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Questions and Answers
What is the primary parameter that affects contrast in radiography?
What is the primary parameter that affects contrast in radiography?
What is the result of using low kVp in radiography?
What is the result of using low kVp in radiography?
What is the study of the biochemical and physiological effects of a drug called?
What is the study of the biochemical and physiological effects of a drug called?
What is the percentage of non-ionic intravenous contrast media eliminated within 4 hours?
What is the percentage of non-ionic intravenous contrast media eliminated within 4 hours?
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What is the purpose of administering contrast media to a patient?
What is the purpose of administering contrast media to a patient?
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What is the result of increasing the thickness of anatomy in radiography?
What is the result of increasing the thickness of anatomy in radiography?
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What is the purpose of using grids or air gap technique in radiography?
What is the purpose of using grids or air gap technique in radiography?
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What is the study of the movement of a drug in the body called?
What is the study of the movement of a drug in the body called?
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What type of contrast media is used to image the GI tract?
What type of contrast media is used to image the GI tract?
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What type of contrast media is radiolucent and appears black on an image?
What type of contrast media is radiolucent and appears black on an image?
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What type of contrast media is used in MRI and administered intravenously?
What type of contrast media is used in MRI and administered intravenously?
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What is the effect of high Z elements in contrast media?
What is the effect of high Z elements in contrast media?
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What is the advantage of using double contrast agent techniques?
What is the advantage of using double contrast agent techniques?
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What is the effect of Gadolinium on MRI signal intensity?
What is the effect of Gadolinium on MRI signal intensity?
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What should you do if a patient experiences sensations after a contrast media examination?
What should you do if a patient experiences sensations after a contrast media examination?
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What percentage of contrast reactions occur within 5 minutes?
What percentage of contrast reactions occur within 5 minutes?
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Why is it essential to screen patients before a contrast media examination?
Why is it essential to screen patients before a contrast media examination?
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What should you do if a patient is experiencing an allergic reaction to the contrast media?
What should you do if a patient is experiencing an allergic reaction to the contrast media?
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Why is it important to have an emergency trolley nearby during a contrast media examination?
Why is it important to have an emergency trolley nearby during a contrast media examination?
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What is the environmental concern related to contrast media?
What is the environmental concern related to contrast media?
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What is the primary characteristic of gas filled microbubbles that makes them useful in medical imaging?
What is the primary characteristic of gas filled microbubbles that makes them useful in medical imaging?
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What is the primary advantage of using low osmolarity contrast media?
What is the primary advantage of using low osmolarity contrast media?
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What is the primary purpose of introducing contrast media directly into the site?
What is the primary purpose of introducing contrast media directly into the site?
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What is the primary difference between barium sulphate and gastrografin?
What is the primary difference between barium sulphate and gastrografin?
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What is the primary purpose of using a pressure injector in CT imaging?
What is the primary purpose of using a pressure injector in CT imaging?
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What is the primary risk associated with extravasation of contrast media?
What is the primary risk associated with extravasation of contrast media?
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What is the primary advantage of using digital subtracted angiography in intra-arterial imaging?
What is the primary advantage of using digital subtracted angiography in intra-arterial imaging?
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What is the primary characteristic of an ideal contrast media?
What is the primary characteristic of an ideal contrast media?
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What is the primary classification of a reaction to contrast media that includes symptoms such as chills, sweats, and nausea?
What is the primary classification of a reaction to contrast media that includes symptoms such as chills, sweats, and nausea?
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What is the primary purpose of performing a venipuncture or cannulation in contrast media administration?
What is the primary purpose of performing a venipuncture or cannulation in contrast media administration?
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What is the primary mechanism by which iodinated compounds produce contrast in imaging the blood vessels, urinary tract, and biliary ducts?
What is the primary mechanism by which iodinated compounds produce contrast in imaging the blood vessels, urinary tract, and biliary ducts?
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How do double contrast agent techniques enhance the diagnostic quality of images?
How do double contrast agent techniques enhance the diagnostic quality of images?
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What is the role of Gadolinium in MRI imaging?
What is the role of Gadolinium in MRI imaging?
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Why are positive contrast agents, such as barium sulphate, preferred for imaging the GI tract?
Why are positive contrast agents, such as barium sulphate, preferred for imaging the GI tract?
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What is the advantage of using low-Z elements in contrast media?
What is the advantage of using low-Z elements in contrast media?
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How do positive and negative contrast agents work together to enhance image quality?
How do positive and negative contrast agents work together to enhance image quality?
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What is the fundamental difference between subject contrast and image contrast in radiography, and how do these two concepts interact to produce the final image?
What is the fundamental difference between subject contrast and image contrast in radiography, and how do these two concepts interact to produce the final image?
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How does the density and thickness of anatomy affect subject contrast, and what implication does this have for radiographic imaging?
How does the density and thickness of anatomy affect subject contrast, and what implication does this have for radiographic imaging?
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What is the role of Compton scatter in radiography, and how can it be reduced to improve image quality?
What is the role of Compton scatter in radiography, and how can it be reduced to improve image quality?
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What is the relationship between kVp and contrast in radiography, and how does this impact the final image?
What is the relationship between kVp and contrast in radiography, and how does this impact the final image?
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What is the primary difference between pharmacodynamics and pharmacokinetics in the context of contrast media, and how do these concepts relate to radiographic imaging?
What is the primary difference between pharmacodynamics and pharmacokinetics in the context of contrast media, and how do these concepts relate to radiographic imaging?
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What is the role of contrast media in radiography, and how does it interact with the body to produce diagnostic images?
What is the role of contrast media in radiography, and how does it interact with the body to produce diagnostic images?
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How does beam strength affect radiographic contrast, and what implications does this have for image quality?
How does beam strength affect radiographic contrast, and what implications does this have for image quality?
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What is the relationship between windowing and image contrast in radiography, and how does this impact the final image?
What is the relationship between windowing and image contrast in radiography, and how does this impact the final image?
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What is the primary characteristic of gas filled microbubbles that makes them useful in medical imaging?
What is the primary characteristic of gas filled microbubbles that makes them useful in medical imaging?
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What is the difference between high and low osmolarity contrast media?
What is the difference between high and low osmolarity contrast media?
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What are the advantages of using gastrografin as an oral contrast agent?
What are the advantages of using gastrografin as an oral contrast agent?
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What are the potential risks associated with extravasation of contrast media?
What are the potential risks associated with extravasation of contrast media?
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What is the primary purpose of using a pressure injector in CT imaging?
What is the primary purpose of using a pressure injector in CT imaging?
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What is the primary classification of a reaction to contrast media that includes symptoms such as chills, sweats, and nausea?
What is the primary classification of a reaction to contrast media that includes symptoms such as chills, sweats, and nausea?
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What is the primary characteristic of an ideal contrast media?
What is the primary characteristic of an ideal contrast media?
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What is the primary purpose of introducing contrast media directly into the site?
What is the primary purpose of introducing contrast media directly into the site?
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What is the primary advantage of using digital subtracted angiography in intra-arterial imaging?
What is the primary advantage of using digital subtracted angiography in intra-arterial imaging?
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What is the primary risk associated with injection of contrast media into a blood vessel?
What is the primary risk associated with injection of contrast media into a blood vessel?
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What is the primary concern for medical staff when a patient experiences sensations after a contrast media examination?
What is the primary concern for medical staff when a patient experiences sensations after a contrast media examination?
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What is the percentage of contrast reactions that occur within 5 minutes?
What is the percentage of contrast reactions that occur within 5 minutes?
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What is the primary purpose of screening patients before a contrast media examination?
What is the primary purpose of screening patients before a contrast media examination?
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What is the environmental concern related to contrast media?
What is the environmental concern related to contrast media?
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What should medical staff do if a patient experiences an allergic reaction to contrast media?
What should medical staff do if a patient experiences an allergic reaction to contrast media?
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Why is it essential to have an emergency trolley nearby during a contrast media examination?
Why is it essential to have an emergency trolley nearby during a contrast media examination?
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Study Notes
Contrast in Imaging
- We use contrast in imaging to distinguish between bones and tissue and to highlight different pathologies by changing differential absorption using contrast media.
Subject and Image Contrast
- Subject contrast is caused by the difference in density of surrounding tissue and cannot be changed, whereas image contrast is what is displayed on the image and can be modified using windowing, etc.
Factors Affecting Subject Contrast
- Density and thickness of anatomy affect subject contrast.
- kVp controls contrast, with low kVp increasing contrast and resulting in better subject contrast.
- Beam strength also affects contrast, with a lower beam strength resulting in increased contrast.
Negatively Impacting Contrast
- Compton scatter negatively impacts contrast and can be reduced using grids or air gap technique or collimation.
- Contrast media can be administered to patients to see densities more clearly, especially in areas of low subject contrast.
Pharmacodynamics and Pharmacokinetics
- Pharmacodynamics is the study of the biochemical and physiological effects of a drug on the body.
- Pharmacokinetics is the study of the absorption, distribution, metabolism, and excretion of a drug by the body.
Types of Contrast Media
- Positive contrast media include radiopaque materials like barium and iodine, which appear white on images.
- Negative contrast media include radiolucent materials like air, which appear black on images.
- Double contrast agent techniques use both positive and negative contrast media to increase clarity.
Administration of Contrast Media
- Contrast media can be introduced intravenously, orally, or directly into the site using a canula.
- Oral administration includes barium meals and small bowel follow-through, with careful timing and mixing with flavouring to make it easier to drink.
- Injected contrast media include iodinated compounds and gadolinium, which are administered intravenously or intra-arterially.
Ideal Properties of Contrast Media
- Ideal contrast media should be non-toxic, inert, stable, physiologically inert, and produce adequate radiographic contrast, with low osmolarity and suitable viscosity and persistence.
Reactions to Contrast Media
- Reactions to contrast media can be mild, moderate, severe, or delayed, with symptoms ranging from chills and sneezing to cardiac arrest and respiratory arrest.
- Management of reactions involves discontinuing injection, remaining calm, and following department protocol.
Precautions and Sustainability
- Precautions include screening patients through questionnaires, informed consent, and checking contrast media contents and route of administration.
- Sustainability efforts include proper disposal of unused contrast media and reducing waste.
- Data shows that contrast media can be found in sewage water, surface water, and drinking water, highlighting the need for sustainable practices.
Contrast in Imaging
- Contrast is used to distinguish between bones and tissue and different pathologies in imaging.
- Contrast media changes the differential absorption of X-rays to enhance image quality.
Types of Contrast
- Positive Contrast Media: • Radiopaque, white on X-rays, high Z (atomic number) • Examples: Barium (Z=56), Iodine (Z=53) • Increases beam attenuation, producing areas of decreased density on the image • Used for imaging GI tract, blood vessels, urinary tract, and biliary ducts
- Negative Contrast Media: • Radiolucent, black on images, low Z • Examples: Air, oxygen, gas-producing tablets • Appears black on image, sometimes used with positive contrast for increased clarity
- Double Contrast Agent Techniques: • Easier to pick up pathology, higher contrast • Used in combination with positive and negative contrast media
Pharmacodynamics and Pharmacokinetics
- Pharmacodynamics: • Study of the biochemical and physiological effects of a drug on the body • What the drug does to the body
- Pharmacokinetics: • Study of the absorption, distribution, metabolism, and excretion of a drug • What the body does with the contrast agent
Introduction of Contrast Media
- Methods of Introduction: • Intravenous injection • Orally (barium meal, Ba swallow, small bowel follow-through) • Introduced directly into the site (canula, etc.)
- Pros and Cons of Oral Contrast Media: • Barium sulphate: high attenuation, not water soluble, may cause allergic reactions • Gastrografin: safe for patients with bowel perforation, bitter flavor, can be mixed with flavoring
Contrast Media in Clinical Settings
- Gadolinium: • Used in MRI • Administered intravenously • Interacts with nearby water molecules to affect signal intensity • Brighter signal on MRI, eliminated from the body through kidneys
- Gas-filled Microbubbles: • Used in US • Injected gas, high degree of echogenicity • Structures with high echogenicity appear brighter • Dissolve in 10-15 minutes
Ideal Properties of Contrast Media
- Non-toxic
- Inert
- Stable compound
- Physiologically inert
- Produces adequate radiographic contrast
- Low osmolarity
- Suitable viscosity
- Suitable persistence
- Miscibility (homogenous)
Reactions to Contrast Media
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Classification:
- Mild: localized reactions (chills, sweats, nausea, vomiting, headaches)
- Moderate: widespread reactions (hives, severe vomiting, respiratory systems, edema, vasovagal attacks)
- Severe: life-threatening reactions (cardiac arrest, hypovolaemic shock, respiratory arrest, convulsion)
- Delayed: reactions occurring after 1 week or 1 hour
- Management: • Discontinue injection • Remain calm • Follow department protocol • Alert for assistance • Have easy access to emergency trolley
Precautions and Sustainability
- Precautions: • Screening of patients through questionnaire • Informed consent • Check contents of contrast media, volume, exp, date, and route of administration • Leave canula in the arm through injection • Observe start • Maintain visual of patient throughout scan • Ensure emergency trolley available • React if reaction occurs
- Sustainability: • Approx 300 million CT scans per year, 40% contrast-enhanced • Data shows contrast media is found in sewage water, surface water, and drinking water in many regions • Unused contrast media should have proper disposal • Need to find sustainable solutions for contrast media use
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Description
Understanding the importance of contrast in imaging, how it enhances differentiation between bones and tissue, and its role in pathology diagnosis. Learn about subject and image contrast, and how they differ.