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Radiology > Contrast Studies > Flashcards

Contrast Studies Flashcards

1
Q

What are the three most commonly performed contrast studies?

A

GI, urogenital, spinal cord

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2
Q

What are the factors that determine the type of contrast agent used?

A

test being performed, level of comfort of the clinician, availability

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3
Q

What are the four types of contrast agents commonly used?

A
  1. Soluble ionic radiopaque mediums
  2. Soluble nonionic radiopaque mediums
  3. Insoluble inert radiopaque mediums
  4. Radiolucent gases
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4
Q

What are examples of soluble ionic radiopaque mediums?

A

Iothalamate, diatrizoate

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5
Q

What are examples of soluble nonionic radiopaque mediums?

A

Iohexol, iopamidol

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6
Q

What is an example of insoluble inert radiopaque mediums?

A

barium sulfate

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7
Q

What are examples of radiolucent gases?

A

air, nitrous oxide, carbon dioxide

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8
Q

Soluble ionic mediums are _________

A

negatively charged benzoic acid derivatives

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9
Q

What are soluble ionic mediums used for?

A

oral administration for GI studies, IV for excretory urography, intraarticular studies, draining wound studies, fistulography

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10
Q

What type of patients shouldn’t receive soluble ionic mediums?

A

dehydrated patients
patients that are sensitive to iodine

***contrast is hyperosmolar salts (causes an increase in intravascular fluid volume when given IV)

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11
Q

What is the side effect of giving soluble ionic mediums orally?

A

diarrhea
direct contact w/ neural tissue can lead to muscle spasms, seizures, cerebral edema, hypotension, coma, death

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12
Q

Soluble ionic mediums are _____ contrast agents

A

positive

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13
Q

What studies can be performed using nonionic radiopaque agents?

A

spinal cord or respiratory tract, myelography

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14
Q

What are examples of soluble nonionic mediums?

A

iohexol, iopamidol

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15
Q

What is a benefit associated with nonionic mediums?

A

lower incidence of adverse effects & a lower osmolality

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16
Q

Nonionic agents are ______ contrast agent

A

Positive

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17
Q

What does BIPS stand for?

A

Barium impregnated polyethylene spheres

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18
Q

Barium is a more ________ solution than the surrounding tissue

A

dense

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19
Q

Due to barium suspension being more dense than the surrounding tissue, what does it result to?

A

Greater absorption of xrays & produces a whiter image on the finished radiograph

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20
Q

What are the benefits of barium suspension?

A

increase radiographic opacity –> allows the clinician to easily evaluate the surrounding structures

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21
Q

Due to barium suspension not being absorbed by the surrounding tissue, what does it do?

A

It effectively coats and soothes the GI tract compared to ionic mediums & it provides increased visualization of the lumen surfaces

22
Q

What are two systems used to measure barium suspension?

A
  1. weight to volume (w/v)
  2. weight to weight (w/w)
23
Q

Insoluble agents are ______ contrast agents

A

positive

24
Q

What forms does barium come in?

A

paste, liquid, powder

25
Q

What study is the barium paste used for?

A

esophagography studies

26
Q

Why is barium paste used for esophagography studies?

A

easier to administer, less likely to cause aspiration, adheres to the mucosa better than liquid barium

27
Q

What type of patients should barium not be used for?

A

constipation, any risk of upper or lower perforation of GI tract

28
Q

How should barium be administered if not evaluating the esophagus?

A

via orogastric tube to decrease risk of aspiration

29
Q

What is the drawback of powder barium?

A

over dilution w/ water –> which results in a solution too thin and doesnt coat the system well enough to provide diagnostic info

30
Q

What forms of barium outline the upper and lower GI system better ?

A

liquid and paste (better than powder)

31
Q

When are BIPS used?

A

used to determine if a motility issue is present

32
Q

What are BIPS related to in terms of structure?

A

Due to chemical structure, they are placed in the same group as barium sulfate agents;
Due to inert structure, they maintain the same weight as ingested food

33
Q

What form does BIPS come in?

A

capsule

34
Q

True or False: Each animal received the same volume of BIPS to evaluate for motility

A

True

35
Q

Can BIPS be given with our without food?

A

both

36
Q

The larger BIPS capsule contains ______ spheres; The smaller BIPS capsule contains _____ spheres

A

10 (5 mm diameter); 30 (1.5 mm diameter)

37
Q

What is the purpose of small BIPS?

A

to be similar to food and to assist in eval of motility

38
Q

What is the purpose of large BIPS?

A

determine if there is a potential obstruction in the GI tract

39
Q

What does BIPS offer an evaluation of besides motility?

A

gastric emptying times as liquid is released from the stomach in a shorter time compared to solids

40
Q

True of False: Liquid barium can give a false negative to motility issues due to its consistency

A

True

41
Q

Radiolucent gases are ____ contrast agents

A

Negative

42
Q

What affect does radiolucent gases have on radiographs?

A

the gases absorb fewer x-rays than the surrounding soft tissue & result in a more radiolucent effect

43
Q

What do negative contrast agents normally combine with?

A

positive contrast agents in a study referred to as a double contrast study

44
Q

What is a double contrast study?

A

a study that uses both a positive and negative contrast agent to evaluate an organ system

45
Q

Negative contrast agents provide _____ mucosal detail than the positive contrast agents used

A

less

46
Q

When should care be taken when using negative contrast agents?

A

prevent over expansion of hollow organs (results in potential rupture)

47
Q

What are the agents of choice when performing negative contrast studies? Why?

A

CO2 and Nitrous Oxide

Because use of room air can produce an air embolism that can result in cardiac arrest

48
Q

What is an esophagography?

A

A contrast study of the esophagus to assess the status of the esophagus, potential motility issues, and surrounding tissue

49
Q

What is the best position for the patient when performing an esophagography?

A

Standing (less risk of aspiration)

50
Q

What else should be performed when doing a esophagography?

A

Fluoroscopy

51
Q

Why would an esophagography be performed?

A

Abnormal swallowing, foreign body obstruction, dysphagia, megaesophagus, regurgitation of undigested food, and head/neck trauma

52
Q

What media is used for esophagography?

A

barium sulfate liquid or paste, commonly mixed w/ canned food

Oral aqueous iodine is used if perforation of the esophagus or GI tract is of concern

Radiology (10 decks)

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