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The Adult Radiographic Shuntogram

Walter S. BartynskiGo,a, Saravanan Valliappana, James H. Uselmana and Michael P. Spearmana

a From the Department of Radiology (W.S.B., S.V., M.P.S.) and the Division of Neurosurgery (J.H.U.), The Western Pennsylvania Hospital, Pittsburgh, PA.



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  		FIG 1. A and B, Patient 2.

A, A 25-gauge needle is placed in the valve component of a Cordis Unishunt ventriculoperitoneal shunt (closed arrow). A shunt reservoir is seen just proximal to the valve (open arrow).

B, Contrast material is injected into the valve (closed arrow). A shunt reservoir is again seen proximal to the valve (open arrow).

C–G, Patient 6.

C and D, 3-minute films show contrast material in the Cordis Unishunt system (arrow).

E and F, 12-minute films show forward motion of the contrast material in the tube (arrow) with slight early peritoneal spillage (arrowhead). Redundant coiling of the peritoneal component is present with occasional catheter overlap noted.

G, 15-minute film of the abdomen after pumping the valve shows clearing of contrast material from the shunt tube and free spillage into the peritoneal cavity (arrow).



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  		FIG 3. FIG 2. Patient 2 (with a Cordis Unishunt system).

A, 12-minute film at the level of the valve shows contrast material in one of two ventriculoperitoneal shunts but no forward motion of contrast agent (arrows). Shunt flow at this point is abnormal.

B, After pumping, the contrast material has cleared from the tube and is seen freely spilling into the peritoneal cavity (arrow). The shunt valve was functioning improperly in this patient and required replacement.

Patient 1 (with a Cordis Unishunt system). 15-minute post pump abdominal film shows encystment of contrast material at the peritoneal end of the drainage catheter (arrow). Abdominal adhesions were lysed and the peritoneal catheter repositioned





Copyright © 2009 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X