Summary Special Radiographic Procedure

RADIOGRAPHIC CONTRAST  Mucosal coating
 Gum of Acasia – Additive use to BaSO4
 Use to visualize certain anatomical structure
of organs after administration of Contrast 2 TYPES OF BaSO4 PREPERATION
Media
 Resistant preparation – Minimizes the
HISTORICAL BACKGROUND substance
 Coilloidal Preperation
1896:
 Suspended of Flocuolation (Additives)
 Cannon used Bismuth subnitrate to study  Additives use: Sodium Carbonate. Sodium
the swallowing machine of Goose using Citrate
Fluoroscopy.  SOCI CARBONara
 Haschek and Liindenthal produced a
DENSITY OF BaSO4
radiograph demonstrating the blood vessel
of an amputated hand using Teichman;s  Weight/Weight (w/w)
Mixture 
 Teichman’s Mixture – Combination of Lead,
Barium, and heavy metal/chalk (?)

1904:
 Weight/Volume (w/v)
 Introduction of Air CM during Retrograde 
Urography

1910:

 Application of BaSO4 in GI Tract
TYPES OF BaSO4
1920:
Commercial BaSO4
 Intravascular administration of Iodinated
 Expensive
CM
 Has additive taste
POSITIVE CM
Plain BaSO4
 Radiopaque, White appearance
 Unpalatable taste
 High density, Absorbs more Radiation
 High mucosal coating
 Ex. BaSO4
CONTRAINDICATION OF BaSO4
NEGATIVE CM
 Fistula
 Radiolucent, Black appearance
 Obstruction
 Low Density, Absorbs less Radiation
 Pre/Post abdomen Operation
 Ex. Any gas
 Perforation
BARIUM SULFATE (BaSO4)  Allergy (rare occurrence)

 Atom number 56, High density (due to high ETTHEL BOOBA
atomic number)
 Ethel – Eskenita (Fistula)
 Nontoxic, chalk-like
 B – Bara (Obstruction)
 Best contrast in GI tract
 OO – Opera (Pre/Post abd. Operation)
 Inert – Physically and Chemically inactive
 B – Butas (Perforation)
 Colloidal suspension
 A – Allergy
 Made up of Barite/Baryte material

,IODINATED CM (IODINE) OIL BASED CONTRAST

 Atomic number of 53  Used in Bronchography, Myelography. And
 Water soluble Lympography
 For Angiography, Biliary, Urographic  First oil based in Myelography CM is
procedures “Pantopaque”
 Used in GIT when BaSo4 is contraindicated  Commonly used Oil Based CM is “Ethiodol”
 Absorbable, has a bitter taste  Ex. Ethiodol, Pantopaque, and Dionosil
 Clear Yellow or pale amber
IONIC CONTRAST (HOCM)
 Iodinated
 6 to 8x more Osmolar (1740-2320) than  Fatty acid
Blood Plasma (290-295)
AIR CONTRAST (NEGATIVE)
 Dissociate – naghihiwalay (Ionic)
 Cation (+) – Increase solubility  For double CM studies
o Sodium Meglumine (SM)  Ex. Room air, Oxygen. Carbon dioxide,
 Anion (-) – Stabilize CM compound Carbonated drinks, Gas, Gastroluft
o Metrizoate, Iothalamte,  Gastroluft – Gas producing tabltes
Diatrizoate, Ioxaglate  Gas Producing Crystals: Calcium and
o MIDI – ATE Magnesium Citrate – CALaMAnsi

NON-IONIC CONTRAST (LOCM) REACTIONS TO CONTRAST MEDIA

 2 to 3x (580-870) more osmolar than blood Local Reaction:
plasma
 Extravasation – Leaking of CM inside vessel
 Gllucose, Amide (GLAM)
which is napupunta sa mga surrounding
 Intact
tissue/s
IODINE – PARTICLE RATIO  Phlebitis – Inflammation

 Tri-Iodinated Benzene Ring Systematic Reaction:
 Ionic Particle – 3
 Mild – No medication needed
 Non-Ionic Particle – 6
 Moderate – Difficulty in breathing, Rashes,
 Benzene ring count – 1 and 2
Bp Fluctuation, Medication needed.
 Ionic Monomer (3:2)
 Hot Flusing and Metallic taste = Most
 Ionic Dimer (6:2) (3:1 simplified)
common CM adverse reaction (MILD)
 Non-Ionic Monomer (3:1)
 Severe – Medication and Hospitalization
 Non-Ionic Dimer (6:1)
needed
 Ratio value and Adverse reaction is
inversely related SENSITIVITY TASTE
CONTRAINDICATIONS  Average absorvation time – 5mins.
 Seleral - Eyedrops
 Hypersensitive to Iodinated CM
 Intravenous – in veins (5cc for 5mins)
 High creatine and Renail failure – Kidney
 Sublingual – ilalim dila (catapres)
function
 Intradermal – Skin Test
 Px taking metformin (Diabetic Px)
 SISI
2 days before and after protocol

, FACTORS TO CONSIDER CM  Mills – Conducted the study of Body habitus
 Hypersthenic – Organ is Mataas
 Viscosity – Resistance of fluid to flow
 Asthenic – Organ is Mababa
(Lapot). High viscous, High concentration,
 Stenic – 50% of the population
high toxicity
 Osmolality – Measure of the total number 4 ABDOMINL QUADRANTS
of particles in a solution/kg of water
 Horizontal plane – At the level of umbilicus
 Miscibility – Mixture ability
 Vertiical plane – MSP
 Persistence – Amount of time the CM stays
in the body
 Iodine content – Volume distribution of
iodine in the CM
 Toxicity – Toxiicity is higher if the osmolality
and viscosity of CM compound is high

4 PHYSICAL STATES OF CONTRAST:
 RUQ -Liver, Stomach, GB, Duodenum, Right
 Liquid
Kidney, Pancreas, Right adrenal gland
 Powder
 RLQ – Appendix, Reproductive organ, Right
 Oil
ureter
 Tablet
 LUQ – Liver, Stomach, Pancreas, Lef kidney,
CM F U B C L U Spleen, Left adrenal gland
 LLQ – Left Ureter
 Fiber optic
 All Four Quads – Contains portion of the
 Urinary System
Small and Large intestine
 Biliary tract examination
 CT scan procedure – abdominal w/ cm 9 REGIONS OF ABDOMEN
 Lower GI series
 Transpyloric Plane – Level of the lower
 Upper GI series
border of L1
Proper CM series study:  Transtubular Plane – Level at L5
 Left and Right Vertical Plane – Level at
 IVP
midasis plane
 Cholangiogram
 BE ESOPHAGOGRAM (Ba SWALLOW)
 UGIS
 Using Radiopaque CM to assess the function
SCOUT FILM (PRELIMINARY FILM) of the Pharynx and Esophagus

 Abdominal Xray PATHOLOGIES/CONTRAINDICATIONS:
 Technical factor checking (manual xray)
 Achalasia -Abnormal contraction of distal
 Centering point
part of esophagus. Has a Rat tail and Bird’s
 Presence of Pathology, and stool remainings
beak appearance
 Body habitus
 Chalasia – Abnormal releaxation of distal
 Routine: Immediate film is the First xray
esophagus
after CM procedure
 Atresia – Congenital defect. (a) without an
opening in the Esophagus
 Barrett’s Esophagus – Ulceration of
Esiophagus due to GERD
BODY HABITUS  Cuastic Ingestion – Acids
 Dysphagia – Difficulty in swallowing