CONTRAST STUDIES

By: Dr. Elias k.

 Contrast imaging studies
• Objective of this session
Why contrast agents are used
What are the desirable features of a contrast
agent
Types of contrast agents used in clinical settings
Methods of administrating contrast agents into
different organs
Problems/issues associated with administration of
contrast agents
 contrast
• The difference in optical density between
different parts of an image on a radiograph.
 Why we use contrast agents?
• Radiocontrast - used to improve the visibility of internal
bodily structures in an X-ray based imaging techniques – can
increase or decrease the density of the given structure.

• Different tissues within the body attenuate the beam of x-

rays to different degrees.
• The degree of attenuation of an x-ray beam can be varied, by
the number of electrons encountered along the beam’s path.
• Fundamentally the number of electrons in the path of the
beam is dependent upon:
The thickness of the object being studied
The density of the object being studied
The number of electrons per atom of the elements
 Types of contrast media
1. Negative contrast agents:
These agents reduce the atomic number of the area to be
demonstrated. They will have little attenuation of the x-
ray beam
• Air , CO2 & O2
2. Positive contrast agents:
Increase the atomic number of the area to be
demonstrated.
A. Barium based
B. Iodine based agents:
Water-soluble: ionic & non-ionic
Water-insoluble :
 Oil soluble
Contrast agent used for MRI: Gadolinium-
Diethylenetriaminepentaacetic acid (Gd-
DTPA).
 Water soluble contrast agents

a) ionic (HOCM): dissociate in solution

-sodium cation
-iodine containing anion
 cause more side effects, therefore it is not in use intravenously
anymore, however, it is used for enterography routinely.
b) non-ionic (LOCM):
• Compounds that don’t ionize in solution
• They are generally used for intravenous and intra-arterial
administration because they are safer. They causing fewer side
effects
 Non-iodinated contrast media

1.Barium preparation: mainstay for radiographic examination

of GIT
 Mode of administration: oral or rectal
 Properties:
 High atomic weight
 It is finely pulverized barium mixed with dispersing agents
and suspended in water.
Side effects:
a. Causes desmoplastic reaction when extravasated
b. Behind an obstruction it compounds patient’s problem
 Double contrast agents
• Incorporates the use of both positive &
negative contrast media. Eg. During a
double contrast Ba enema examination.
 air + BaSo4
 Types of Contrast examination
1.Ba studies:
• Single contrast => Ba suspension
• Double contrast=> Ba suspension+air
Types barium study : Barium swallow, barium
meal, barium followthrough,and barium enema
2.GB study ( cholecystography)
3.Urography : IVU, retrograde pyelography, voiding
cystouretherography and retrograde
urethrography
4. Hysterosalpingography
5. Sinogram (fistulogram)
Cont….
6. Angiography/cardioangiography
7. Lymphangiography
8. Myelography
9.Bronchography
10.Sialography
11. Arthrography
Barium meal.
Double contrast barium enema.
Single contrast barium enema
Barium swallow
IVP
CUG
Hysterosalpingography
Coronary angiography
Carotid angio
type cardiovas respirat cutane GI nervo urina
cular ory ous us ry

mild pallor
diaphoresis
sneezing
coughing
erythema nausea anxiety
feeling of- vomitin headache
tachycardia rhinorrhea warmth g dizziness
metallic
-taste

intermid bradycardia
palpitations
wheezing
acute -
urticaria
pruritis
abdomi
nal
agitation
vertigo
oliguria

iate hypotension asthma

attack
crump
diarrho
slurred
speech
ea

severe acute
pulmonary
laryngospasm angioneuro paralytic
cyanosis tic edema ileus
disorientati ARF
on
edema laryngeal stupor
shock edema coma
CHF, cardiac arr. apnea convulsions
Thank you