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Radionuclide cisternogram

Definition

A radionuclide cisternogram is a nuclear scan test. It is used to diagnose problems with the flow of spinal fluid.

Alternative Names

CSF flow scan; Cisternogram

How the Test is Performed

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

You will then be scanned 4 to 6 hours after getting the injection. A special camera takes images that show how the radioactive materials travel with the cerebrospinal fluid through the spine. The images also show if the fluid leaks outside the spine or brain.

You will be scanned again 24 hours after injection. You may need additional scans possibly at 48 and 72 hours after injection.

How to Prepare for the Test

Most of the time, you do not need to prepare for this test. Your health care provider may give you a medicine to calm your nerves if you are very anxious. You will sign a consent form before the test.

You will wear a hospital gown during the scan so the doctors have access to your spine. You will also need to remove jewelry or metallic objects before the scan.

How the Test will Feel

Numbing medicine will be put on your lower back before the lumbar puncture. However, many people find lumbar puncture somewhat uncomfortable. This is often due to the pressure on the spine when the needle is inserted.

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 flow of spinal fluid and spinal fluid leaks. In some cases, there may be a concern the CSF fluid is leaking after a trauma to the head or a surgery in the head. This test will be done to diagnose the leak.

Normal Results

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

What Abnormal Results Mean

An abnormal result indicates disorders of CSF circulation. These disorders may include:

Risks

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. Almost all of the radiation is gone within a few days. There are no known cases of the radioisotope causing harm to the person getting the scan. However, as with any radiation exposure, caution is advised if you are pregnant or breastfeeding.

Very rarely, a person may have an allergic reaction to the radioisotope used during the scan. This may include a serious anaphylactic reaction.

Considerations

You should lie flat after the lumbar puncture. This can help prevent headache from the lumbar puncture. No other special care is necessary.

References

Bartleson JD, Black DF, Swanson JW. Cranial and facial pain. In: Daroff RB, Fenichel GM, Jankovic J, Mazziotta JC, eds. Bradley's Neurology in Clinical Practice. 6th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 18.


Review Date: 7/4/2015
Reviewed By: Jason Levy, MD, Northside Radiology Associates, Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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