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Warm or cold contrast medium in the micturating cystourethrogram (MCUG): which is best?
T R Goodman1, T Kilborn, R Pearce
1Department of Radiology, John Radcliffe Hospital, Oxford, UK. robin.goodman@orh.nhs.uk
Clinical Radiology
|July 2, 2003
Summary
Using warm contrast medium during voiding cystourethrography (VCUG) in infants significantly reduces patient distress compared to cold contrast. This finding aids in optimizing the VCUG procedure for better infant tolerance.
Area of Science:
- Pediatric Radiology
- Medical Imaging
Background:
- Voiding cystourethrography (VCUG) is a common diagnostic imaging procedure for infants.
- The temperature of the contrast medium used in VCUG may influence examination outcomes and patient comfort.
Purpose of the Study:
- To compare the effects of room temperature (cold) versus body temperature (warm) contrast medium on VCUG outcomes in infants under one year of age.
Main Methods:
- A randomized controlled trial involving 100 infants undergoing VCUG.
- Infants were assigned to receive either cold or warm contrast medium.
- Key outcomes measured included screening time, contrast volume, voiding attempts, patient distress, bladder emptying, and reflux incidence.
Main Results:
- No significant differences were observed in screening time, contrast volume, or voiding attempts between the groups.
- Significantly less patient distress (crying) was noted with warm contrast medium (p<0.05).
- While not statistically significant, cold contrast showed higher rates of complete bladder emptying (32% vs 16%), and warm contrast showed higher rates of vesicoureteric reflux (VUR) demonstration (16% vs 6%).
Conclusions:
- Warm contrast medium significantly reduces infant distress during VCUG examinations.
- The temperature of the contrast medium does not impact screening time or the volume required.
- Further investigation may be warranted for the observed trends in bladder emptying and VUR demonstration.