Contrast Media Flashcards

(43 cards)

1
Q

Why do we use contrast media

A

To visualise soft tissues

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2
Q

Gastrogram

A

+ve cm barium is used to line the organ and then distended with -ve cm air

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3
Q

Cystogram

A

+ve cm iodine is used to line the bladder and then distended with the negative cm air

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4
Q

Positive contrast media

A

contains elements of a high atomic number that are radio opaque (i.e. appear white on xray film - whiter than bone)

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5
Q

Negative contrast media

A

Gases which because of thier low density are radiolucent and appear black on x-ray. Commonly used gases, O2, room air, CO2,

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6
Q

Examples of common +VE contrast media

A

Barium

Water soluble iodine

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7
Q

Barium

A

Micropaque - powder, paste or solution

Used in GI tract

Adv - inert, insoluble

Dis- may cause a foreign body reaction if leaks

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8
Q

Water soluble iodine - Most common

A

Conray

Gastro-conray

Urografin

Gastrogafin

Hypaque

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9
Q

Water soluble iodine - Features

A

Hypertonic

Soluble

Following IV - excreted via kidney

Can use direct into lower urinary tract

Can use direct into GIT (not as effective as barium but can use if GI rupture)

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10
Q

Water soluble iodine- side effects

A

IV may cause fall in blood pressure or anaphylactic reaction

If animal conscious may cause whining or retching

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11
Q

Lower osmolar ionic media

A

e.g. Hexabrix

Fewer side effects than water soluble iodine

Better contrast in GIT than water soluble iodine

Not good for myelogram - draws water in and causes pressure

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12
Q

Lower osmolar non-ionic media

A

E.g. Omnipaque

Safe for myelography

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13
Q

Contrast radiography methods

A

Myelography

Gastrogram

Cystogram

Retrograde urography

IV urography

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14
Q

Myelography

A

Used to indicate lesions that are not detectable on ordinary x-rays

Indications- spinal pain, neurological signs, prolapsed invertebral discs

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15
Q

Myelography preperation of patient and equipment

A

Anaesthetised

Clip area (caudal to skull or lumbar spine)

Spinal needle (20-22g)

Warmed contrast media

Check dose ( variations between cisternal tap and lumbar tap)

Syringe

Sample bottle for CSF

Aid to elevate head

Surgical scrub

Sterile gloves

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16
Q

Myelography method of restraint

A

GA essential

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17
Q

Myelography method

A

Cisterna Magna puncture (most common for myelogram)

Lumbar puncture

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18
Q

Cisterna magna puncture method

A

Elevate table to about 10 degree of tilt

Clip and surgically clean site

Head flexed 90degrees to spine

VS inserts needle between skull and atlas vertebra

Advance needle slowly until CSF drips out

CSF for cytology analysis

inject warm contrast media slowly 1min

Patient must not move for injection/while spinal needle is in place

Needle removed and head extended again

Head to remain elevated until completely recovered

19
Q

X-rays

A

Sequential lateral to follow media

VD when lesion identified

Same for lumbar puncture

20
Q

Upper Gastrointestinal study

A

to evaluate the stomach and small intestines

Indicated for patients;
V+
Abnormal bowel movements
Suspected FB or obstruction
Chronic weight loss
Persistant abdominal pain
21
Q

Upper Gastrointestinal study contrast media

A

Orally administered via stomach tube

Barium sulphate normally used (+ve CM)

Water soluble iodine to be used if intestinal perforation is suspected

both +ve and -ve contrast media can be used

22
Q

Upper Gastrointestinal study equipment

A

Stomach tube

Large syringe

Water soluble iodine

Lubricant

23
Q

Upper Gastrointestinal study patient preperation

A

Fast for 24 hours

Enema day before, 4hrs before and 1hour before

Sedate if necessary (suggested sedative ACP)

glucagon (GI hypotonic agent that induces hypomobility)

GA slows gut

Atropine slows gut

24
Q

Upper Gastrointestinal study procedure

A

Survey radiographs to be taken

Administer barium (or water soluble iodine if suspect perforation)

Place contrast media using syring into patients mouth allowing to swallow OR orogastric tube

(small amount water infused to check placement - will couch if incorrectly placed)

25
Upper Gastrointestinal study radiographs to be taken
DV, VD, R lateral, L lateral Take immediately after CM administration Take at 15, 30, 60 and 90 minute intervals
26
Pneumocystography
Contrast media is air or gas such as carbon dioxide
27
Pneumocystography air/gas dosage
Small dogs/cats - 35ml Larger dogs - 50 - 300ml
28
Pneumocystography precautions
Palpate bladder whilst administering gas to prevent rupture/ over distention Patient to be placed in L lateral recumbency to administer - reduces risk of air embolism
29
Pneumocystography equipment
``` Urinary catheter 3 way tap syringes sterile lubricant sterile spray/germicidal soap prep gauze 2% lidocaine or GA/sedation sterile gloves otoscope speculum kidney dish ```
30
Pneumocystography patient preperation
Fasted 12-24hrs Enema at least 4hrs prior to exam Sedated/anaesthetised Abdo imaging should be taken prior to sedation/GA
31
Pneumocystography procedure
R lat and VD views of abdomen External areas cleaned w appropriate solution sterile lubricant to catheter Insert catheter aseptically lidocain into bladder (dog 3-5ml, cat 2-5ml) place in L lat recumbency administer air or gas Bladder palpated to avoid over distension L lat, VD and oblique views of bladder
32
Double cystography contrast media
gas/air water sol iodine
33
Double cystography precautions
(same as pneumocystogram) Palpate bladder whilst administering gas to prevent rupture/ over distention Patient to be placed in L lateral recumbency to administer - reduces risk of air embolism
34
Double cystography precautions
(same as pneumocystogram) Palpate bladder whilst administering gas to prevent rupture/ over distention Patient to be placed in L lateral recumbency to administer - reduces risk of air embolism
35
Double cystography equipment
``` Urinary catheter 3 way tap syringes sterile lubricant skin prep solution gauze 2% lidocaine sterile gloves Otoscope speculum Kidney dish Water sol iodine ```
36
Double cystography patient prep
Fasted 12-24hrs Enema at least 4 hrs prior to exam GA / sedation Abdominal images should be taken prior to GA/sedation
37
Double cystography procedure
R lat and VD views of abdomen External areas cleaned w appropriate solution sterile lubricant to catheter Insert catheter aseptically lidocain into bladder (dog 3-5ml, cat 2-5ml) place in L lat recumbency administer air or gas Bladder palpated to avoid over distension L lat, VD and oblique views of bladder
38
Double cystography indications
Haematauria Dysuria Infection Bladder rupture Anuria Calculi
39
Angiocardiography
congential/aquired cardiac disease GA required CM injected into jugular/cephalic vein or directly into heart chambers via catheters into jugular vein and carotid/femoral arteries Several radiographs taken
40
Portal venography
Liver disease GA laparotomy perfomed and splenic or mesentric vein cannulated Iodine CM is injected as a bolus A normal liver will show the CM entering through the portal vein & through liver (branching)
41
Bronchography
Viscous iodine Patient is anaesthetised and placed in lat recumbency with side to be investigated downwards CM injected through ET tube Will show parasites, FB an tumours
42
Arthrogrophy
-ve, +ve or double CM used GA required as painful Will show joint distension or rupture and defects in the joint cartilage Most commonly used in the shoulder of the dog (1-1.5ml iodine) to demonstrate OCD
43
Fistulography
Will show up sinus tracts and fistulae using water soluble iodine Used to show extent of damage and whether there are any foreign bodies