Dacryocystography

Changed by Raymond Chieng, 8 May 2022

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Dacryocystography (DCG) is a fluoroscopic contrast examination of the nasolacrimal apparatus. The nasolacrimal duct is cannulated enabling iodinated contrast to be instilled into the nasolacrimal system.

Indications

The most frequent indication is epiphora: excessive tearing or watering of the eye(s) ³. DCG is mainly to locate the site of obstruction in the lacrimal drainage system, to differentiate canalicular from proximal sac obstruction, and detect the presence of stenotic segments that cannot be passed by a cannula ⁴.

Types

There are several ways of performing a DCG ⁴:

conventional DCG
distension DCG
macrography DCG
seriography DCG
digitally subtracted DCG (DS-DCG)
kinetic conventional DCG
real-time DS-DCG
three-dimensional rotational DCG (3DR-DCG)

Technique

Equipment is similar to that used to perform a sialogram.

One suggested technique:

patient in the supine position
similar projection to an OM view in most cases
acquisition of a preliminary control film to confirm patient positioning and exposure
dilate the punctum to insert the cannula
non-ionic iodinated contrast injection into a cannulated duct, avoiding air bubbles
acquire images, whilst ask the patient to look straight ahead to avoid blinking
a post-removal of cannula erect view may be useful in diagnosing functional blocks

CT and MRI dacryocystography have also been described ^1,2.

History

Dacrocystography was first performed by Ewing A.E in 1909. He used bismuth subnitrate to demonstrate a lacrimal abscess cavity ³.

-<p><strong>Dacryocystography </strong>(<strong>DCG</strong>) is a fluoroscopic contrast examination of the <a href="/articles/nasolacrimal-drainage-apparatus">nasolacrimal apparatus</a>. The nasolacrimal duct is cannulated enabling iodinated contrast to be instilled into the nasolacrimal system.</p><h4>Indications</h4><p>The most frequent indication is <a href="/articles/epiphora">epiphora</a>: excessive tearing or watering of the eye(s) <sup>3</sup>.</p><h4>Technique</h4><p>Equipment is similar to that used to perform a <a href="/articles/sialography">sialogram</a>.</p><p>One suggested technique:</p><ol>
+<p><strong>Dacryocystography </strong>(<strong>DCG</strong>) is a fluoroscopic contrast examination of the <a href="/articles/nasolacrimal-drainage-apparatus">nasolacrimal apparatus</a>. The nasolacrimal duct is cannulated enabling iodinated contrast to be instilled into the nasolacrimal system.</p><h4>Indications</h4><p>The most frequent indication is <a href="/articles/epiphora">epiphora</a>: excessive tearing or watering of the eye(s) <sup>3</sup>. DCG is mainly to locate the site of obstruction in the lacrimal drainage system, to differentiate canalicular from proximal sac obstruction, and detect the presence of stenotic segments that cannot be passed by a cannula <sup>4</sup>.</p><h4>Types</h4><p>There are several ways of performing a DCG <sup>4</sup>:</p><ul>
+<li>conventional DCG</li>
+<li>distension DCG</li>
+<li>macrography DCG</li>
+<li>seriography DCG</li>
+<li>digitally subtracted DCG (DS-DCG)</li>
+<li>kinetic conventional DCG</li>
+<li>real-time DS-DCG</li>
+<li>three-dimensional rotational DCG (3DR-DCG)</li>
+</ul><h4>Technique</h4><p>Equipment is similar to that used to perform a <a href="/articles/sialography">sialogram</a>.</p><p>One suggested technique:</p><ol>

References changed:

4. Singh S, Ali M, Paulsen F. Dacryocystography: From Theory to Current Practice. Annals of Anatomy - Anatomischer Anzeiger. 2019;224:33-40. <a href="https://doi.org/10.1016/j.aanat.2019.03.009">doi:10.1016/j.aanat.2019.03.009</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/30954539">Pubmed</a>

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