Diagnosis imaging and therapy is not only limited to improvements in equipment and techniques but also in terms of 'dipping' is used. A `dipping 'or contrast media is a liquid substance that is used during a radiological examination for the purpose of describing the internal structures or an organ that is being studied should be difficult to be produced using x-ray film. This is the only way to do so. Contrast media can be inserted into the body through catheters, injected (through a vein, artery or lymphatic), by mouth, or from the bottom of the rectum. Contrast media features can not be penetrated or can be penetrated by radiation, known as contrast agents.
There are three types of Contrast Media:
1) Contrast Media beriodin (injections, are given by mouth).
2) Barium Sulfate (oral or rectal).
3) Gadolinium (injection).
Contrast Media effectively through one of the following ways. When an injected contrast media, contrast media will make the channels and organs with a good blood supply appear opaque or white when the image is. Therefore, the examination of angiography, vessels may appear thick or opaque on x-ray is taken. On computerized tomography, vessels and organs with a good blood supply will appear opaque. Contrast media is then excreted by the kidneys and therefore the Urografi intravenous, urinary system (bladder) will appear opaque on the films of x-ray. In this way, the various organs or structures can be seen clearly.
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When contrast media is given by mouth in the form of barium meal, the stomach will appear opaque or white on x-ray film. Similarly, when given via the rectum in barium enema, the colon will look more opaque or white on x-ray film.
Gadolinium contrast media are given in the form of injections during magnetic resonance imaging. It works by making vessels and organs with a good blood supply, it looks white on the MRI images.
Modern intravenous contrast media to be retained by most patients and quickly eliminated by the body without adverse side effects. Contrast media containing iodine and can cause a heat when injected. Sometimes, it may cause nausea.
Therefore, patients are advised not to eat before exercising radiological examinations requiring contrast media. Rarely, iodine-based contrast media may cause an allergic reaction to the patient.
Contrast media containing barium sulfate is not harmful. It will terkumuh out within a day or two. Gadolinium containing contrast media rarely cause side effects.
In any case, the use of contrast media for pregnant women is not advised because of the lack of conclusive evidence about how safe contrast media in pregnancy.Nevertheless, if the examination is to save the lives of these patients, the risks should be considered in the circumstances of the case.
A.02: Types and Uses
I) Iodinated (intravascular)
Iodine contrast media are usually classified as ionic or non ionic. Both types are usually used in radiology, because the interactions are relatively harmless to the body and solubility. Especially, it is used to show the vessels, and the changes in the tissues of radiography and CT, but can also be used for tests of urinary tract, uterus and tubes falopio. It can cause patients to feel as if he had diabetes. It also put the metallic taste in the mouth of the patient.
Modern intravenous contrast agents are typically based on iodine. This may be bound either in the organic (non-ionic) compound or an ionic compound. Ionic agents have been developed and is still widely used depending on the conditions but can cause additional complications. Agents with covalent binding of organic iodine has fewer side effects because they are not separated into molecular components. Most of the side effects are due to injection of hyperosmolar solutions.
There are many different molecules. Some examples of organic iodine molecules are iohexol, iodixanol and ioversol. Iodine Contrast Media-based water-soluble and not harmful to the body. These contrast agents are sold as a solution of water that is colorless, the focus is usually expressed as mg I / ml. Modern iodinated contrast agents can be used almost anywhere in the body. The most frequently used in intrarena, except for various purposes, they can also be used intraarterially, intrathecally (as in spinal diskography) and intraabdominally - about any body cavity or potential space.
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Iodine contrast agents used for:
ü VCUG (Voiding Cystourethrography)
ü HSG (Hysterosalpinogram)
ü IVU (intravenous Urography)
II) barium (Gastro-intestinal)
Barium sulfate is used primarily in imaging the digestive system. Materials such as a water soluble white powder that is not made to a slurry with water and given directly to the gastrointestinal tract.
• Barium enema and DCBE (Double Contrast Barium Enema)
• Barium swallow
• Double contrast barium meal and barium meal
• Barium Follow Through
• CT Pneumocolon
Barium sulfate, an insoluble white powder commonly used to increase the contrast to the GI tract. Depending on how it would be a compound that is mixed with water, thickeners, coagulating agents and flavor to contrast agents. As barium sulfate, the type of contrast agent is a mixture of opaque white. It is only used in the digestive tract. It is usually swallowed or carried as an enema. Upon inspection, he came out through a large stool.
A.03: Special Preparation and Precautions
If you do not have one of the following conditions, you only need a fast (not eat or drink, empty stomach) 4-6 hours before the examination. If you have the following problems, you will need to take special precautions and realize additional risk:
§ History of known allergies
§ Never had a reaction to the Konras Media
§ Never had a reaction to medication
§ Heart disease
§ myeloma Multipelor myelodysplastik syndrome (diabetes critical)
§ age factors, elderly (> 65 years) and too young (<6 months)
If you have any allergies or reactions in the past, you may be asked to take medication Prednisolone 40 mg, 12 hours before and 40 mg, 2 hours before the examination.Inspection requirements should be compared with the risk. Doctors usually recommend you check this. If you are unsure about the risk factors, please tell your doctor about any allergies or medical conditions.
For patients with Multiple myeloma or myelodysplastik syndrome, you need to drink enough water (to prevent dehydration conditions) even though such examination Urogram Intravenous (IVU).
! Type of intravenous contrast used in such patients must often on a non ionic contrast media.
If you are a person who has diabetes or is taking Glucophage (Metformin), please stop your medication 48 hours before the examination that require injection of contrast media intravenously or intra-arteria.
A.04: The difficulty or complications that may arise
Despite the above explanations on this matter, the possibility of a simple reaction to the strong reaction is very low. The doctor had to take into account the risk ratio kebaikkannya than when they propose some kind of check to you.
Contrast media are other medicines that you know. Contrast Media is the latest to be safe. Like all medications (including drugs that often take the Panadol / Paracetamol), Contrast Media also has the potential undesirable reactions. It is classified as low, moderate and severe. Through a non-ionic contrast media, the possibility of reactions occur is very low or less. Most of the reactions were weak, temporary and require no treatment, and occurred in the first 20 minutes after injection.
Examples of patient reaction to contrast media:
I) weak reaction
Ø Nausea or vomiting
Ø heat throughout the body (as if after exercise)
Ø Itching on the body (temporary or last for a few days, given the antihistamine drug)
II) reaction medium
Ø Trouble breathing (like asthma)
Ø Hypotension (blood pressure dropped suddenly)
III) Severe Reactions
Ø anaphylactic rare but can happen and is not expected.
Why do you need a contrast media in radiology examinations?
Several investigations in the radiology needs of this contrast into your body through a vein or artery. A common example is Urogram Intravenous. There are two types of iodine-containing contrast media, non-ionic and ionic species.
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Usually only the bones, and the wind will be produced on x-ray film. To distinguish the path of blood in the urine or blood vessels, contrast media containing iodine to be added to increase the density of urine or blood. Then, this will cause them to look 'white' in the film, such as your bones on x-ray.