CONTRAST STUDIES

1. CONTRAST STUDIES

2. Categories of Contrast • Intravenous • Intrarterial • Oral • Intrathecal • Intraarticular

3. CONTRAST TYPES ARE BASED ON RADIOGRAPHIC APPEARANCE • NEGATIVE CONTRAST- AIR/GAS AND APPEARS BLACK ON THE IMAGE RECEPTOR • POSITIVE CONTRAST- BARIUM/IODINE AND APPEARS WHITE ON THE IMAGE RECEPTOR

4. BARIUM SULFATE

5. Ba K-SHELL BINDING ENERGY37 keV

6. BARIUM FACTS • FEW SIDE AFFECTS • ADMINISTER RECTALLY OR ORALLY • DRY POWDER OR SOLUTION • WATER INSOLUBLE • ORAL BARIUM IS THICKER THAN RECTAL BARIUM • SPEED AT WHICH BARIUM TRAVELS IS AFFECTED BY TEMPERATURE, MOTILITY OF THE GI TRACT AND CONSISTENCY.

7. PROBLEMS WITH BARIUM SULFATE • CAN SOLIDIFY LIKE PLASTER OF PARIS • CARE MUST BE TAKEN TO AVOID IMPACTION • GERIATRIC AND PEDIATRIC PATIENTS ARE A CONCERN(LAXATIVES ARE GIVEN POST EXAM)

10. IV contrast • The iodine in the contrast increases the attenuation of the x-ray beam and causes enhancement on the images!

11. IODINATED FACTS • MOVES THROUGH THE GI TRACT IN 1 TO 2 HOURS AND REACHES THE COLON IN 4 HOURS. • GOOD MUCOSAL DILINEATION • OUTLINES BUT DOES NOT STICK TO WALLS OF THE GI TRACT • IODINATED CONTRAST IS MORE EXPENSIVE

12. I K-SHELL BINDING ENERGY33 keV

13. WATER SOLUBLE IODINATED CONTRAST MEDIA • IONIC-divide into particles called ions when in a solution. Many particles enter the bloodstream due to the breaking up of the particle. • NON-IONIC-do not divide! The entire molecule remains intact when injected.

14. OSMOLALITY • IS THE NUMBER OF PARTICLES THAT DISSOLVE IN A SOLUTION. • LOCM- low osmolar contrast media.(500 to 850 mOsm/kg) • HOCM-high osmolar contrast media.(1300 to 1600mOsm/kg) • Agents that have lower osmality are better tolerated by patients.

15. Hypertonic • This is when a net movement of particles from within the tissue into the vascular space. This can cause dehydration! • Blood plasma osmolality is 285mOsm/kg

16. VISCOSITY • IS THE MEASURE OF THE THICKNESS OF A LIQUID. The thicker the solution the more force is exerted. • Particles are large with high viscosity solutions! • Kidneys could have problems clearing these large particles.

17. VISCOSITY IS INVERSELY PROPORTIONAL TO TEMPERATURE. AS TEMPERATURE INCREASES, VISCOSITY DECREASES. THIS IS WHY CONTRAST MUST BE WARM!

22. IODINATED CONTRAST IS WATER SOLUBLE • SOME IODINATED CONTRAST CONTAIN SALTS WHICH ARE MORE SOLUBLE IN WATER!

24. UGI WITH Ba SO4

25. BE WITH Ba SO4

26. CT OF ABDOMEN WITH Ba SO4

27. IVU (IVP)

28. CHOLECYSTOGRAM

29. BRONCHOGRAM

30. SIALOGRAM

31. ARTHROGRAM

32. HYSTEROSALPINGOGRAM

33. ANGIOGRAM

34. CYSTOGRAM

35. MYELOGRAM

36. NEGATIVE CONTRAST STUDIES

37. BE WITH AIR

38. ENTEROCLYSIS- SMALL BOWEL SERIES

39. UGI

40. ARTHROGRAM

41. CONTRAST STUDIES CLASSIFICATION BASED ON THE DIRECTION OF CONTRAST APPLICATION • RETROGRADE • ANTEGRADE

42. RETROGRADE: AGAINST THE NORMAL PHYSIOLOGIC ROUTE

43. RETROGRADE

44. ERCP

45. ANTEGRADE WITH THE NORMAL PHYSIOLOGIC ROUTE

46. ANTEGRADE

47. RETROGRADE STUDIES • BE • MYELOGRAM • ERCP • HYSTEROSALPINGOGRAM • SIALOGRAM • CYSTOGRAM

48. ANTEGRADE STUDIES • UGI • SBS • IVU • CHOLECYSTOGRAM

49. CONTRAST MEDIA CLASSIFICATION BASED ON THEIR ORIGIN • INDIGENOUS-WITHIN THE BODY • EXOGENOUS- FROM OUTSIDE THE BODY

50. INDIGENOUS CONTRAST AIR IN THE LUNGS