Contrast media is a medical substance used to describe the contrast of a structure or fluid in the body in the context of shooting diagnostic. Therefore it is not possible to describe a particular anatomical structure image on the imaging technique itself can not generate or describe this information. This is usually used to reveal the presence of images such as blood vessels and gastrointestinal tract. Contrast media can be introduced into the body through the gastrointestinal tract (oral or rectal), in the blood vessel system (usually by intravenous or intra-arterial route) or directly into the duct or tract (eg, lymph vessels).
Here are generally three types of contrast medium. Among the contrast medium injected iodine and (it may also be taken by mouth), barium sulfate given by mouth or anus and Gadolinium is injected (typically used in MRI).
There are two types of contrast media used. Iodine is classified as non-ionic or ionic.ionic contrast media media in terms of higher osmolarity and more side effects such as urografin, telebrix, gastrografin and so forth. While non ionic contrast media, is lower in terms of osmolarity, and tend to provide less side effects, as omnipaque, ultravist, visipaque and so forth. Both types of contrast media are commonly used in radiology, because the effects are relatively harmless interaction the body of a man and it is something that can soluble. It primarily accustomed to giving effect to the changes in the tissues of the radiographic and CT and can also be used for testing urinary tract, uterus and tubes falopio.
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Agents other than iodine used for the procedure are angiography, venografi, VCUG (empty cystourethrography), HSG (hysterosalpinogram), IVU (intravenous urography) sulphat barium imaging is often used in the digestive system. Barium is shaped like a water-soluble white powder with water and given directly to the digestion channel. Barium types commonly used in radiological examinations are barium enema (an investigation of the large intestine) and DCBE (double contrast barium enema), barium swallow (inquiry oesophagel), barium meal (stomach inquiry) and double contrast barium meal, CT pnemocolon / virtual colonscopy. Side effect of contrast media are reactions are expected from the small, medium and so is the severe side effects, sometimes it can lead to death. The reaction is at a low level, side effects are common and if it happens it does not require further treatment because it will eventually disappear. Between the symptoms of side effects, the patient will feel warm or hot flush. Patients will also feel nausea, feel like vomiting or both. It can also cause temporary or irritation lasted for several days. If this occurs can be given antihistamine medicines. Patients with such conditions will get flu. Side effects were moderate. If the side this occurs, patients should be treated. Between the symptoms of this stage is a reaction effect urticaria hives on the skin. Patients may also experience difficulty breathing or bronkopasm. Blood pressure fell suddenly upon the injection of contrast medium. The last stage is the severe side effects. These side effects can be fatal to patients. Patients usually require intensive care. Between her symptoms were as patient heart stopped and the reaction of the anaphylactic shock that can not be expected (anaphylactic shock).
The procedure are the contrast medium affects the image through one of from the following ways. When a contrast medium is injected, the image of x-ray contrast medium appears white to meet anatomical structures like blood vessels or organs. So in the angiography examination, blood vessels may appear thicker or opaque when the x-ray pictures are taken. On computerized tomography, blood vessels and organs will be seen opaque. Contrast medium is then excreted by the kidneys and the urografy intravenous, urinary system and will look at the multitude color illustrations on how to do well in the x-ray images. This way, the various organs or anatomical structures can be seen and studied. When the contrast medium through the mouth (oral) in the form of barium meal, the stomach will look darker or white on x-ray film. So, when given in the form of barium enema through, the colon appeared more opaque or white in the x-ray film. This way, the colon can be viewed and studied. Gadolinium is a contrast medium injection during in magnetic imaging (MRI). contrast medium is a function of blood vessels and organs appear white in the MRI images. Modern intravenous contrast medium can be accepted by most patients because it is rapidly eliminated from the body without adverse side effects. Iodine containing contrast medium can cause a feeling of warmth when injected but in some cases, it causes nausea because the patient is advised not to take any food before the inspection that require contrast media. Rarely, iodine-based contrast medium can cause an allergic reaction. Contrast medium containing barium sulfate is not too dangerous. Barium will out of body system within a day or two. While, Gadolinium containing contrast medium is also likely to cause side effects. in between all the cases, the use of contrast medium for pregnant women is not advised because of the lack of conclusive evidence about how safe a pregnant woman to be given orally or injected contrast medium. However, if this type of inspection can safe lives, the risks that exist should be reconsidered with circumstances.
Follow up care patient, after contrast medium injected or given orally, confirm the patient is in stable condition.make sure no anaphylactic shock reactions. Patients are encouraged to drink plenty of water and make sure the patient is not in the state of dehydration. Most of the contrast medium will be out of the body systems most in 4 days. Right thing to note is patient, because after this examination, the patient will be white droppings cause of contrast medium (barium).
During the injection, the radiologist must know where the placed to be reached. Evaluate the patient’s vital signs and observe respiration, pulse, blood pressure, patient colour and level of conciousness. After the injection, remain with the patient for at least 15 minutes. Correct completion of all relevant information regarding the contrast agent used should be undertaken upon completion of any contrast administration must be included in the patient’s permanent medical record such as contrast medium used, volume administrated, density, batch number, who performed the injection and any adverse effects and any treatment or drug therapy given. Any adverse reactions should be reported to the manufacturing company to coordinate worldwide data collection on reactions and ensure a global perspective. When the examination is complete check that the patient is fit to travel home and do not allow them to leave if there is any doubt. If any concerns are identified the patient should be checked by a medic prior to leaving.
INTRAVENOUS UROGRAPHY
It can also be known as intravenous pyelography. Intravenous urography (IVU) is a test that uses x-rays and a special dye that can help to assess the anatomical structures that may be problematic in the kidney, ureter, bladder and urethra. Urinary tract can not be explained by either the x-ray image of the ordinary but with intravenous urography a contrast dye in the blood vessels get cle illustrates the image. After the contrast dye is facing istem bleeding in the body, it eventually will be concentrated in the kidneys and the discharge through the ureter and bladder and will be visible in white light in the x-ray images. X-ray contrast dye can not penetrate it, so that the image of the kidney or kidneys, ureters and bladder can be seen clearly in the x-ray images contrast with other structures. X-ray image produced is called an intravenous urogram (IVU) and also known as intravenous pyelogram (IVP).
This examination aims to assess the fatherly excretion and absorption of the structure of the kidneys or kidney, ureter, bladder and urethra. In addition, the size, shape and position of soft tissue around kidney will be shown. In this examination is to show any pathology or disturbance in the system through a series of radiograph is taken. Intravenous urography can estimate the various problems such as kidney stones in the kidney. A stone in the kidney or ureter will usually appear on the x-ray images clearly. Urinary infections that happened a long time back to the patient, an IVU examination may detect restriction (blockage) or other abnormalities in his urinary tract, blood in the urine. This may be caused by various types of infection, inflammation and tumor in the kidney. IVU examination may help to resolve the cause and the damage or disruption in any part of the urinary tract can be seen through examination of IVU.
Patient preparation, kidney patients should be able to filter out the dye. So rarely do if the patient has renal failure. Before the procedure performed, a blood test may need to be pushing to ensure that patients do not have kidney failure. Make sure patients do not have any allergies, especially allergies to contrast dye such as iodine. Advise patients not to take any food several hours before the examination is to ensure the patient’s colon of food that will prodecu image is clearer. Give the patient a laxative before examination. The goal is to ensure that the intestine is empty of food. Ask the patient signed a consent form fatherly ensure that patients understand this examination. This examination may cause side effects, but it is extremely rare. If an event occurs one in a million this is the best hospital for no charge. If the patient has diabetes and takes medication fomin met, ask the patient to stop taking the medication fatherly two days before the IVU examination. This is due to a combination of meth fomin and contrast dye may have a bad effect on the kidney (ask the patient to discuss with their doctors to manage diabetes more at this time).
Providing psychological groundwork and provide assurance to patients and a description of the techniques of this procedure. First,ask the patient to change to a hospital gown. Bladder is emptied before the examination. Then, ask the patient to urinate prior to inspection. Interviewing patients and examine the patient form. If the patient is a woman, asked about the 10-day rule. Whenever possible, make sure they are not pregnant before doing inspections.
The procedure is to ask the patients to change their clothes to the hospital gown and told them to lie down after changing clothes. Contrast media injection into a vein in the hand or arm (brachial vein). After the contrast dye is first filtered by the kidneys and the discharge into the ureter. A series of x-ray pictures will be taken in the abdomen, usually between 5-10 minutes. Fatherly x-ray images of the last patient to empty the bladder, is to see the difference and ensure that no contrast media is in the patient’s system. Examination usually takes about half an hour or an hour. Patients can go home after the examination and eat normally.
Follow up patient care, it is important to provide follow-up care to patients, because patients would be confused or not sure ask the interpreter fatherly x-ray. Is a must for an x-ray interpreters to provide public confidence in the psychology of the patient after the examination is conducted. Effects of the injection puncture patched and see if there are effects of extravasation and told the doctor to make further treatment. Extravasation is generally a liquid leaking from the container. In this case, blood leaking from blood vessels. Tell the patient how fatherly get results from this examination is to see their doctor at the date specified. Ensure that patients understand all instructions given by asking the patient to repeat what has been told. Sometimes patients do not understand what it is informed by fair to ask them to repeat what has been told. Lastly and most importantly, patients procession to the conversion of clothes and say goodbye.
Possible side effects of IVU examination. Side effects in the IVU examination was thin. This is because the contrast is characterized iodine. But it may have side effects on some people. Possible side effects such as irritation and moderate skin rashes and slight swelling of the lips. Severe side effects are rare and if it is symptom such patients have difficulty in breathing and fainting due to low blood pressure. It is asserted that the severe side effects are rare and, if applicable, the hospital department that does this procedure have a full recovery tool.
The sequence of the film: 1) preliminary film: 14×17 inches in size cassettes. It is a common KUB examinations. It is due to the level of the kidneys, bowel preparation the patient to see, looking at the appropriate exposure by contrast, sees the practice of pathology and patients to understand instructions for breathing and hold your breath. 2) immediate: 10×12 inches in size cassettes used and focused only on the kidney. Flow of contrast dye will travel through the blood vessels immediately after the injection in the brachial vein. In the immediate sequence of the film we can see the contrast dye flows and the expansion of the kidney because the kidney will be filled with the dye. 3) 5 minute film: the cassette size 10×12 inches. In the renal done. This is a fatherly sure if excretion in the kidney that are symmetrical. If the injection of contrast is less or a little more, an additional dose of contrast required. Or in other words, this film 5 minutes to determine the efficiency of the contrast. 4) compression view: the tape size 14×17 inches. This procedure requires a device called a compression tool. It will be used in this procedure to Compress or expand pelvicalyceal system to demonstrate that there are no defects. 5) Release: This procedure should be in alikasikan the accuracy of the optimum current besause contrast flowing from the junction urethropelvic the urethrovesical junction is the main reason for this release procedures. 6) post micturition film: need a cassette-sized 10x12inci. This Prodesur mnedemonstrasikan kontas removal media in the bladder and ureter. Before prodedur is done, patients are asked to urinate. This technique is centered caudal angle of 15 degrees centigrade 5 cm above the symphysis pubis on the border.
Barium enema
Lower gastrointestinal examinations, also known as double contrast barium enema or barium enema. It was a test in which a white liquid called barium to be delivered via a catheter (tube) inserted through the anus into the rectum so that the large bowel barium meet (large colon). Colon x-ray pictures are taken and illustrated what can be in the picture is the outline of the colon (large colon). Double contrast barium enema and barium enema is used to distinguish the normal anatomy of the large bowel abnormalities (large colon) and rectum. Purpose of this inspection was to review the nature and function of the colon and detect abnormalities in the large intestine. Barium enema is included in the study of the large intestine. There are risks in such an x-ray including the development of colon causes discomfort. Only some patients develop colon just feel hurt such an x-ray procedures involve some risk of radiation exposure. Minimize radiation exposure in a consistent technique in which it was developed and agreed upon by national and international committees and councils radiology. All x-ray interpreters are qualified to perform this procedure. Women who are pregnant or may become pregnant, should tell the doctor that requires them to do this procedure and the radiology staff because there is a risk that potential negative effects on the fetus. Complications caused by barium enema are rare. Tip catheter (tube) or the development of colon enema can reduce or penetrate the colon wall and increase the risk of infection or peritonitis (infection in the abdominal cavity). It is usually effective only when extreme pressure is used to barium.
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For the patient preparation, before the patient comes to testing for barium enema (lower GI), it is important for a patient to remove all fecal material from the colon and rectum (rectum) Blanket Guarantee to be because fecal material may confusing x-ray images and test the accuracy of barium enema.3 misleading days before the examination, patients typically begin to diet, bowel cleaned. A liquid diet or cleansing enema used to cleanse the colon.
Before the examination, the patient should not drink large amounts of gaseous, taking a combination laxative fatherly emptying the bowel and to take water enemas (cleansing enema) fatherly clear any residual fecal material in the colon. Patients will be advised about the types of foods that should be taken one day before the examination. Next, the patient will be asked to change clothes to the hospital gown.
For the preparation of contrast media, the instructions given by the manufacturer infusion of contrast followed by the appropriate emotion. Some experts recommend using cold water (40 *- 45 * F) in the preparation of contrast medium. Cold water in a single anesthetic effect on the colon and improve the retention of the contrast medium. Critics have indicated that cold water is likely to lead to colonic spasm. The maximum room temperature water (85 *- 90 *) is recommended by most experts fatherly producing a good inspection. X-ray interpreters should not use hot water to provide contrast medium. Maybe hot water can burn the mucous layer caused of the colon. Cramping during the procedure is one of the common side effects, patient concerns, intestinal wall development, the discomfort is associated with colon spasms this. To minimize spasm, like a tropical anesthetic can be added fatherly lidokania contrast medium. If cramps occur during the test, glucagon can be given through an intravenous.
Types of measures for the use of contrast media is 115% w / v 500ml (or more as required), air and barium sulphate (Ba Soa4) – 15% -25% (w / v). This methods are, colon filled with barium contrast fatherly single. It describes the outline of the intestine and reveal abnormalities. The second method is the double contrast or air, where the colon is first filled with barium and then distributed out of barium, abandon only a thin layer of barium in the colon wall then colon filled with air to provide an in-depth on the inner surface area colon, making it more to see colon polyps, colorectal cancer or inflammation. For it procedure is the patient laid on the table next to x-rays and put a ‘incontinence sheet’ and rectal tube is inserted gently into the rectum. It is normal for the patient’s fatherly feeling of discomfort in the abdomen. Iv injection buscopa one (200mg) or glucagon (1mg) may be given. Iv injection is to relax the muscles of patients. barium will flow through the catheter. Intermittent examination asserted to be here to inspect the progress of the barium. Colon image obtained after x-ray exposure in the abdomen occurs. Colon including barium can illustrate this with a good image. Infusion of air will be when arriving at the sphlenic flexural barium then gently pump air into the colon, the colon to the transverse colon decsending so that the air arrives at the hepatic flexural stop pumping the air and let the air moving on its own in the ascending colon. Contrast medium is then produced berium enema.the use of some central CO2 as a negative contrast agent is said to reduce pain to the patient. If the air is pumped stopped, the patient will feel pain in the flexure of the lungs. If air pump too many causes split in the colon and cause pain to the patient. The supine position, patients turn to the left and more to the position of RAO (right anterior oblique) to barium can include intestinal mucosa. Pump air into the colon to develop and to look for pathological changes, including the colon when barium was mixed with the air to illustrate the pathology well and it is called a double contrast barium enema.
There are 4 views of this examination. It is prone views. It was performed as an organ prone to want to be inspected are located close to the tapes. The second view is the view of Hampton. it shows the structure of the rectum. It was done in 35-degree caudal. The third and fourth views are right and left decubitus. There is a reason why the conventional exposure and spot. It is because of exposure to conventional x-ray shows the entire structure. A practical examination and will train for an x-ray interpreters not to repeat the examination and inspection that are not useful and this will sharpen the skills of an interpreter x-ray. Minimize fluoroscopy exposure time and mA to lower the dosage to the patient’s acceptance. Make a course for interpreters to optimize x-ray expertise in this area and equipment performance. Collimate x-ray beam can be minimum. The gonad shield for the protection of x-ray interpreters who manage this procedure and hospital department using modern image intensifier which has a photocathode that is sensitive and can process the digital images.
Follow-up care is important for the patient. X-ray interpreter must record the amount of contrast media used and the drugs used muscle. X-ray interpreters should also provide psychological care to patients, such as giving patients the confidence and praise of excellence in this procedure. make sure the patient understands the procedure after this inspection, such as how to take a fatherly result inspection. If need to ask them to repeat instruction given. Patients with fecal material should be told that they would look white fatherly few days after the inspection. Fecal material will look normal after all the barium is not in the colon. Patients should be informed of the possibility to have diarrhea. Advise patients to drink water, eat lots of fruit. Patients are advised not to leave fatherly x-ray department so that all the small side effects such as blurring view lost or less. Responsibility as an interpreter of x-rays are to be brief and clear explanation and easy to understand the inspection will be conducted on patients for patient understand the fear and loss. X-ray interpreters should work with patients as soon as possible. X-ray interpreters to accompany patients to change clothes in patient change room. X-ray of an interpreter should help doctors or patients if they need help. X-ray interpreters should also make the procedure of piercing tube enter the rectal barium in the rectum and air pump. X-ray interpreters need to prepare in terms of equipment providing the correct contrast and sufficient numbers were included in the syringe. Which will facilitate the procedure will be performed. X-ray interpreters must ensure that the selection of appropriate sterile gloves and dressing sets available. The most important and comprehensive emergency trolleys are always available in the room during the procedure done. X-ray of an interpreter should be well prepared in terms of patient background. Among them are ensuring that the patient has no allergy to the barium, allergic to any drugs, medicines and has asthma or had experienced fever. Complications may occur in the barium enema procedure because it is an interpreter of x-rays should be competent in this field. The complications that can occur is the leakage of barium in the peritoneal cavity due to penetration of the colon. This may occur because the air is pumped into the colon is too much. the effect of this penetration will cause damage to the colon. Patients with allergies will react to muscle injections given. Patients also may have an adverse effect of the reaction of the contrast medium is given regardless of medium or severe. It is up to the patient’s condition.
BARIUM SWALLOW
This is in contrast radiology visualization of the esophagus. Static views esophagus with contrast medium is called barium swallow. Image to be displayed in two dimensions for a better grade (A.P and side view). Barium swallow may be some contrast media studies (barium solution only) or double contrast studies. In some contrast, only barium solution as a radio-opaque material. In a double contrast, barium solution and air used to swell the esophagus. Minor injuries can be better seen with double-contrast studies. Barium has superior contrast qualities and unless there are specific contraindications, its use (rather than water soluble agents) is preferred. The barium swallow is virtually always done in conjunction with a barium meal. Blood-stained vomiting, loss or unexplained weight barium swallow is a test that can be used to determine the cause painful swallowing, difficulty with swallowing, pain in the abdomen. Barium sulfate is a metallic compound that appears in the X-ray and used to help to see abnormalities in the esophagus and stomach. When you take the test, and drink preparation containing this solution. X-rays through the digestive track. Narrowing or irritation of the esophagus (muscular tube between the back of the throat and stomach), swallowing disorder, hiatal hernia (a defect of procedure which causes the stomach to slide partially into the chest), enlarged veins are unusual in the esophagus and this cause bleeding, botch, tumors, polyps (Is the growth rates that are usually non-cancerous, but it must cancerous), cen detect these problem with barium swallow. Barium sulfate is a type of contrast that is visible to x-rays. If the patient swallows the barium suspension, it coats the esophagus with a thin layer of barium. This enables the hollow structure are depicted.
It is commonly used with baking soda (sodium bicarbonate crystals) gas production (see Reaction of sodium bicarbonate). If gas is low in density, and the X-rays through easily, it will appear as black spots, in contrast with the white produced by a relatively-thick barium. As such, it is very useful in providing a contrast to the barium, a double contrast image to produce a better interpretation of the contrasting characteristics to allow within the mucosal layer of the esophagus. Barium sulfate is agitated outside the digestive tract. In cases where a leak is suspected or needs to be shown is contrast imaging involving the use of water-soluble contrast media containing iodine used.
As with all X-rays, the barium swallow technique works radiation, and the patient may be irradiated unnecessarily. The barium swallow should not be used unless required, and although it can not be replaced by endoscopy as the barium enema, should be avoided as much as possible for children and pregnant women. Patient preparation, nil orally for 6 hour prior to the examination. The patient is advised not to smoke on the day of the examination, as it increase gastric motility. It should be ensured that there are no contraindications to the pharmacological agents used. The patient asked for suspension of barium sulfate to drink. Fluoroscopy images were taken as the barium is swallowed. The 2 or 3 frames per second rate is usually. Patient barium swallow a few times, the different positions, ie standing AP, oblique and lateral, 3D structure as well as possible can be assessed said. This technique induces the production of gas in the esophagus, and may be uncomfortable for the subject.
Preperation, X-ray of the breast (both AP and lateral views) were always performed and interpreted before evaluation. This test is performed A patient who has held fast for 8-12 hours for the examination. Oesophageal aspiration was performed in cases of chronic oesophageal obstruction with the help of nasogastric tube. Oesophageal lavage was performed with normal saline solution examination in case of large quantities of liquid and food is present in the oesophagus. In single contrast film, the patients sit in erectposition, the fluoroscopy is started. Barium solution is geven to the patient. The patient is advised to drink the liquid in several mouth fulls of barium solution.
Conclusion, radiographic and fluoroscopy examination of the gastrointestinal tract frequently require preparation by diet, cathartics, suppositories, or enemas. Radiographers prepare barium sulphate suspensions that are then administered orally or rectally to enhance soft tissue contrast for adequate visualization. The radiographer may be responsible for scheduling examinations and for providing instructions for preparation and follow-up care that will be serve the diagnostic requirements and the patient’s physical needs. Precautions are needed to reduce the risk of adverse effects from both the preparations and the procedures.
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