google ads
Search

Everything you need to know about Computed Tomography (CT) & CT Scanning


IV Contrast

question1. Why do we use IV contrast material?
questionIV contrast is a critical part of CT scanning regardless of the application. Some of the reasons we use IV contrast are listed below and a series of select case studies is also provided. I have provided an organ based approach to its use which gives sample situations but is not all inclusive.

IV Contrast Use: Clinical Applications

  • Brain- define perfusion of the brain in the case of suspected stroke

  • Chest- r/o the presence of a pulmonary embolism or aortic dissection

  • Liver- help detect the presence of a liver mass and then determine whether the mass is benign or malignant

  • Pancreas- detect the presence of a pancreatic tumor and then determine whether the mass is resectable

  • Kidney- detect the presence of acute pyelonephritis or a renal neoplasm

  • Small Bowel- detect the presence of ischemic bowel disease or inflammatory bowel disease

question2. Do you use serum creatinine levels or GFR in your practice for establishing risk prior to CT scanning?
question3. What is GFR and why is it a more accurate measure than simply getting a creatinine level?
question4. Why are GFR numbers different for Caucasians and African Americans?
question5. Are all CT scans with IV contrast done the same way?
question6. What type of IV contrast material do we use and why?
question7. At what temperature do we store IV contrast material?
question8. Why do you warm IV contrast?
question9. What is the advantage of Visipaque as written in the literature?
question10. When do you use Visipaque-320 and when Omnipaque-350?
question11. Does the concentration of contrast mean that higher concentrations are better (AKA-isn’t a higher number better)?
question12. What is the volume of IV contrast material we use?
question13. What patients are considered high risk patients for IV contrast for CIN?
question14. Do we have set cutoffs for creatinine levels and if so what are they?
question15. Can we pretreat patients who have borderline renal function? If yes then how?
question16. Should patients be NPO for CT scanning? If yes for how long?
question17. What are the common volumes of contrast used for IV injection?
question18. What kind of IV access is ideal for use for IV contrast injection?
question19. Has there been any new developments in technology that may help us high injection rates in patients who can not tolerate an 18g needle (or at times even a 20g)?
question20. Can any IV the patient has in place be used to inject the contrast material?
question21. Can we use a central line or a PICC line for injection?
question22. What about the new “purple PICC/central lines” I hear about?
question23. What are some of the common normal “side effects” of IV contrast agents?
question24. Is there a relationship between patients receiving chemotherapy and CIN?
question25. Is it ok for patients to have both an MR and a CT with contrast on the same day?
question26. Have you ever seen a patient develop diffuse erythema distal to the IV injection site in the absence of extravasation?
question27. Patients often report a metallic taste in their mouth following use of IV iodinated contrast. Is there an explanation?
question28. Are there any contrast volume limitations for the use of IV contrast?
question29. Can you tell me a bit more about GFR and what it really means?

 

 

© 1999-2020 Elliot K. Fishman, MD, FACR. All rights reserved.