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Contrast CT, or contrast-enhanced computed tomography (CECT), is X-ray computed tomography (CT) using radiocontrast. Radiocontrasts for X-ray CT are generally iodine-based types . [ 1 ] This is useful to highlight structures such as blood vessels that otherwise would be difficult to delineate from their surroundings.
An intravenous cannula is required for the administration of iodinated contrast. The typical dose is 30-40 g of iodine (corresponding to 20–30 cc of 370 mg/ml iodine solution). [10] However, for patients at high risk of contrast-induced nephropathy, it is possible to reduce the required amount of contrast using dual energy CT.
Also, the iodinated contrast medium used in contrast CT and contrast radiography can cause allergic reactions, including severe ones. [5] The contrast dye may also be toxic to the kidneys. [7] Because a cannula is inserted, there is also a risk of a cannula site infection, that may cause fevers or redness of the cannula area. [7]
A reaction may occur whenever iodine contrast is injected. These reactions range in severity and it is difficult to predict if they will occur. With the current practice of using low-osmolar contrast these adverse reactions only occur in ~0.1% of cases. [4] The severity of the reaction can be broken down into three groups:
Contrast CT of a patient with brain metastases from breast cancer, before (left) and after (right) injection of iodinated contrast.. Iodinated contrast is a form of water-soluble, intravenous radiocontrast agent containing iodine, which enhances the visibility of vascular structures and organs during radiographic procedures.
Baseline color and black and white red-free filtered images are taken prior to injection. The black and white images are filtered red-free (a green filter) to increase contrast and often gives a better image of the fundus than the color image. A 6-second bolus injection of 2-5 cc of sodium fluorescein into a vein in the arm or hand
Iodinated contrast contains iodine.It is the main type of radiocontrast used for intravenous administration.Iodine has a particular advantage as a contrast agent for radiography because its innermost electron ("k-shell") binding energy is 33.2 keV, similar to the average energy of x-rays used in diagnostic radiography.
If the patient is receiving a "concomitant" medicinal drug (prescribed to the patient by another physician), and the radiologist performing the imaging procedure is unaware of this, potentially harmful side-effects can occur and increase the risk of contrast medium-induced nephropathy (i.e. increase the risk of damage to the kidneys).