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Unique Clinical Scenarios

question1. The patient has sickle cell disease. Can they get IV contrast?
question2. The patient has multiple myeloma. Can they get IV contrast material?
question3. If a patient has thyroid disease is iodinated contrast contraindicated?
question4. If a patient has thyroid cancer is iodinated contrast contraindicated?
question5. If a patient has myathenia gravis should iodinated contrast be used for a chest CT?
question6. If a patient is on glucophage (or other oral diabetes medications) is there an issue with iodinated contrast agents? What is the current rule with oral diabetes drugs? (glucophage)
question7. What patients take glucophage (metformin)?
question8. What is the danger of Metformin and iodinated contrast?
question9. What are the other names for metformin?
question10. What are the current guidelines for patients taking metformin and needing a contrast study?
question11. Is there any problem with using iodinated contrast for CT if a patient is on the cardiac drug Amiodarone?
question12. Can you use iodinated contrast on a patient with suspected or known pheochromocytoma?
question13. If a patient is nursing can she receive IV contrast?
questionThe answer as shown from the best available literature is yes but if a patient is apprehensive then a 24 hour delay would be advisable.

"Because of the very small percentage of iodinated contrast medium that is excreted into the breast milk and absorbed by the infants gut, we believe that the available data suggest that it is safe for the mother and infant to continue breast feeding after receiving such an agent."

Manuel on Contrast Media 
ACR Version 5.0

"If the mother remains concerned about any potential ill affects to the infant, she may abstain from breast feeding for 24 hours with active expression and discarding of breast milk from both breast during that period."

Manuel on Contrast Media
ACR Version 5.0

"Consequently the use of iodinated contrast agents in nursing mothers is considered safe."

Guidelines for Use of Medical Imaging During Pregnancy and Lactation Tremblay E et al.
RadioGraphics 2012; 32:897-911
question14. What is our policy for scanning a pregnant patient?
question15. If a CT is done on a pregnant patient and iodinated contrast is used can that affect the fetus?
question16. Who should get baseline serum creatinine levels before CT?

 

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