Preliminary Diagnosis: Cystocele
I. What imaging technique is first-line for this diagnosis?
-
Fluoroscopic guided voiding cystourethrogram.
II. Describe the advantages and disadvantages of this technique for diagnosing cystocele.
Advantages
-
Highly portable imaging modality.
-
Highly sensitive and less specific in detailing and diagnosing a cystocele.
Disadvantages
-
May expose patients to large amounts of ionizing radiation.
-
Less adept in detailing the surrounding anatomical structures than other imaging modalities.
-
Highly operator dependent.
III. What are the contraindications for the first-line imaging technique?
Contraindicated in pregnant patients.
IV. What alternative imaging techniques are available?
-
Dynamic contrasted MR imaging
-
Ultrasound
V. Describe the advantages and disadvantages of the alternative techniques for diagnosing cystocele.
Dynamic contrasted MR imaging
Advantages
-
Does not expose patients to ionizing radiation.
-
Offers more exquisite detail of the surrounding anatomical structures than other imaging modalities.
-
Sensitive and specific in detailing and characterizing the primary abnormality and characterizing any secondary complications.
-
Offers the best visualization of the pelvic floor and helps characterize and detail the surrounding anatomical structures.
Disadvantages
-
Expensive.
-
Time consuming.
-
Requires significant patient cooperation to minimize motion artifact.
Ultrasound
Advantages
-
Does not expose patients to ionizing radiation.
-
Highly portable.
-
May be used to guide treatment.
Disadvantages
-
Highly operator dependent.
-
Less adept in detailing the surrounding anatomical structures.
VI. What are the contraindications for the alternative imaging techniques?
Dynamic contrasted MR imaging
May be contraindicated in patients with non-MR compatible hardware.
Ultrasound
None.
Copyright © 2017, 2013 Decision Support in Medicine, LLC. All rights reserved.
No sponsor or advertiser has participated in, approved or paid for the content provided by Decision Support in Medicine LLC. The Licensed Content is the property of and copyrighted by DSM.