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


Unique Clinical Scenarios

question1. The patient has sickle cell disease. Can they get IV contrast?
question2. The patient has multiple myeloma. Can they get IV contrast material?
question3. If a patient has thyroid disease is iodinated contrast contraindicated?
question4. If a patient has thyroid cancer is iodinated contrast contraindicated?
question5. If a patient has myathenia gravis should iodinated contrast be used for a chest CT?
question6. If a patient is on glucophage (or other oral diabetes medications) is there an issue with iodinated contrast agents? What is the current rule with oral diabetes drugs? (glucophage)
question7. What patients take glucophage (metformin)?
question8. What is the danger of Metformin and iodinated contrast?
question9. What are the other names for metformin?
question10. What are the current guidelines for patients taking metformin and needing a contrast study?
question11. Is there any problem with using iodinated contrast for CT if a patient is on the cardiac drug Amiodarone?
questionThis was a new question to me when posted on www.ctisus.com in October 2008. I spoke to an expert on contrast from GE Healthcare and there response is below. Please note at Hopkins there is no issue with this drug and IV contrast agents.

The problem is complex with amiodaraone but I will try to summarize:

  • Only one retrospective analysis on iohexol showed this Q-T prolongation and only with intracoronary use.
  • It has been shown in dog experiments that this effect is due to hyperosmolality of iohexol (twice blood) and lack of electrolytes in the contrast medium when injected intracoronary (Pedersen article). It may also have something to do with the fact that contrast media injected in high concentration in small arteries carries no oxygen. The same effect has not been shown with IA injections outside the heart or with IV injections, so the effect is likely a local one with intracoronary injection.
  • The effect is likely to occur with all current LOCMs on the market,as osmolality and chemical formulation are similar. Also, none contain electrolytes
  • This is part of the reason that isosmolar Visipaque was formulated with Na and Ca in a specific ratio, and why this agent was originally marketed in the cath lab. 5. Amiodarone contains no warning against the use of iodinated contrast agents. helps.

- Richard A. Vitti, MD
Medical and Professional Services
GE Healthcare

question12. Can you use iodinated contrast on a patient with suspected or known pheochromocytoma?
question13. If a patient is nursing can she receive IV contrast?
question14. What is our policy for scanning a pregnant patient?
question15. If a CT is done on a pregnant patient and iodinated contrast is used can that affect the fetus?
question16. Who should get baseline serum creatinine levels before CT?

 

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