 | 1. Why do we use IV contrast material? |
 | IV contrast is a critical part of CT scanning regardless of the application. Some of the reasons we use IV contrast are listed below and a series of select case studies is also provided. I have provided an organ based approach to its use which gives sample situations but is not all inclusive.
IV Contrast Use: Clinical Applications Brain- define perfusion of the brain in the case of suspected stroke Chest- r/o the presence of a pulmonary embolism or aortic dissection Liver- help detect the presence of a liver mass and then determine whether the mass is benign or malignant Pancreas- detect the presence of a pancreatic tumor and then determine whether the mass is resectable Kidney- detect the presence of acute pyelonephritis or a renal neoplasm Small Bowel- detect the presence of ischemic bowel disease or inflammatory bowel disease
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| 2. Do you use serum creatinine levels or GFR in your practice for establishing risk prior to CT scanning? |
| 3. What is GFR and why is it a more accurate measure than simply getting a creatinine level? |
| 4. Why are GFR numbers different for Caucasians and African Americans? |
| 5. Are all CT scans with IV contrast done the same way? |
| 6. What type of IV contrast material do we use and why? |
| 7. At what temperature do we store IV contrast material? |
| 8. Why do you warm IV contrast? |
| 9. What is the advantage of Visipaque as written in the literature? |
| 10. When do you use Visipaque-320 and when Omnipaque-350? |
| 11. Does the concentration of contrast mean that higher concentrations are better (AKA-isn’t a higher number better)? |
| 12. What is the volume of IV contrast material we use? |
| 13. What patients are considered high risk patients for IV contrast for CIN? |
| 14. Do we have set cutoffs for creatinine levels and if so what are they? |
| 15. Can we pretreat patients who have borderline renal function? If yes then how? |
| 16. Should patients be NPO for CT scanning? If yes for how long? |
| 17. What are the common volumes of contrast used for IV injection? |
| 18. What kind of IV access is ideal for use for IV contrast injection? |
| 19. Has there been any new developments in technology that may help us high injection rates in patients who can not tolerate an 18g needle (or at times even a 20g)? |
| 20. Can any IV the patient has in place be used to inject the contrast material? |
| 21. Can we use a central line or a PICC line for injection? |
| 22. What about the new “purple PICC/central lines” I hear about? |
| 23. What are some of the common normal “side effects” of IV contrast agents? |
| 24. Is there a relationship between patients receiving chemotherapy and CIN? |
| 25. Is it ok for patients to have both an MR and a CT with contrast on the same day? |
| 26. Have you ever seen a patient develop diffuse erythema distal to the IV injection site in the absence of extravasation? |
| 27. Patients often report a metallic taste in their mouth following use of IV iodinated contrast. Is there an explanation? |
| 28. Are there any contrast volume limitations for the use of IV contrast? |
| 29. Can you tell me a bit more about GFR and what it really means? |
