The provider's guide: Contrast vs non-contrast CT?
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- เผยแพร่เมื่อ 5 ก.พ. 2025
- 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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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!💕
Sharing so many example cases is genius! Thank you for the knowledge and the practice.
Super helpful regarding a subject matter that is not always explicitly explained. Thank you so much!
I am wondering about the injections. Allergic reactions, side effects, how does it leave the body, potential long term harm to the body etc...
IV contrast is excreted in urine by the kidneys. Renal failure is a contraindication for IV contrast.
Fantastic subjects to explain , ive enjoyed most of your videos , thanks alot
Is it ok to get new ct lung scan with contrast after 1 year gap from previous scan
i like music and Buzzing and the way he is talking well done
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
Had blood test today for cancer screening, the hospital told me that I would be waiting around 5 weeks for a CT. They rang me back 5 hours later saying that some had cancelled their CT, so could I come back in. It seems like they might of found something in my bloods, why call me back in when there is a 5 weeks waiting list. Surely they would of called someone that is higher up on the waiting list?
Contrast needed or not for Follow up case of VP shunt
Wanted to hear about cancer tumors in the breast..
For neck and skull ct due to week vocal cords . Is it iv or oral only? 28 years patient
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.
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..
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?
Hi!
For those who are alergic to contrast (iodine) is it worth doing any CT scan without contrast?
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!
@@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
Thankyou, absolutely nailed it.
Would you use contrast for a chest CT to look for possible hormone secreting adenomas?
Concise and informative! Thank you for the great content, Dr Alrahamneh.
Glad you enjoyed it!
What about a CAT scan for a hernia not suspected of infection or strangulation? No contrast okay?
Very useful tips. Thanks for sharing
Glad you found it useful
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?
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.
How are you right now?
@@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
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!
@@godschild3640😮
So basically. Without contrast enhancement can tell u about the tumor clearly?
thank you so much for this video, it is extremely helpful!
Glad you found it useful
very nice thank you for the great effort
How about the sarcoma they need IV contrast?
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.
very helpful, thank you
Glad it was helpful!
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
Glad you liked the video, penetrating injuries can be easily recognized on physical exam including any vessel bleeding externally or if internal bleeding suspected
@@Hospitalista Can I ask one more question 🙏🏼 how can I understand internal bleeding with physical examination ? Can you give me more details ?
Just thank you.
You are most welcome!
Is that ok to have ct scan with contrast dye - if you have kidney disease pls?
Thanks for reaching out! I strongly recommend you consult with your doctor regarding this matter, each patient is different.
I have read that the radiation for CT scans is not goo for the body.
This is an inaccurate general statement!
@@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.
Thank you
Do you need contrast for endometrial cancer?
In general we prefer to give contrast whenever assessing any neoplastic issue but the final decision should be up to the patient’s physician
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.
How does it work ? First without than with means 2 scans
@@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.
@@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
@@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.
@@ColonelMarcellus I have more than 80 msv in 3 years
How about Poor sleep? Do i need to contrast IV?
Am sorry that I can’t answer this specific question, patients are different so please follow your doctor’s advice
No
Great video! Can you make one on when to use transesophageal vs transthoracic echocardiography?
I will do in the future, thanks for your suggestion
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.
In appeniceal mucoceal
Iv contrast should be given or oral???
Plz reply
Usually IV contrast
Thanku for reply
My Dr preferred oral...
For appendiceal mucoceal...
Any reasons
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.
Thankyou so much sir!!!
You are welcome!
Does CT temporal bones need contrast?
No need unless you're ordering for any neoplastic condition
Can it be done together
Yes Syma, first you take the images without contrast then you get the contrast and images retaken after
@@Hospitalista that means more radiation ? What’s the radiation of ctpa ?
@@Hospitalista I am only 22 and done 3 ct and including this 4 ct
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.
Will ct scan without contrast show brain tumours both large and small ones?
most likely will show larger ones, but MRI is better at this
Great thank you
Is Non Contrasted CT scan shows brain tumours.
Is IV contrast safe? Is there anyway to know if your allergic?
only one way to finds out, get sick and need one.
What about cta?
CTA by definition done with IV contrast
Thank You.... You are Amazing Helpful.
Glad it helped!
Does rectovaginal fistula diagnose requires contrast ? can we get any clue on plain pelvis MRI of rectovaginal fistula ?
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.
Orally???? You actually drink it?
Isn't it toxic?
Yes, there is oral contrast that's safe to swallow!
@Hospitalista is it iodinated?
oh boy the culture shock i got coming from a 3rd world country when one of case scenario mentioned doing a ct scan for someone with diabetic foot 😅