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Introduction
Clinical presentation
Clin. aproach to ivestig. and menag. of UTI
Cortical scintigraphy in urinary tract infection
Cystigraphy in urinary tract infection
Vesicourethral reflux (VUR)
The grading systems for vesicourethral eflux
Detection of vesicourethral reflux
Micturating cystourethrography (MCUG)
Radionucleotide cystography (RNC)
Direct radionuclide cystography (DRC)
Indirect radionuclide cystography (IRC)
Dynamic renal scintigraphy in UTI
Practical problems in pediatric nucl.med.
Preparation
Dose schedule
Injection
Imobilisation/ sedation
Conclusion

4.2.1. Micturating cystourethrography MCUG

The bladder is filled through an indwelling catheter; images of the filling phase and the avoiding phase are obtained. The major disadvantages are the unfavourable dosimetry, fact that only snap shots are available , thus offering possibility of missing some transitory reflux and the invasive character. The advantages of this technique are possibility of grading and demonstration of some morphological changes like urethral valve, ureterocoele, duplicated ureters[9]. Undetected posterior uirethral valves will result in serious renal damage. Any male patient in whom this diagnosis has not already been excluded should have contrast cystography as the initial study. Contrast cystography should be considered in any child with abnormal external genitalia because of increased incidence of structural abnormality of bladder and ureters. In all other patients, including all those in whom ultrasound finds no structural abnormality, the radionuclide cystogram should be the first cystographic study performed.

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