Most Common Contrast Studies in Radiology Basic Principles for interpretation

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Most Common Contrast Studies in RadiologyBasic
Principles for interpretation

• Robert Cruz, DVM, MS

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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
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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

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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

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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)

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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)

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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

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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

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Excretory Urography (EU) Intravenous Pyelogram
(contd)

• Interpretation
• Vascular phase
• 5 10 sec
• Nephrogram phase
• 1 2 min
• Normal pattern InitialGood, thengradual
  decrease
• Abnormal patterns
• Poor persistent
• Poor continued decrease
• Poor continued increase
• Good continued increase
• Pyelogram phase

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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

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Cystography

• Interpretation

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Urethrography

• Indications
• Investigate stranguria / hematuria / dysuria
• Urethral rupture
• Malformations
• Procedure
• Positive contrast medium (iodine)
• Vaginourethrography
• Interpretation

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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 gt no exito tratar L4 L5

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Radiografias oblicuas ayudan a decidir derecho o
izq
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• More questions??