TsISTOGRAFYYa (Greek kystis a bladder + grapho to write, represent) — a method of X-ray inspection of a bladder by its artificial contrasting.
For the first time C. it is made in 1902 by A. Wittek.
By means of C. estimate a form, size and position of a bladder. C. apply to diagnosis of anatomic anomalies of a bubble, napr, a double bubble, diverticulums (fig. 1), and also to identification of urinary stones, tumors (fig. 2), damages of a bubble, vesical fistulas, paracystitis, adenoma and a prostate cancer, to detection of vesicoureteral refluxes. Distinguish ascending (retrograde) C. and descending C., being the final stage of excretory urography (see). Ascending C. protivopoka-
Fig. 1. Tsistogramma of the patient with dibelief-tikulami of a bladder (the ascending tsistografiya): shooters are specified by di
of a vertikula.
Zahn at a stricture of an urethra, acute cystitis and prostatitis, danger to cause bleeding from a bladder, urethral fever; do not produce C. at the moment or soon after a hamaturia, in the presence in a bladder of clots, to-rye can look on roentgenograms as defects of filling, phymatoid a bladder.
At ascending C. by means of a catheter enter 150 — 200 ml of 10 — 30% of solution of radiopaque substance into a bladder (triombras-that, Iodamidum, Verografinum, Urografinum, etc.). If ascending C. it is impracticable, make descending C. At descending C. the X-ray analysis of a bladder is made after its optimum filling with the contrasted urine emitted with kidneys and which arrived from upper uric ways. Ascending and descending C. do not give the chance to receive images of small tumors and low-contrast or X-ray low-contrast stones. In such cases carry out one of kinds of C. — gas C. (pnevmotsistografiya) or double contrast study of a bladder (lacunary C.). For carrying out gas C. in an uric pu-
of Fig. 2. A lacunary tsistogramma of the patient with adenoma of a prostate, a papillary tumor and stones of a bladder: 1 — a papillary tumor of a bladder; 2 — stones of a bladder; z — adenoma of a prostate.
«>yr enter 150 — 200 cm3 of gas (carbon dioxide gas, nitrous oxide, oxygen). For a double contrast study at first enter into a bladder through a catheter 15 — 20 ml of 20 — 30% of water-soluble triyodi-sty radiopaque substance, and then — 150 — 200 sm6 carbon dioxide gas, nitrous oxide or oxygen. At diagnosis of tumors of a bladder make a so-called sedimentary pnevmotsistografiya, for carrying out the cut into a bladder is entered by 100 — 150 ml of 10 — 15% of a suspension of fixed white. For uniform sedimentation of fixed white on walls of a bladder after introduction of a suspension of the patient lies, turning on the right and left side, on a back and a stomach. At localization of a tumor in a neck of a bubble of the patient during the research shall stand or sit. In 30 — 40 min. the suspension of barium at any urination is removed, and enter 100 — 150 cm3 of nitrous oxide into a bubble or carbon dioxide gas. The X-ray analysis under control of television raying is made in a straight line, slanting or atypical projections at horizontal position of the patient on a back and a stomach. Use of a tomography (see) promotes the best visualization of walls of a bladder, identification intravesical and paravesical patol. processes, diverticulums, and also the increased prostate pressing in a cavity of a bladder. For determination of wall thickness of a bladder, hl. obr. at tumors, apply a pnevmoperitsistografiya, to-ruyu reasonable to combine with a sedimentary pnevmotsiyetografiya. Administration of gas in paravesical cellulose at a pnevmoperitsistografiya is carried out intraperitoneal, suprapubic or perineal access. At the most widespread perineal peritsisto-grafiya gas (nitrous oxide or carbon dioxide gas in number of 500 — 600 cm3) by means of a needle enter into paravesical cellulose, punktiruya a crotch from two parties from the centerline.
At an acute ischuria, if catheterization of a bladder for C. it is not possible, make a transdermal puncture of a bubble or trocar cystostomy (see). Through a needle or a drainage enter radiopaque substance into a bladder and carry out puncture Ts.
Oslozhneny Ts. possible infection of a bladder is; at a pnevmoperitsistografiya there is a danger of a gas embolism. For prevention of this terrible complication during the carrying out a research it is necessary to use carbon dioxide gas or nitrous oxide.
Bibliography: Ggerslmanv. M. Rent
genologichesky recognition of tumors of a bladder, M., 1966; Pytel
A. Ya. and Pytelyyu. A. Radiodiagnosis of urological diseases, M., 1966; DeutickeP. Die Rontgenun-tersuchung der Niere und des Harnleiters in der urologischen Diagnostik, Miinc hen — Grafelfing, 1965; Emmett’s clinical urography, Atlas and text-book of roentgenologic diagnosis, ed. by D. M. Witten a. o., v. 1, Philadelphia a *, o., 1977; Kneise O. u. Schober K. Z. Die Rontgenun-tersuchung der Harnorgane, Lpz., 1963.
V. M. Perelman.