How much iv contrast to give a child
Guidelines for IV contrast media use, management in pediatric patients
A survey of a subset of Society of Pediatric Radiology (SPR) members provided the foundation for guidelines for clinical histories necessary before IV contrast media, maximum IV contrast injection rates for standard angiocatheters, contrast media injection rates for specific CT studies and management of IV contrast media soft-tissue extravasation, according to a study published in the April issue of American Journal of Roentgenology.
Though iodinated IV contrast media is often used for pediatric CT studies, few guidelines exist on appropriate administration. Lead author Michael J. Callahan, MD, of Boston Children’s Hospital, and colleagues distributed an anonymous web-based survey to investigate the practice patterns of SPR members in their use of iodinated IV contrast media for pediatric CT. They hoped to create a point of reference for practice development and modification for all radiologists.
After distributing a 15-question survey to 1,545 members, the researchers had a 6 percent response return rate. These 88 respondents represented 26 percent of the SPR membership. Most respondents thought that IV contrast media administration (97 percent), renal insufficiency (97 percent), current metformin use (72 percent), significant allergies (61 percent), diabetes (54 percent) and asthma (52 percent) were pieces of clinical information mandatory before administration.
Most participants administered contrast media through nonimplanted central venous catheters (78 percent), implanted venous ports (78 percent) and peripherally inserted central catheters (72 percent).
IV contrast medium injection rates were most commonly maxed at 5 mL/s or more for a 16-gauge angiocatheter, 4 mL/s for an 18-gauge angiocatheter, 3 mL/s for a 20-gauge angiocatheter and 2 mL/s for a 22-gauge.
Ninety-five percent of participants elevated the affected extremity after soft-tissue extravasation of IV contrast media, while 76 percent used ice and 45 percent used heat.
“At a minimum, we suggest that the following clinical information should be obtained before the administration of iodinated IV contrast media in children: history of allergy to iodinated IV contrast media, history of severe allergies or atopy to other allergens, history of renal insufficiency, and current use of metformin-containing medication,” wrote Callahan and colleagues.
“Other clinical information could be obtained at the discretion of the individual practice or institution. A history of, or a potential for, sickle cell disease or sickle cell crisis, pheochromocytoma, myasthenia gravis, diabetes mellitus, or medical history of asthma might be clinically useful in certain patients, but a history of one of these disease processes should not affect a radiologist's decision to administer iodinated IV contrast media for a clinically indicated CT study,” they continued.
The authors also recommended maximum IV contrast media injection rates for the pediatric demographic as 5 mL/s for 16- to 18-gauge angiocatheters, 4 mL/s for 20-gauge, 2.
5 mL/s for 22-gauge and 1 mL/s for 24-gauge angiocatheters.
They suggested an initial clinical evaluation and examination by a radiologist after soft-tissue extravasation of IV contrast media. If the extravasated media is believed to be clinically significant, the affected extremity should be raised and an ice pack should be used.
“Because most pediatric patients are imaged at adult-based radiology practices, we hope that this article will serve as a general guideline for those adult radiologists who occasionally image children and will provide some direction for the effective use of iodinated IV contrast media and management of IV contrast media extravasation for CT studies in children,” they concluded.
Multidetector CT in children: current concepts and dose reduction strategies
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CT with contrast - prices in Moscow, make a contrast computed tomography at the medical center "SM-Clinic"
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Computed tomography with contrast enhancement is a highly informative diagnostic procedure used in all branches of medicine. It involves a CT scan after the introduction of a radiopaque preparation into the body.
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The substance is carried by the blood, accumulates in areas with an active blood supply and reflects X-rays. With the help of contrast enhancement, you can make CT images clearer, visualize soft tissues, blood vessels, areas of inflammation and oncological growth.
Computed tomography at SM-Clinic is
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Increased accuracy and speed of research. Reduced exposure
We use equipment that conducts up to 128 sections. This is a very high indicator, which indicates the speed of the procedure and the accuracy of its results. Our CT scanners have several automatic modes that allow you to scan with minimal radiation exposure to the patient without loss of image quality. nine0017
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For patients weighing up to 220 kg
Our equipment makes it possible to examine patients weighing up to 220 kg. This ensures the availability of quality medical care and allows people of different sizes to undergo CT examinations. Here you can undergo virtual colonoscopy, cardiological examinations (MSCT angiography of the aorta, heart, pulmonary artery and its branches, MSCT of coronary calcium), CT densitometry of the lumbar region and almost all known types of computed tomography.
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Around the clock and the result of the study immediately "at hand"
In some of our centers, computed tomography can be performed even at night. We did this for the convenience of patients: we understand that it is not always possible to allocate time during the day to undergo an examination. This should not become an obstacle in order to preserve your health, which is why our CT rooms work around the clock.
CT target with contrast
The introduction of a radiopaque preparation allows you to clearly visualize the vascular bed, assess the diameter and patency of veins and arteries, identify pathologically narrowed or dilated areas, and diagnose vascular occlusion resulting from thrombosis.
The compound used for amplification accumulates in tissues with an active blood supply. Due to this, CT with a contrast agent makes it possible to detect foci of inflammation, necrosis, and purulent fusion of tissues.
Amplification is applied when oncopathology is suspected.
Malignant tumors are almost always well supplied with blood and have an extensive vascular network. After the introduction of contrast, they are well visualized.
The doctor has the opportunity to make an assumption about the nature of the neoplasm (the final conclusions are made based on the results of histological analysis), assess its effect on the surrounding structures, and draw up a plan for surgical or conservative treatment.
Indications for CT with contrast
Native (non-contrast) CT is informative of anatomical areas with high natural contrast (bones, lungs). In all other cases, a standard study may provide even less information than an ultrasound. But the use of contrast immediately increases the value of diagnostics by dozens of times and makes it indispensable in assessing the following structures:
- soft tissues;
- articular elements;
- abdominal and parenchymal organs of the small pelvis, abdominal cavity; nine0020
- vessels;
- nerves;
- lymphatic structures;
- neoplasms.
CT with contrast is often prescribed by the attending physician, but the final decision on the possibility and need for enhancement is made by the radiologist, based on the quality and information content of native images.
How CT with contrast works
Exam duration
30 minutes
Preparation of a conclusion
from 2 hours*
Results of the procedure:
pictures and a detailed conclusion of a diagnostician with a description of the state of the organs and structures under study
The person lies down on the machine's conveyor. If necessary, the body is fixed with straps, rollers are placed. Areas that cannot be scanned are covered with lead pads. A catheter is inserted into a patient's vein, which is connected to special automatic equipment for delivering the drug. nine0003
The doctor enters a nearby office, from where he observes the patient through the glass.
The X-ray technician turns on the equipment, and native scanning takes place within 1-3 minutes. At this time, the patient is reminded of the need to remain still or asked to hold his breath. Next, the doctor turns on the automatic supply of contrast and almost simultaneously starts the tomograph. Scanning is repeated at the time of the transition of the drug from the arteries to the veins, as well as in the phase of excretion from the tissues.
After the end of the study, the patient is asked to remain in the clinic in a calm position for 30 minutes. At this time, doctors monitor the person's condition in order to prevent possible negative reactions of the body.
The choice of contrast medium and the method of administration of contrast according to the indications are determined by the doctor before the examination.
* in diagnostically difficult cases, and if it is necessary to obtain a second opinion from the leading specialists of the holding, the result of the study is issued within 24 hours (as agreed with the patient).
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Equipment
Siemens SOMATOM Perspective CT (128 slices)
Siemens SOMATOM Perspective CT (64 slices)
SOMATOM Scope Power CT (16 slices)
CT scan results with contrast
The radiologist compares images taken before and after contrast. The doctor fixes any deviations from the norm, reveals pathological changes. The radiologist describes all the information received in the conclusion. If necessary, you can print individual images on film or paper, or burn all received scans to a laser disc. nine0003
For details on examining specific anatomical regions using CT with contrast agent, as well as prices for procedures, please call or visit the clinic in person. During registration, the patient will receive detailed instructions regarding the preparation and features of the diagnostics.
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CT preparation with contrast
The list of preparatory activities depends on the field of study.
For example, preparing for a CT scan of the abdominal cavity involves dieting and taking drugs to reduce gas formation in the intestines, while diagnostics of the joints do not require preparation at all. Before the introduction of contrast (2-3 hours), patients are advised to refrain from eating. Persons with diabetes mellitus should consult with an endocrinologist in advance, as a correction of the regimen for the use or withdrawal of certain drugs (insulin, metformin) is required. nine0003
All patients scheduled for CT with contrast must provide the clinic with the results of a biochemical blood test for creatinine. An elevated level of the substance may indicate renal pathology, which is considered a contraindication for the administration of iodine preparations.
Women who support breastfeeding need to make milk supplies for the baby for 2-3 consecutive feedings, since the radiopaque is eliminated from the body within 12-16 hours. The patient comes to the clinic, fills out the documents.
At a personal consultation, the radiologist conducts a survey in order to identify contraindications to the procedure. Specifies the weight of a person, calculates the dose of the drug, selects the optimal method of administration. Next, the patient is asked to remove metal objects and taken to the CT room. nine0003
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Useful information
Computed tomography enhanced with contrast should not be performed in the following cases:
- pregnancy;
- severe renal and hepatic insufficiency;
- decompensated diabetes mellitus; nine0015 intolerance to iodine preparations;
- General serious condition of the patient.
X-ray contrast studies are contraindicated in children (under 14 years of age). However, they can be carried out in cases of urgent need, when it comes to life-threatening conditions.
Restrictions: weight no more than 200 kg.
CT with contrast can be done at the medical center "SM-Clinic". We have modern high-precision equipment, we use only certified contrast agents, the safety of which has been verified in a series of clinical studies. Diagnostic procedures and interpretation of images are carried out by radiologists with vast practical experience, who have undergone training in the best European clinics. Specialists carefully monitor the patient's condition before the administration of the drug, during the diagnosis, and also after contrast CT. Our doctors are ready to provide qualified assistance in a timely manner. nine0003
CT with contrast is an informative way to diagnose both the simplest and the most insidious diseases. Take care of your health without wasting a minute - consult with the doctor of the SM-Clinic multidisciplinary holding about the need for a CT scan in your case!
CT scan with contrast
Early detection of serious diseases will give you the opportunity to get rid of the disease in a short time, and in many cases without surgical intervention.
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You can find out the details of the procedure, prices for CT with contrast and sign up for an examination by phone:
+7 (495) 292-39-72
Request a call back Book online
Prices for CT with contrast
| Administration of contrast agent (per os) (including cost of contrast agent) | 1 850 rub |
| CT Bolus Contrast Enhancement (Contrast cost included) | 7 350 rub | +7 (495) 292-39-72 The posted price is not an offer. Medical services are provided on the basis of a contract.
