The provider's guide: Contrast vs non-contrast CT?

Рет қаралды 48,498

Күн бұрын

How to decide if contrast required or not for CT study is the topic of this video, will teach you how to easily decide if CT study requires IV, and or oral contrast or needs to be done without contrast based on the indication of the study, MRI will be covered in a separate video
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Пікірлер: 91

@LaptopNewbie 11 күн бұрын

Sharing so many example cases is genius! Thank you for the knowledge and the practice.

@chelsearae6883 Жыл бұрын

Super helpful regarding a subject matter that is not always explicitly explained. Thank you so much!

@badrowes Жыл бұрын

Fantastic subjects to explain , ive enjoyed most of your videos , thanks alot

@claudiamiller7730 8 ай бұрын

That was fun! I have no medical training - but got 99% right on the contrast/no contrast “quiz”! Stupid pride, I know…but I needed a little lift to my ego today - and this helped!💕

@ramseslong5614 3 жыл бұрын

Very clear and exactly what I needed. Thanks a lot

@Hospitalista 3 жыл бұрын

Glad you found it helpful

@dalivelaz9389 2 жыл бұрын

i like music and Buzzing and the way he is talking well done

@nissosaliman 2 жыл бұрын

thank you so much for this video, it is extremely helpful!

@Hospitalista 2 жыл бұрын

Glad you found it useful

@samsaon7153 Ай бұрын

Thankyou, absolutely nailed it.

@moradzayed Жыл бұрын

very nice thank you for the great effort

@shail6770 2 жыл бұрын

Concise and informative! Thank you for the great content, Dr Alrahamneh.

@Hospitalista 2 жыл бұрын

Glad you enjoyed it!

@khanalam6414 3 жыл бұрын

Very useful tips. Thanks for sharing

@Hospitalista 3 жыл бұрын

Glad you found it useful

@opaloakley Жыл бұрын

Would you use contrast for a chest CT to look for possible hormone secreting adenomas?

@hebahalrahamneh9922 2 жыл бұрын

Great thank you

@brianshishnia3278 2 жыл бұрын

What about a CAT scan for a hernia not suspected of infection or strangulation? No contrast okay?

@omarct 2 жыл бұрын

I am wondering about the injections. Allergic reactions, side effects, how does it leave the body, potential long term harm to the body etc...

@greensky01 Жыл бұрын

IV contrast is excreted in urine by the kidneys. Renal failure is a contraindication for IV contrast.

@ClearlyPixelated Жыл бұрын

Just thank you.

@Hospitalista Жыл бұрын

You are most welcome!

@VinayKJ Жыл бұрын

Thankyou so much sir!!!

@Hospitalista Жыл бұрын

You are welcome!

@DrTLedo Жыл бұрын

very helpful, thank you

@Hospitalista Жыл бұрын

Glad it was helpful!

@tinastv2071 28 күн бұрын

Thank you

@Litepaw 7 ай бұрын

I'm trying to figure out what kinds of CT scans i got while i was in the hospital for sepsis and bacterial endocarditis. 2 weeks before i was admitted i had a head scan to check for bleeding because i kept getting worse after an unrelated concussion. Im not even sure which ones were CT or MRI, and i only remember having the contrast stuff once. And i think that was for a back MRI to check if the infection had spread to my back. I remember having 3 CT scans and one MRI.. I hope at least 1 was low dose because it's an absolutely massive dose of radiation to recieve in a 2 month timespan..

@tylerjames4242 2 ай бұрын

Hello, my order is CT ABDOMEN & PELVIS WITH AND WITHOUT CONTRAST. I first refused the iodine contrast when I went the other day and had them reorder a new CT scan without the iodine. I can do the barium sulfate all day long, just afraid of the IV and contrast. Is that new order still with the IV contrast and is it necessary for suspected gallbladder issues or diverticulitis?

@babinaditya9786 2 жыл бұрын

Contrast needed or not for Follow up case of VP shunt

@brendancarson2009 8 ай бұрын

These are excellent videos, and I am grateful for your work, but it may be that the sound effects are a little distracting. Thank you, regardless

@criminalmentality1834 Жыл бұрын

So basically. Without contrast enhancement can tell u about the tumor clearly?

@katiapearson9541 3 жыл бұрын

Thank You.... You are Amazing Helpful.

@Hospitalista 3 жыл бұрын

Glad it helped!

@jacobstravail Жыл бұрын

Phillips has CT machines that don't use any contrast. Just ask around to see who has them. These contrast are nephrotoxic

@user-nm3bj4vv1t 6 ай бұрын

For neck and skull ct due to week vocal cords . Is it iv or oral only? 28 years patient

@Hospitalista 6 ай бұрын

I am sorry I can’t give any specific clinical advice on this platform, please follow your doctor recommendations. In general we don’t use oral contrast for vocal cords issues.

@edzkieverdidaromero671 9 ай бұрын

How about the sarcoma they need IV contrast?

@Hospitalista 9 ай бұрын

Thanks for reaching out! I don’t give any specific clinical advice here and you should follow your doctor advice. That’s being said CT done for tumors in general requires CT with IV contrast.

@okanzngn 3 жыл бұрын

video is excellent but I want to ask a question you say we don't need contrast non penetran trauma and non vascular pathology okay but how can I understand patient has vascular pathology or not

@Hospitalista 3 жыл бұрын

Glad you liked the video, penetrating injuries can be easily recognized on physical exam including any vessel bleeding externally or if internal bleeding suspected

@okanzngn 3 жыл бұрын

@@Hospitalista Can I ask one more question 🙏🏼 how can I understand internal bleeding with physical examination ? Can you give me more details ?

@ash91297 3 жыл бұрын

Great video! Can you make one on when to use transesophageal vs transthoracic echocardiography?

@Hospitalista 3 жыл бұрын

I will do in the future, thanks for your suggestion

@greensky01 Жыл бұрын

TEE is better than TTE. TEE is more invasive and therefore used if a more definitive diagnosis is required. For example, while doing a FAST examination in ED on a patient in a motor vehicle accident, you would do TTE. TEE is also done for an old A-fib if the goal is cardioversion in evaluation for leaflet pathologies. TEE is used for assessing unstable patients for thoracic aortic injury (aortic dissection) without moving them to the CT scanner.

@miar600 8 ай бұрын

Hi! For those who are alergic to contrast (iodine) is it worth doing any CT scan without contrast?

@Hospitalista 8 ай бұрын

This really depends on why you getting a CT? The doctor who ordered the CT should be able to answer this question better than me!

@miar600 8 ай бұрын

@@Hospitalista Yes Thanks. The problem is, I'm not being followed by a specific doctor, in fact, the doctor who prescribed the various CT scans I don't even get to talk to. I can deny doing the exams but I would like to do them, I just wanted to understand wether it would be worth it, meaning wether they'd still be useful for the doctors. In my opinion if it serves for nothing a CT scan without contrast, they shouldn't even allow us to do it! Thanks anyway

@ernestkola0 Жыл бұрын

Is that ok to have ct scan with contrast dye - if you have kidney disease pls?

@Hospitalista Жыл бұрын

Thanks for reaching out! I strongly recommend you consult with your doctor regarding this matter, each patient is different.

@Hitchie_buddy Жыл бұрын

I got a non contrast CT scan done at the ER 2 months ago for left sided weakness... Apperantly nothing was wrong but my health anxiety tells me they missed a brain tumor. What are the odds of them missing it?

@Hospitalista Жыл бұрын

Thanks Kj's for reaching out, I hope you will understand that we can't give any specific clinical advice on this platform, we highly recommend you follow with your doctor for further advice and guidance.

@lamborghinidreamers8158 Жыл бұрын

How are you right now?

@godschild3640 Жыл бұрын

@@Hospitalista. So I had CT no contrast …the next day they wanted CT with. Have 3 lung Nodgle ….1. Upper right lung …Nodgle in lower right left lung 🫁..it’s been 3 weeks no call from doctor. All they told me was I have3 nodules …so DO I NEED A NEWS DOCTOR

@Hospitalista Жыл бұрын

Hey there, I can’t give any advice on this platform, I suggest you call them and remind them. Whether to find a new doctor or not is totally up to you. Good luck!

@randotopicsgirl4234 2 жыл бұрын

Do you need contrast for endometrial cancer?

@Hospitalista 2 жыл бұрын

In general we prefer to give contrast whenever assessing any neoplastic issue but the final decision should be up to the patient’s physician

@sylphrenae Жыл бұрын

Does CT temporal bones need contrast?

@bini9462 Жыл бұрын

No need unless you're ordering for any neoplastic condition

@sultanasultan6459 2 жыл бұрын

In appeniceal mucoceal Iv contrast should be given or oral??? Plz reply

@Hospitalista 2 жыл бұрын

Usually IV contrast

@sultanasultan6459 2 жыл бұрын

Thanku for reply My Dr preferred oral... For appendiceal mucoceal... Any reasons

@Hospitalista 2 жыл бұрын

Not sure why! But am sure he has his own reasons, at the end he knows the case and what's best for that specific patient.

@katrinabruce9476 2 жыл бұрын

Will ct scan without contrast show brain tumours both large and small ones?

@greensky01 Жыл бұрын

most likely will show larger ones, but MRI is better at this

@ColonelMarcellus 2 жыл бұрын

Most providers will order it without AND with. Whether by incompetence or enthusiasm or greed, it seems they are taught that more is better. Contrast media is very expensive, also.

@symanowrin1941 Жыл бұрын

How does it work ? First without than with means 2 scans

@ColonelMarcellus Жыл бұрын

@@symanowrin1941 Yes, you get 2 scans and of course about twice the radiation and much more expense. Sometimes you need it both ways but usually not.

@symanowrin1941 Жыл бұрын

@@ColonelMarcellus oh god I have done 4 scans than at the age of 22 I have high risk of developing cancer very soon I am very much worried

@ColonelMarcellus Жыл бұрын

@@symanowrin1941 Not as bad as all that; radiation doses are not as bad as they used to be. The question is risk vs benefit which your doctor is supposed to weigh when deciding to order a scan. Just don't wait til you're on the scanner and ask the Technologist: it's a question for the doctor.

@symanowrin1941 Жыл бұрын

@@ColonelMarcellus I have more than 80 msv in 3 years

@iliganon_mhay3396 2 жыл бұрын

How about Poor sleep? Do i need to contrast IV?

@Hospitalista 2 жыл бұрын

Am sorry that I can’t answer this specific question, patients are different so please follow your doctor’s advice

@believe8464 2 жыл бұрын

Is IV contrast safe? Is there anyway to know if your allergic?

@greensky01 Жыл бұрын

only one way to finds out, get sick and need one.

@sk00977 Жыл бұрын

Does rectovaginal fistula diagnose requires contrast ? can we get any clue on plain pelvis MRI of rectovaginal fistula ?

@oneofthoseguys1000 Жыл бұрын

What about cta?

@Hospitalista Жыл бұрын

CTA by definition done with IV contrast

@lamborghinidreamers8158 2 жыл бұрын

Is Non Contrasted CT scan shows brain tumours.

@jamesvolz9105 2 жыл бұрын

I have read that the radiation for CT scans is not goo for the body.

@Hospitalista 2 жыл бұрын

This is an inaccurate general statement!

@sarahmccoy1941 2 жыл бұрын

@@Hospitalista So the ionizing radiation from a CT scan is not bad of a patient? From what I understand about radiation, there is no acceptable level of ionizing radiation that is good for a person. An MRI would seem safer as it does not use radiation.

@symanowrin1941 Жыл бұрын

Can it be done together

@Hospitalista Жыл бұрын

Yes Syma, first you take the images without contrast then you get the contrast and images retaken after

@symanowrin1941 Жыл бұрын

@@Hospitalista that means more radiation ? What’s the radiation of ctpa ?

@symanowrin1941 Жыл бұрын

@@Hospitalista I am only 22 and done 3 ct and including this 4 ct

@Hospitalista Жыл бұрын

Your physician should decide if you need that kind of study or not and outweigh risk and benefits, am not sure about the exact amount of radiation but you can visit this FDA website that has a lot of information about that www.fda.gov/radiation-emitting-products/medical-x-ray-imaging/what-are-radiation-risks-ct#:~:text=for%20cancer%20mortality.-,Risk%20Estimates,survivors%20of%20the%20atomic%20bombs.

@itrollluimarcodaylee4751 2 жыл бұрын

Absolutely give i.v. contrast in patients with blunt trauma to assess for lacerations, bleed, pseudoaneurysm etc. This is misleading and dangerous. Anyways, it doesnt really matter what your "order", if you write a good history and what youre looking for the radiologist will find an appropriate protocol.