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Most Common Contrast Studies in Radiology Basic Principles for interpretation Robert Cruz, DVM, MS Basic Radiographic Opacities Radiographic image: produced by the aftermath obtained when x ray goes through the body part: penetration and absorption, hence==  What you got??

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most common contrast studies in radiology basic principles for interpretation

Most Common Contrast Studies in RadiologyBasic Principles for interpretation

Robert Cruz, DVM, MS

basic radiographic opacities
Basic Radiographic Opacities
  • Radiographic image: produced by the aftermath obtained when x ray goes through the body part: penetration and absorption, hence== What you got??
  • Basic radiographic opacities

Air Fat Water/ST Bone Metal/+Contrast

BLACKGRAY- GRAY - GRAY WHITE

contrast radiography
Contrast Radiography
  • Group of radiographic procedures performed by administration of a contrast medium
  • Contrast medium: positive (absorb X rays =radiopaque) or negative (do not absorb X – rays, then radiolucent)
  • What for??
    • Visualization of individual organs
    • Enhance lesions in a particular organ
    • Some physiologic information
    • Always performed after a survey radiograph
contrast media
Contrast Media
  • Positive
    • Barium (inert, no hypertonic, no metabolized or absorbed)
      • Liquid
      • Paste
    • Iodine: Tri – iodinated derivatives of benzoic acid
      • Ionic
      • Non – ionic
  • Negative
    • Air room
    • Carbon dioxide
    • Nitrous oxide
contrast studies for the gi tract
Contrast studies for the GI tract
  • Esophagogram, esophagram, esophogram
    • Indications:
      • Suspected esophageal disease
      • Confirm questionable findings on survey rads
      • Esophageal motility
    • Procedure
      • Survey rads
      • Sedation not recommended (Acepromazine)
    • Interpretation
      • No distention, you can see the bolus
      • Longitudinal folds and herringbone pattern (cats)
gastrography
Gastrography
  • Indications
    • Suspected gastric wall lesion
    • Gastric location
    • Pyloric obstruction (check on fluoroscopy)
  • Procedure
    • Double contrast study (barium + air)
      • Good for gastric mucosa
    • Single contrast (either barium or air – pneumogastrogram -)
      • Barium: good for gastric motility
      • Air: hunt for foreign body
  • Interpretation
    • Position
    • Rugal folds
    • Motility (gastric emptying) (follow with fluoroscopy/contractions)
upper gi study series
Upper GI Study (Series)
  • Indications
    • Size, shape, mucosa of SI
    • Suspect of SI disease
    • Diagnosis of obstruction
  • Contraindication
    • Barium if suspected rupture of hollow viscous, use iodine (ionic) instead
  • Procedure
    • Preparation
  • Interpretation
    • Lumen diameter
    • Mucosa
contrast studies for the urinary tract
Contrast Studies for the Urinary Tract
  • Excretory Urography (EU) – Intravenous Pyelogram (IVP) – Intravenous Urography (IVU)
    • Indications
      • Evaluate kidney morphology – position. Ureters.
      • Suspected renal disease
      • Increased radiopacity in the retroperitoneal space
      • Gross idea of kidney function
    • Procedure
      • Preparation required (24 h fasting; enema)
      • IV access/dose
      • Radiographic views
excretory urography eu intravenous pyelogram cont d
Excretory Urography (EU) – Intravenous Pyelogram (cont’d)
  • Interpretation
    • Vascular phase
      • 5 – 10 sec
    • Nephrogram phase
      • 1 – 2 min
      • Normal pattern: Initial=Good, then=gradual decrease
      • Abnormal patterns:
        • Poor – persistent
        • Poor – continued decrease
        • Poor – continued increase
        • Good – continued increase
    • Pyelogram phase
cystography
Cystography
  • Indications
    • Suspected bladder disease
    • Caudal abdominal mass
    • Bladder rupture
    • Persistent dysuria /hematuria /stranguria
    • Congenital anomalies
  • Procedure
    • 24 hour fast – enema
    • Empty bladder
    • Four views
    • Positive contrast
    • Double contrast
    • Negative contrast (pneumocystogram)
    • “Paddle” or compression technique
cystography24
Cystography
  • Interpretation
urethrography
Urethrography
  • Indications
    • Investigate stranguria / hematuria / dysuria
    • Urethral rupture
    • Malformations
  • Procedure
    • Positive contrast medium (iodine)
    • Vaginourethrography
  • Interpretation
mielografia
Mielografia
  • Injeccion de medio de contraste en el espacio subaracnoideo
  • Medio de contraste: iodado/no ionico: Iopamidol o Iohexol (Omnipaque)
    • Sito de injeccion: L5 – L6 (mas recomendado), no exito = tratar L6 – L7 => no exito tratar L4 – L5