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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?
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?
answer
  • Age > 60
  • History of renal disease, including:
    • Dialysis
    • Kidney transplant
    • Single kidney
    • Renal cancer
    • Renal surgery
  • History of hypertension requiring medical therapy
  • History of diabetes mellitus
  • Metformin or metformin-containing drug combinations

"The major preventive action against CIN is to ensure adequate hydration. The ideal infusion rate and volume is unknown, but isotonic fluids are preferred (Lactated RingerÕs or 0.9% normal saline). One possible protocol would be 0.9% saline at 100 mL/hr, beginning 6 to 12 hours before and continuing 4 to 12 hours after intravascular iodinated contrast medium administration. Oral hydration has also been utilized, but with less demonstrated effectiveness."

ACR Manual on Contrast Media
Version 9 (2013)

 

 

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