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Diagnostic Imaging Techniques > Contrast media > Flashcards

Contrast media Flashcards

1
Q

Name the 2 basic categories of CM

A
  • Positive CM

- Negative CM

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2
Q

How do positive CM appear on an x-ray film and why?

A
  • Positive CM contains elements with a high atomic number.
  • These are radio-opaque.
  • They appear white on an x-ray film.
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3
Q

How do negative CM appear on an x-ray film and why?

A
  • Negative CM are gases with low density.
  • These are radiolucent.
  • They appear black on an x-ray film.
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4
Q

Name 2 examples of positive CM

A
  • Barium

- Water Soluble Iodine

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5
Q

Name 4 gases commonly used for negative CM

A
  • Room air
  • O2
  • CO2
  • N2O
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6
Q

What is a double contrast radiograph?

A

It is when negative CM and positive CM are both used to view a specific area

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7
Q

What is used in a double contrast gastrogram?

A

Positive CM barium is used to line the stomach and then distended with Negative CM air

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8
Q

What is used in a double contrast cystogram?

A

Positive CM iodine is used to line the bladder and then distended with Negative CM air

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9
Q

What forms can barium come in?

A
  • powder
  • paste
  • solution
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10
Q

What are the advantages of Barium?

A
  • inert

- insoluble

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11
Q

What is a disadvantage of Barium?

A

May cause foreign body reaction if it leaks from GI tract

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12
Q

When should Barium NOT be used in the GI tract?

A

Do not use if there is a GI rupture as it will cause reaction in peritoneum and could be fatal

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13
Q

Name a brand of water soluble iodine

A
  • Conray
  • Gastro-conray
  • Urografin
  • Gastrografin
  • Hypaque
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14
Q

How is water soluble iodine excreted if administered IV?

A

Via the kidneys

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15
Q

Name 2 places water soluble iodine can be used as a CM.

A
  • The lower urinary tract

- The GI tract (not as good as barium)

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16
Q

When should water soluble iodine be used instead of barium for a GI tract CM?

A

If there is a GI rupture

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17
Q

Water soluble iodine is ………… - tonic.

A

Hyper

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18
Q

List 4 side effects of water soluble iodine

A
  • fall in blood pressure (if IV)
  • anaphylactic reaction (if IV)
  • whining (if conscious)
  • retching (if conscious)
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19
Q

Give an example of a brand of Lower Osmolar Ionic Media

A

Hexabrix

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20
Q

What done ionic mean?

A

contains salts

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21
Q

What is not suitable for a myelogram and why?

A
  • Lower osmolar ionic solution

- Because it’s a salt solution therefore draws water in to the cisterna magna causing pressure to build up in the area.

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22
Q

List 2 advantages of Lower Osmolar ionic media

A
  • Fewer side effects than water soluble iodine

- Better contrast in GI tract than water soluble iodine

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23
Q

What CM is suitable for a myelogram?

A

Lower osmolar non-ionic media

24
Q

Give an example of lower osmolar non-ionic media brand name

A

Omnipaque

25
Q

What does non-ionic mean?

A

does not contain salts

26
Q

What is lower osmolar non-ionic media especially safe for and why?

A

Myelography because there’s no salt so no water is drawn in to the costerna magna and pressure remains safe.

27
Q

What should be carried out before doing a myelogram?

A

Normal x-rays

28
Q

Why perform a myelogram?

A

To indicate lesions that are not detectable on ordinary x-rays

29
Q

Why would myeography be indicated?

A
  • spinal pain
  • neurological signs
  • prolapsed intervertebral disks
30
Q

What method of restraint should be carried out for a myelogram?

A

General anaesthetic

31
Q

How would the patient be prepared and what equipment would be needed for myelography?

A
  • Patient anaesthetised
  • Clip relevent area
  • Surgical scrub of patients skin
  • Patient head elevated
  • Spinal needle selected (size depends on size of patient)
  • Correct dose of appropriate contrast media (warmed)
  • Syringe
  • Sample bottle for CSF
  • Vet should scrub up as if for sterile surgery and don sterile gloves
32
Q

Why should the head be elevated during myelography?

A

Convulsions can occur if the head is not elevated

33
Q

Where would the spinal needle be placed for a myelogram?

A
  • Most commonly the Cisterna Magna

- Less commonly the Lumbar

34
Q

Explain the Cisterna Magna puncture method.

A
  • Tilt the table to 10°
  • Clip and surgically clean site
  • Head flexed to 90° of spine
  • VS inserts needle between skull and atlas vertibra
  • Needle advanced slowly until CSF drips out of hub (needle is in cisterna magna now)
  • Take CSF sample for cytology
  • Inject warm CM slowly over 1 min
  • Patient must remain completely still during procedure
  • Head extended once needle removed
  • radiographs of both lateral views and VD once lesion identified
  • Head remains elevated until completely recovered
35
Q

What should be kept to hand during myelography?

A
  • Crash box

- Diazepam in case of seizure

36
Q

The patient should always have an ……… ………………. placed and be well …………………. prior to CM.

A

The patient should always have an IV Catheter placed and be well hydrated prior to CM.

37
Q

What drug should NOT be given prior to myelography and why?

A

ACP - lowers seizure threshold

38
Q

When can reactions occur due to the CM?

A

They could happen straight away or be delayed.

39
Q

Why would an Upper Gastrointestinal Study be carried out?

A

To evaluate the stomach and small intestines (But CM can be used to study the oesophagus right through to the anus.)

40
Q

What would indicate an upper gastrointestinal study?

A
  • vomiting
  • abnormal bowel movements
  • suspected foreign body or obstruction
  • chronic weight loss
  • persistent abdominal pain
41
Q

How would the CM media be administered for a upper gastrointestinal study?

A

Orally using syringe if patient willing to swallow or a stomach tube if not.

42
Q

What CM would be used in a upper gastrointestinal study?

A
  • Barium sulphate normally used (positive CM)
  • Water soluble iodine if perforation suspected (positive CM)
  • Positive and Negative CM can be used if stomach is the target
43
Q

List the equipment needed to do a upper gastrointestinal study.

A
  • Stomach tube
  • Large syringe (catheter tip preferrably)
  • Contrast Media
  • Lubricant
44
Q

How long should a patient be fasted prior to a upper gastrointestinal study?

A

Fast for 24 hours prior to upper gastrointestinal study.

45
Q

When should enemas be performed prior to the upper gastrointestinal study?

A
  • 24 hours before
  • 4 hours before
  • 1 hour before
46
Q

What drugs are suggested for upper gastrointestinal study and why?

A
  • ACP = sedative
  • Glucagon = gastrointestinal hypotonic agent that induces gastric hypomotility
  • GA = slows gut
  • Atropine = slows gut
47
Q

How can you ensure the orogastric tube is placed correctly?

A

Inject small amount of water in to tube. If patient coughs then tube is incorrectly placed in the trachea. Tube should be re-placed.

48
Q

What intervals should radiographs be taken at after CM administered for upper gastrointestinal study?

A
  • immediately after CM administration
  • 15 mins
  • 30 mins
  • 60 mins
  • 90 mins
49
Q

What types of radiographs should be taken after CM administration for upper gastrointestinal study?

A
  • DV
  • VD
  • R. Lat
  • L. Lat
50
Q

What is the dose rate for water soluble iodine used in a upper gastrointestinal study?

A

1ml/1lb

51
Q

What are the indications for a cystogram?

A
  • haematuria
  • dysuria
  • infection
  • bladder rupture
  • anuria
  • calculi
52
Q

What are the precautions for a cystogram?

A
  • palpate bladder while administering CM so as not to rupture or over-distend
  • place patient in left lateral recumbency to administer CM to reduce risk of air embolism
53
Q

List the equipment needed for a cystogram

A
  • urinary catheter
  • 3 way tap
  • syringes
  • sterile lubricant
  • skin prep solution
  • gauze
  • 2% lidocaine
  • sterile gloves
  • otoscope speculum
  • kidney dish
  • water soluble iodine
54
Q

What is the patient prep for a cystogram?

A
  • fasted for 12-24 hours
  • enema 4 hours prior to exam
  • abdo images should be taken prior to sedating/anaesthetising the patient
  • sedate/anaesthetise patient
55
Q

How is a cystogram performed?

A
  • take R. lat and VD radiographs of abdomen
  • external area cleaned with appropriate solution
  • apply sterile lubricant to catheter
  • insert catheter aseptically
  • empty as much urine as possible
  • administer 3-5ml of 2% lidocaine in to bladder (less for feline patients)
  • L. lat recumbency for CM administration
  • bladder held as air administered to prevent over distension
  • slowly administer water soluble iodine and roll patient 360° to coat mucosa with CM
  • take L.lat, VD and oblique radiographs of bladder

Diagnostic Imaging Techniques (5 decks)

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