: double contrast cystography
Synonym(s): DCC
Introduction
- Introduction of negative and positive contrast into bladder gives maximum radiographic information on bladder disease.
Uses
- Investigation of hematuria Hematuria.
- Investigation of dysuria.
- Identification of non-radiodense uroliths Urolithiasis.
- Assessment of bladder wall thickness.
- Assessment of bladder mucosal lining
. - Identification of bladder masses.
Advantages
- Relatively simple procedure in most patients.
- Non-invasive.
- Improved mucosal detail over pneumocystogram or positive contrast cystogram.
- Enables identification of radiolucent foreign body or blood clots.
Disadvantages
- Can be impossible to catheterize some patients (with obstructed urethras).
- Risk of air embolus or bladder rupture if bladder over-inflated with air or severe hematuria.
- Not appropriate if bladder or urethral rupture suspected.
Technical problems
- Requires bladder catheterization Urethral catheterization: female which may be difficult for inexperienced operator in some bitches.
Alternative techniques
- Bladder ultrasonography.
- Pneumocystogram.
- Positive contrast cystography.
- Intravenous urography Radiography: intravenous urography.
Time required
Preparation
- Dependent upon method of restraint.
- If chemical restraint (GA or sedation) required, about 5 min to gather equipment.
Procedure
- 30 min dependent largely upon skill of radiographer and cooperation of patient.
Decision taking
Criteria for choosing test
- Is the examination appropriate?
- Can you make the diagnosis without it?
- Will your management of the case be affected by the outcome of the examination?
Risk assessment
- Samples for urinalysis should be collected prior to contrast radiography.
- If bladder or urethral rupture is suspected Bladder: trauma rupture a positive contrast study is preferred.
Requirements
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Preparation
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Technique
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Aftercare
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Outcomes
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Further Reading
Publications
Refereed papers
- Recent references from PubMed and VetMedResource.
- Weichselbaum R C, Feeney D A, Jessen C R et al (1999) Urocystolith detection: comparison of survey, contrast radiographic and ultrasonographic techniques in an in vitro bladder phantom. Vet Radiol Ultrasound 40 (4), 386-400 PubMed.
- Weichselbaum R C, Feeney D A, Jessen C R et al (1998) In vitro evaluation of contrast medium concentration and depth effects on the radiographic appearance of specific canine urolith mineral types. Vet Radiol Ultrasound 39 (5), 396-411 PubMed.
- Scrivani P V, Léveillé R, Collins R L (1997) The effect of patient positioning on mural filling defects during double contrast cystography. Vet Radiol Ultrasound 38 (5), 355-359 PubMed.
- Mahaffey M B, Barsanti J A, Crowell W A et al (1989) Cystography - effect of technique on diagnosis of cystitis in dogs. Vet Radiol and Ultrasound 30 (6), 261-267 VetMedResource.
- Park R D (1974) Radiographic contrast studies of the lower urinary tract. Vet Clin N A 4 (4), 863-87 PubMed.