Contrast media
Author:
Mikael Häggström [notes 1]
Contents
Intravenous
CT
- Main article: CT with IV contrast
In low renal function
- Main article: CT with IV contrast in low renal function
Decreased renal function and several other conditions increase the risk of contrast-induced nephropathy, which is a potentially lethal renal injury to the kidney following intravenous radiocontrast.[1]
Contrast medium reaction
- Main article: Contrast medium reaction
In a more severe reaction:[2]
- Adrenaline shot, 0.3-0.5mg in adults, given intramuscularly.
- Summon an anesthesiologist
- Prevention
- Main article: Prevention of contrast medium reaction
Before a contrast CT of a patient with known allergic-like or unknown-type of contrast reaction to the same class of contrast medium (such as iodinated), the American College of of Radiology recommends premedication with a glucocorticoid, preferably starting 12 or 13 hours before contrast administration.[3]
Hyperthyroidism
- Main article: Iodinated contrast and hyperthyroidism
Iodinated contrast can cause thyrotoxicosis in people with hyperthyroid diseases, mainly toxic multinodular goiter, Graves’ disease, or Hashimoto’s thyroiditis.[4]
Peroral
Rectal
Projectional radiography and fluoroscopy
- Choice of contrast medium
- Barium sulfate is generally used.
- An iodine-based contrast medium is used where there is a risk perforation, where barium may cause chemical inflammation.<[5]
- However, 1-2% of oral iodine is absorbed in the gastrointestinal tract, and can potentially case a contrast medium reaction.[6] Also, it is more expensive than barium
- Iodine-based
Recommended concentration:
- Adults: 70 mg iodine per ml, such as 240 ml of a 370mg/ml solution in 1,000 mL of tap water.[notes 2]
- Children over 5 years: 55 mg iodine per ml such as 90 ml of a 370mg/ml solution in 500 mL tap water.[notes 2]
CT scans
Rectally administered contrast is indicated in cases where a suspicion remains of penetrating trauma to the colon where an initial CT shows no reason for immediate surgery.[7]
Notes
- ↑ For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Radlines:Authorship for details.
- ↑ 2.0 2.1 370mg/ml for undiluted gastrografin:
- . AUSTRALIAN PRODUCT INFORMATION - GASTROGRAFIN (Sodium amidotrizoate / Amidotrizoate meglumine). Bayer. Retrieved on 2018-11-07.<
- . Gastrografin Dosage. Drugs.com.Medically reviewed on December 2, 2017.
References
- ↑ Rudnick, M.; Feldman, H. (2008). "Contrast-Induced Nephropathy: What Are the True Clinical Consequences? ". Clinical Journal of the American Society of Nephrology 3 (1): 263–272. doi: . ISSN 1555-9041.
- ↑ Unless otherwise specified in lists and table: . Hypersensitivity reactions against contrast media - Swedish Society of Uroradiology [Swedish: Överkänslighetsreaktioner mot kontrastmedel – SURFs kontrastmedelsgrupp ], 2014-10-17].
- ↑ Error on call to Template:cite web: Parameters url and title must be specified. . American College of Radiology, Committee on Drugs and Contrast Media. Retrieved on 2018-08-25. Version 10.3. 2018. ACR
- ↑ Yıldız, Sema; Kuşkonmaz, Şerife Mehlika (2016). "Effect of iodinated contrast media on thyroid: a brief review ". Journal of Health Sciences 6 (1): 12. doi: . ISSN 1986-8049.
- ↑ Dr Vikas Shah ◉ and Dr Jeremy Jones. CT luminal contrast. Radiopaedia. Retrieved on 2018-11-07.
- ↑ . Oral Contrast Policies. Yale School of Medicine. Retrieved on 2018-11-07.
- ↑ Stephen Ledbetter and Robin Smithuis (2007-08-02). Acute Abdomen - Role of CT in Trauma. Radiopaedia.