X-Ray And Other Imaging Contrast Examinations

The main contraindication in X-ray contrast media studies is a suspicion of a perforation because free barium causes severe irritation to the mediastinum or peritoneum; water-soluble contrast agents are less irritating and can be used in cases of possible perforation. In elderly patients, storage and rotation for optimum positioning of barium and intraluminal air often causes difficulties.

X-ray and other imaging contrast examinations are the entire GIT from the pharynx to the rectum, and are extremely useful for the diagnosis of lesions and pathological structures (eg., Tumors, strictures). Simple contrast examinations fill the lumen with a radiopaque material, which reproduces the structure. Better and more detailed images obtained with the double contrast technique, encase in the small amounts of dense barium the mucosal surface, air aufdehnt the organ and increases the contrast. The air is given by the examiner in double contrast, while in other studies intrinsically present in the GIT air is sufficient. In all cases, the patients position themselves in the right position to distribute air and barium. Under fluoroscopy, the progress of the contrast agent can be controlled. To document video and movies are used, however, video is particularly suitable for the diagnosis of motor disorders (eg. As Krikopharyngealspasmus, achalasia). The main contraindication in X-ray contrast media studies is a suspicion of a perforation because free barium causes severe irritation to the mediastinum or peritoneum; water-soluble contrast agents are less irritating and can be used in cases of possible perforation. In elderly patients, storage and rotation for optimum positioning of barium and intraluminal air often causes difficulties. Patients in whom an X-ray contrast examination of the upper GIT is provided must remain sober on Study after midnight. Patients in whom a barium enema is intended to be pretreated with a clear liquid diet one day receive an oral sodium phosphate laxative afternoon and a Bisacodylzäpfchen evening. Other laxatives are just as effective. Complications are rare. A perforation can occur when a barium enema is carried out on a patient with toxic megacolon. The entrapment of barium can be prevented according to the investigation by the oral administration of liquid and sometimes of laxatives. In the examination of the upper GIT is best used in two phases before, starting with a double contrast examination of the esophagus, stomach and duodenum, followed by a simple contrast examination with barium low density. The investigation can be obtained by the administration of glucagon 0.5 mg i.v. be facilitated to produce a stomach hypotension. A small intestine contrast is performed with fluoroscopy and enables a more accurate assessment of the small intestine. Just before the examination, the patient receives metoclopramide 20 mg po, to speed up the transport of the contrast agent. Enteroclysis (small bowel enema) provides an even better view of the small intestine, but requires intubation of the duodenum with a flexible balloon catheter. A barium suspension is introduced, followed by a solution of methyl cellulose, which acts as a double contrast agent and improves the appearance of the intestinal mucosa. A barium enema can be used as a simple or double contrast method. Simple Kontrastbariumeinläufe be carried out at a potential closure, diverticulitis, fistulas and megacolon. Double contrast examinations are preferably used for the diagnosis of tumors. Abdominal CT A CT scan with oral and iv applique contrast agent enables an excellent representation of both the small and large intestine as well as other intra-abdominal structures. A CT Enterographie provides an optimal representation of the intestinal mucosa; it is preferably carried out using a multi-detector CT apparatus (MDCT). Patients will receive a large amount (1350 ml) of 0.1% barium sulfate prior to testing. For certain indications (eg. As obscure gastrointestinal bleeding, small bowel tumors, chronic ischemia) is carried out a two-phase contrast-enhanced MDCT examination. The CT Kolongraphie (virtual colonoscopy) generates 3-D and 2-D images of the colon using an MDCT and represents a combination of oral contrast media and gas expansion of the colon. The display of high-resolution 3-D images to simulate the appearance the optical endoscopy, hence the name. An optimal CT Kolongraphietechnik requires careful cleaning and expansion of the colon. Residual chair causes similar problems as they occur during barium enema because it simulates polyps or masses. Three-dimensional endoluminal images are useful to confirm a lesion and improve diagnostic confidence. CT Enterographie and CT colonoscopy have small bowel and Bariumkontrasteinläufe largely replaced as standard.

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