Contrast Studies

Question 1

What are the three most commonly performed contrast studies?

Answer 1

GI, urogenital, spinal cord

Question 2

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

Answer 2

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

Question 3

What are the four types of contrast agents commonly used?

Answer 3

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

Question 4

What are examples of soluble ionic radiopaque mediums?

Answer 4

Iothalamate, diatrizoate

Question 5

What are examples of soluble nonionic radiopaque mediums?

Answer 5

Iohexol, iopamidol

Question 6

What is an example of insoluble inert radiopaque mediums?

Answer 6

barium sulfate

Question 7

What are examples of radiolucent gases?

Answer 7

air, nitrous oxide, carbon dioxide

Question 8

Soluble ionic mediums are _________

Answer 8

negatively charged benzoic acid derivatives

Question 9

What are soluble ionic mediums used for?

Answer 9

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

Question 10

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

Answer 10

dehydrated patients
patients that are sensitive to iodine

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

Question 11

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

Answer 11

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

Question 12

Soluble ionic mediums are _____ contrast agents

Answer 12

positive

Question 13

What studies can be performed using nonionic radiopaque agents?

Answer 13

spinal cord or respiratory tract, myelography

Question 14

What are examples of soluble nonionic mediums?

Answer 14

iohexol, iopamidol

Question 15

What is a benefit associated with nonionic mediums?

Answer 15

lower incidence of adverse effects & a lower osmolality

Question 16

Nonionic agents are ______ contrast agent

Answer 16

Positive

Question 17

What does BIPS stand for?

Answer 17

Barium impregnated polyethylene spheres

Question 18

Barium is a more ________ solution than the surrounding tissue

Answer 18

dense

Question 19

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

Answer 19

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

Question 20

What are the benefits of barium suspension?

Answer 20

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

Question 21

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

Answer 21

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

Question 22

What are two systems used to measure barium suspension?

Answer 22

1. weight to volume (w/v)
2. weight to weight (w/w)

Question 23

Insoluble agents are ______ contrast agents

Answer 23

positive

Question 24

What forms does barium come in?

Answer 24

paste, liquid, powder

Question 25

What study is the barium paste used for?

Answer 25

esophagography studies

Question 26

Why is barium paste used for esophagography studies?

Answer 26

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

Question 27

What type of patients should barium not be used for?

Answer 27

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

Question 28

How should barium be administered if not evaluating the esophagus?

Answer 28

via orogastric tube to decrease risk of aspiration

Question 29

What is the drawback of powder barium?

Answer 29

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

Question 30

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

Answer 30

liquid and paste (better than powder)

Question 31

When are BIPS used?

Answer 31

used to determine if a motility issue is present

Question 32

What are BIPS related to in terms of structure?

Answer 32

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

Question 33

What form does BIPS come in?

Answer 33

capsule

Question 34

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

Answer 34

True

Question 35

Can BIPS be given with our without food?

Answer 35

both

Question 36

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

Answer 36

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

Question 37

What is the purpose of small BIPS?

Answer 37

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

Question 38

What is the purpose of large BIPS?

Answer 38

determine if there is a potential obstruction in the GI tract

Question 39

What does BIPS offer an evaluation of besides motility?

Answer 39

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

Question 40

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

Answer 40

True

Question 41

Radiolucent gases are ____ contrast agents

Answer 41

Negative

Question 42

What affect does radiolucent gases have on radiographs?

Answer 42

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

Question 43

What do negative contrast agents normally combine with?

Answer 43

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

Question 44

What is a double contrast study?

Answer 44

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

Question 45

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

Answer 45

less

Question 46

When should care be taken when using negative contrast agents?

Answer 46

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

Question 47

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

Answer 47

CO2 and Nitrous Oxide Because use of room air can produce an air embolism that can result in cardiac arrest

Question 48

What is an esophagography?

Answer 48

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

Question 49

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

Answer 49

Standing (less risk of aspiration)

Question 50

What else should be performed when doing a esophagography?

Answer 50

Fluoroscopy

Question 51

Why would an esophagography be performed?

Answer 51

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

Question 52

What media is used for esophagography?

Answer 52

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