What is a DRCG scan?
A DRCG (Direct Radionucleide Cystography) scan may be needed for
- Detection of vesicoureteric reflux (VUR) in children after UTI (MCUG is the preferred first test).
- Follow up of children with known VUR during prophylactic antibiotic treatment
- Assessment of the results of endoscopic or surgical treatment for VUR.
- Screening of siblings of children/parents with proven VUR
What is the procedure for the scan?
The procedure involves putting a fine tubing (catheter)in the bladder with local anaesthetic jelly, under all aseptic precautions and instillation of a radionuclide Tc-99m DTPA (diethylene triamine pentaacetic acid) or Tc-99m Pertechnetate mixed with saline. Bladder is slowly filled, volume depends on expected bladder capacity, which depends on age.
Then the catheter is removed and images are taken with the gamma camera while child passes urine.
Is there any risk of UTI due to this procedure?
A UTI resulting from bladder catheterization during the procedure is very uncommon. All sterile precautions are taken during the procedure. A prophylactic antibiotic is usually started prior to the procedure and given for 48 hours after the procedure.
How is DRCG different from MCUG?
DRCG is a sensitive investigation for VUR. But it does not provide anatomic details as provided by MCUG. While MCUG is good for initial evaluation, DRCG may be used for follow up of VUR or screening for VUR in siblings.