8) Contrast GI/GU

Question 1

Contrast studies of the GI tract

Answer 1

• Barium swallow
• Upper GI (single or double contrast)
• Barium Enema (BE), (single or double contrast)

Question 2

Fluoroscopy

Answer 2

• A radiologic technique that allows real-time visualization of the patient

Question 3

During fluoroscopy,

Answer 3

• A continuous beam of x-rays passes through the patient to cast an image on a fluorescing screen
• Amplified by an electronic image intensifier
• Viewed on a high resolution screen

Question 4

Filling defects

Answer 4

• Must be seen on several different views if they are to be believed

Question 5

If clinical suspicion of an esophageal foreign body is high, and no radiopaque foreign body is identified on plain films,

Answer 5

• Barium swallow can exclude the presence of a nonradiopaque foreign body

Question 6

Upper GI (UGI) key concepts (same as barium enema key concepts)

Answer 6

• Barium usually used as a positive contrast agent; air used as a negative contrast agent
• For the evaluation of mucosal lining and to search for filling defects
• Single contrast UGI = barium only
• Double contrast UGI = barium + air

Question 7

Barium is contraindicated if

Answer 7

• A erforated bowel is suspected

- Patient is given Gastrografin

Question 8

Rigidity of the bowel wall

Answer 8

• Tumor
• Edema
• Post inflammatory changes

Question 9

Contraindications to barium studies key concepts

Answer 9

• Patients with a large bowel obstruction should not be given barium by mouth
• Electrolyte imbalance
• Perforated bowel

Question 10

Genitourinary studies

Answer 10

• Intravenous pyelogram (IVP)
• Retrograde urethrogram (RUG)
• Retrograde cystogram
• Voiding cystourethrogram (VCUG)

Question 11

IVP key concepts

Answer 11

• Usually the initial imaging study in the workup of kidney stones or hematuria
• A radiopaque contrast material in injected into a vein in the arm
• Abdominal films are taken at 5 to 10 min time intervals, until the contrast makes through both kidneys, ureters, and to the bladder

Question 12

The IVP begins with a preliminary plain film, because

Answer 12

• 90% of kidney stones are radiopaque and dense enough to be seen on plain films

Question 13

The urinary bladder

Answer 13

• Retrograde cystogram
• RUG-imaging the male urethra by injection of a water soluble contrast agent via a small catheter
• VCUG-films are taken while patient urinates on the fluoroscopy table