CONTRAST AGENTS

CONTRAST
MEDIA

Doc Vanikah Feliciano

Definition: an agent that, when introduced, aids in
visualizing/imaging an internal organ/ structure
Mode of Administration:
Orally
Parenterally
o Topical
o Subcutaneous
o Intradermal
o Intramuscular
o Intravenous
o intrathecal

Radiopaque/
Positive
Barium
Sulfate

Radioluscent/
Negative

Iodinated

Oil-based

Water-based

non-ionic

ionic

RADIOPAQUE
- Higher atomic number
- Greater absorption of X-ray photons
- Greater density of structure
- Higher radiographic contrast
RADIOLUSCENT
- Lesser atomic number
- Lesser absorption of X-ray photons
- Lesser density of structure
- Higher radiographic contrast
Purpose:
To artificially increase subject contrast in body
tissue/areas where there is little natural subject
contrast

DOUBLE CONTRAST STUDIES

Radiopaque/Positive
Radiolucent/Negative
To coat the various parts To fill the spaces
under study
To permit visualization
through the gaseous
medium

Barium enema

BARIUM SULFATE
Suspension
o Orally: UGIS
o Rectally: LIS
Perforation: a contraindication

PERITONITIS
Barium + Intestinal content VS sterile barium
peritonitis
o 50% mortality
The logical treatment:
- Antibiotics: fecal contamination
- Parenteral fluids: hypovolemia
- Early operation: treat perforation and
removal of barium sulfate (Copious
irrigation with normal saline + removal
of the greater omentum)

Inspissation
- To expect light-colored stools for the
next few days
- To drink plenty of fluids
- To increase fiber intake
MILD CONSTIPATION OBSTRUCTION

WATER-BASED
Urinary system
Vascular system
GB
GI tract, when barium sulfate is contraindicated
IONIC WATER-BASED CONTRAST
Higher osmolality:
- Higher number of particles in a given
amount of solution
NON-IONIC WATER-BASED CONTRAST
Low osmolality
Children
Elderly
Patients with renal diseases
Patients having a history of allergic reaction
to CM
Patient with multiple allergies
less injection discomfort
lower incidence of nausea, vomiting, CV
complications
cost: only disadvantage

OIL-BASED
- water soluble
- not readily absorbed by the body
- remain in the body tissue for lengthy periods of
time
lymphangiograms
Sialograms
Bronchograms

REACTIONS AND EMERGENCY SITUATIONS

Production of histamine
Mild reactions
-

Flushed appearance
Nausea
Vomiting
Metallic taste
Nasal congestion
Urticarial
An antihistamine
or epinephrine

Life-threatening
responses
Respiratory failure
Shock
Death

Anaphylactic reaction
(early symptoms)
- Itching of palms
and soles
- Wheezing
- Constriction of
the throat
- Dyspnea
- Dysphagia
- Hypotension
- Cardiopulmonary
arrest