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CT 2 > Unit 1 - Injection Techniques > Flashcards

Unit 1 - Injection Techniques Flashcards

1
Q

What is the need for contrast?

A
  • to differentiate adjacent structures
  • improves observation
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2
Q

What are the other name/s of Contrast studies?

A
  • ## Enhanced studies
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3
Q

Nonionic, Dimer, watersoluble

A

The most expensive BUT least harmful

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4
Q

Routes of Contrast: for the gastrointestinal tract enhancement

A

Orally

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5
Q

Routes of Contrast: for vascular and systemic enhancement

A

Intravenously (IV)

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6
Q

Routes of Contrast: for the LOWER gastrointestinal tract enhancement

A

Rectally

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7
Q

Routes of Contrast: for the spinal cord enhancement

A

Intrathecally

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8
Q

Routes of Contrast: for the joints enhancement

A

Intra-articularly

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9
Q

Routes of Contrast: for the bladder enhancement

A

Intravesical

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10
Q

Types of Oral contrast

A
  • Positive
  • Neutral
  • Negative
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11
Q

Examples of Positive Types of Oral Contrast

A
  • Barium Sulfate (BaSO4)
  • Iodine Based:
    1. Omnipaque
    2. Gastrografin
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12
Q

Examples of Neutral Types of Oral Contrast

A

Water (H2O)

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13
Q

Examples of Negative Types of Oral Contrast

A
  • Carbondioxide (CO2)
  • Air
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14
Q

Opacification of vasculature and distributes to the extravascular space/parenchyma

A

Intravenous

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15
Q

Cons of Contrast

A
  • High attenuation of IV contrast = increased beam attenuation (Streaky Image)
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16
Q

Other names of unenhanced Image

A
  • Pre-contrast image
  • non-contrast image
  • non-enhanced image
  • baseline image
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17
Q

Properties of IV Contrast

A
  1. Osmolality
  2. Viscosity
  3. Ionicity
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18
Q

Characteristics of a stable IV access site

A
  1. Well located
  2. Recently established
  3. No medication running
  4. No signs of complications
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19
Q

How to test IV site?

A

Inject saline prior, 2-5 ml PREFERABLY 10 ml

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20
Q

Alternate vascular access options

A
  • Central Venous Access Device
  • Peripherally Inserted Central Catheter
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21
Q

Methods of Contrast Media Injection

A
  • Drip infusion
  • Bolus Techniques:
    1. Hand injection
    2. Mechanical Injection System
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22
Q

Fluid sent directly into SVC, IVC or Right Atrium

A

Central Venous Access Device (CVAD)

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23
Q

Its tip is located in the lower third of SVC and usually uses hand bolus method of injection.

A

Peripherally Inserted Central Catheter (PICC)

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24
Q

Specially designed PICC - can be uses for injections with rates of 5 ml/s has a different colored lines to be distinguished from the normal PICC Line

A

Power PICC

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25
Q

The two types of CVADs

A

Longer term solutions for IV therapy
1. Tunneled - under the skin
2. Non-tunneled

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26
Q

The same CVAD intended for dialysis should or should not be used for CM administration?

A

should NOT

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27
Q

Documentation of CM Administration

A
  • Name of CM
  • Dose (Volume and concentration)
  • Flow rate/s
  • Injection site
  • any adverse events and associated interventions
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28
Q

Planning of contrast exam are based on what factors?

A
  • Pharmacokinetic
  • Patient (Anatomy and pathology of interest)
  • Equipment-related factors
29
Q

Phases of Tissue Enhancement

A
  1. Arterial Phase (Bolus)
  2. Venous Phase (Non-equilibrium)
  3. Equilibrium Phase (Delayed)
30
Q

Characteristics of General Phases/ determined by these factors:

A
  • rate of the contrast material
  • time elapsed from the start of injection to scan (scan delay time)
31
Q

What is AVID?

A

Arteriovenous Iodine Difference (AVID) is used to compare and differentiate the three phases in CT images.

Compares Abdominal artery to IVC

32
Q

AVID: 30 or more HU

A

Arterial Phase (Bolus)

33
Q

Scan delay time: first minute/60 secs. SDT < 60

A

Arterial Phase (Bolus)

34
Q

Contrast in the arterial structures.

A

Arterial Phase (Bolus)

35
Q

Scan delay time: after the first minute. 60 < SDT

A

Venous Phase (Non-equilibrium)

36
Q

AVID: 10 to 30 HU

A

Venous Phase (Non-equilibrium)

37
Q

Contrast in the parenchyma.

A

Venous Phase (Non-equilibrium)

38
Q

AVID: less than 10 HU.

A

Equilibrium Phase (Delayed)

39
Q

Contrast in everywhere, diluted in the veins and soaked the organ parenchyma.

A

Equilibrium Phase (Delayed)

40
Q

Scan delay time: After 2 minutes. 120 < SDT

A

Equilibrium Phase (Delayed)

41
Q

CM drips during a period of several minutes, and the patient is scanned after most/all of the CM is administered.

A

Drip infusion

42
Q

Method that uses gravity, the flow rate is a variable and could be affecter by many factors: bottle height, CM volume and viscosity, IV catheter length and size.

Taken images usually in the equilibrium phase

A

Drip infusion

43
Q

It is not advised to use this method for the neck, chest, abdomen or pelvis

A

Drip infusion

44
Q

It could be used in the brain, because its extended period of time can cross the Blood Brain Barrier.

A

Drip infusion

45
Q

Rapid injection of contrast followed by image acquisition.

Volume: 50 - 200 ml
Rate: 1-6 mL/s

A

Bolus technique

46
Q

Characteristics of hand injection

A
  • Variable flow rate
  • inconsistent images thus less reproducibility.
  • requires two operators
    + INEXPENSIVE and extravasation events are rare
47
Q

Most common method for CM delivery

A

Mechanical injection

48
Q

Characteristics of Mechanical

A

+ consistent reproduceable
+ Accurate flow rates and volumes
- More chances of extravasation and air embolism
- expensive

49
Q

More chances for extravasation and air embolism to occur

A

Mechanical Injection

50
Q

Maximum pressure value in the mechanical injector

A

300 psi

51
Q

Flow rates: Slow

A

1 - 2 mL/s
- used for suboptimal IV Access
- for routine contrast-enhanced brain study

52
Q

Flow rates: Standard

A

3 mL/s
- for MOST contrast-enhanced studies

53
Q

Flow rates: Fast

A

4 - 5 mL/s
- for angiographic studies

54
Q

Determines the amount of contrast enhancement in a patient’s vessels and tissues.

A

Factors affecting contrast enhancement

55
Q

Demonstrates the effect of any of the factors on the enhancement peak (Amplitude, width, and shape)

A

Time-density curves

56
Q

Pharmacokinetics Factors include:

A
  • concentration, osmolality, and viscosity
  • volume, flow rate, and injection duration
  • Scan delay time
  • total scan time
57
Q

A fast injection with low concentration of CM will produce the same concentration with

A

slow injection with high concentration

58
Q

High flowrate = time to peak enhancement?

A

Decreases - reduces the scan delay time

59
Q

High flowrate = injection duration?

A

Decreases

60
Q

High flowrate = peak height?

A

High and narrow

61
Q

To capture the same level of contrast enhancement of slow scanners, faster scanners require less volumes but must be given a longer scan delay.

True or False?

A

True

62
Q

Automated Injection triggering methods

A
  • Test Bolus
  • Bolus triggering/tracking
63
Q

Administer a small initial amount of contrast (10-20 mL)

A

Test bolus

64
Q

8 to 15 seconds after injection a number of low-dose serial scans are performed every 2 seconds at a specific anatomical level (Aortic arch, pulmonary trunk)

A

Test bolus and Bolus triggering/tracking

65
Q

how to decide at what time to scan the patient with the method of test bolus

A

The image with the max enhancement is selected, its used to determine the time to peak enhancement and its scan delay for the actual diagnostic scan

66
Q

What is the formula for test bolus?

A

Trial scan delay + (2 x img #) + 3 seconds

67
Q

Alternate method to determine the scan delay for each pt

A

Bolus triggering/tracking

68
Q

Administering the full contrast dose, once near peak enhancement of the target structure is reached the table moves back to the starting position and actual diagnostic scan begins.

A

Bolus triggering/tracking

CT 2 (1 decks)

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