Evaluation of radionuclide cerebrospinal fluid scintigraphy as a guide in the management of patients with hydrocephalus

Nuclear medicine and the emergency department patient: an illustrative case-based approach

Radiologists are familiar with the use of radiographs, computed tomography, magnetic resonance imaging and ultrasound in the acute clinical setting. However, there are some specific clinical scenarios which may be found in nuclear medicine imaging problem-solving tools. These clinical scenarios and imaging techniques are less frequent, and the referring clinician from the emergency department may not consider these alternatives. It is important for the radiologist to be aware of these techniques to be able to guide the clinician to use those tools, which may result in optimal patient care. In this article, we will discuss those nuclear medicine studies which have application in the setting of an emergency radiology practice.

Techniques that decrease or eliminate ionizing radiation for evaluation of ventricular shunts in children with hydrocephalus

Shunted hydrocephalus in children is a commonly seen diagnosis in hospitals throughout the world and is one of the most common chronic pediatric neurosurgical conditions. These children undergo numerous studies for routine surveillance as well as for evaluation of shunt malfunction, many of which are associated with significant radiation exposure over the child׳s lifetime. It is in the child׳s best interest to minimize the overall exposure to ionizing radiation so as to decrease the chance of the deleterious effects from occurring. The article outlines the epidemiology of ventricular shunt catheters, the typical indications and methods for shunt evaluation, and the preferred alternative imaging methods that eliminate or reduce radiation exposure.