54-year-old female with a history of pseudomeningocele status post closure and placement of a ventriculocisternal atrial shunt with a Codman programmable valve, referred for shunt evaluation.

 

Intense tracer activity is noted in the right lateral reservoir post tracer injection. Within the first 10 minutes, tracer activity is seen in the basal cistern. Tracer activity is seen in the shunt limb to the lateral ventricle on the right side. Tracer is also seen in the limb that extends to the atrium. Early tracer uptake in the bilateral kidneys and urinary bladder is visualized at 20 minutes post tracer injection. In the delayed images, there is diffuse activity seen in the basal cistern and the CSF space of the spinal cord.

Immediately after injection tracer activity is noted in the region of the basal cistern, as well as the shunt-limb to the lateral ventricles and the atrium together. The above together with rapid visualization of the kidneys are suggestive of a patent shunt system.