Health Encyclopedia

Radionuclide cisternogram

Definition

A radionuclide cisternogram is a nuclear scan test used to diagnose spinal fluid circulation problems.

Alternative Names

Intrathecal scan; Spinal cord scan; CSF flow scan; Cisternogram

How the test is performed

A lumbar puncture (spinal tap) is done first. Small amounts of radioactive material, called a radioisotope, are injected into the fluid in the lower spine.

You will be scanned 4 - 6 hours after receiving this injection. A special camera creates images that show how the radioactive materials travel with the cerebrospinal fluid through the spine and if the fluid leaks outside the spine.

You will be scanned again 24 hours after injection, and possibly at 48 and 72 hours after injection.

How to prepare for the test

No preparation is usually necessary. However, if you are very anxious or agitated, sedation may be necessary. You must sign a consent form. You will wear a hospital gown to make the spine more accessible. Remove jewelry or metallic objects before the scan.

How the test will feel

During lumbar puncture, the lower back over the spine is numbed with an anesthetic. However, many people find lumbar puncture somewhat uncomfortable, usually because of the pressure on the spine during insertion of the needle.

The scan is painless, although the table may be cold or hard. No discomfort is produced by the radioisotope or the scanner.

Why the test is performed

The test is performed to detect problems with spinal fluid circulation and spinal fluid leaks.

Normal Values

A normal value indicates normal circulation of CSF through all parts of the brain and spinal cord.

What abnormal results mean

An abnormal study indicates disorders of CSF circulation, including:

Hydrocephalus
CSF leak
Normal pressure hydrocephalus (NPH)
Whether or not a CSF shunt is open or blocked

What the risks are

Risks associated with a lumbar puncture include pain at the injection site, bleeding, and infection. There is also a very rare chance of nerve damage.

The amount of radiation used during the nuclear scan is very small, and virtually all of the radiation is gone within a few days. There have been no documented cases of injury or damage caused by the radioisotope used with this scan. However, as with any radiation exposure, caution is advised if you are pregnant or breastfeeding.

In extremely rare cases, a person will develop an allergic reaction to the radioisotope used during the scan. This may include a serious anaphylactic reaction.

Special considerations

You should lie flat after the lumbar puncture (to help prevent headache from the lumbar puncture). No other special care is usually necessary.

References

Spelle L, Boulin A, Tainturier C, Visot A, Graveleau P, Pierot L. Neuroimaging features of spontaneous intracranial hypotension.Neuroradiology. 2001 Aug;43(8):622-7.

Spieth ME, Kasner DL. Traumatic thoracic thecal sac laceration, leak, and pleural effusion diagnosed by radionuclide cisternogram. Clin Nucl Med. 2002 Nov;27(11):830-1.

Lund VJ, Savy L, Lloyd G, Howard D. Optimum imaging and diagnosis of cerebrospinal fluid rhinorrhoea. J Laryngol Otol. 2000 Dec;114(12):988-92.

Review Date:7/17/2007
Reviewed By:Stuart Bentley-Hibbert, M.D., Ph.D., Department of Radiology, Weill Cornell Medical Center, New York, NY. Review provided by VeriMed Healthcare Network.

ADAM Quality A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is the first of its kind, requiring compliance with 53 standards of quality and accountability, verified by independent audit. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial process. A.D.A.M. is also a founding member of Hi-Ethics (www.hiethics.com) and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The Agency for Health Care Administration (Agency) and this website do not claim the information on, or referred to by, this site is error free. This site may include links to websites of other government agencies or private groups. Our Agency and this website do not control such sites and are not responsible for their content. Reference to or links to any other group, product, service, or information does not mean our Agency or this website approves of that group, product, service, or information.

Additionally, while health information provided through this website may be a valuable resource for the public, it is not designed to offer medical advice. Talk with your doctor about medical care questions you may have.