Short reports Radionuclide cystography in vesicoureteric reflux

The optimal investigation of children with urinary tract infections is controversial and is periodically reviewed.' 2 The dilemma, to ensure adequate investigation while avoiding undue trauma or radiation exposure, is familiar to paediatricians and radiologists. The most unpleasant investigation used is undoubtedly the radiological micturating cystogram, which requires urethral catheterisation. This study was performed to determine whether a selected group of children can be spared this cystogram with its associated hazards of infection, radiation exposure and, rarely, urethral stricture formation. Indirect radionuclide cystography, using an intravenously injected radioactive marker excreted by the kidney, was pioneered by Dodge in 1963. The availbility of radiopharmaceuticals more suitable than the original 1311 hippuran, in particular 99"llTc DTPA (diethylene triamine penta-acetic acid), and improved imaging with the gamma camera, has now made the technique suitable for routine clinical use.