CONTRAST RADIOGRAPHY OF GIT.

USE OF CONTRAST MEDIA IN VETERINARY RADIOLOGY;

Substance administered to the patient that is either more radiopaque or more radiolucent than surrounding tissue. Allows assessment of position ,shape,size and internal architecture of organ which is not apparent on original radiograph. Gives the assessment of dynamics of body .eg stomach emptying or peristalsis. POPERTIES OF IDEAL CONTRAST MEDIUM;

Different absorptive power from tissue. No irritant or toxic side effect. Accurate demarcation of organs. Persistence for sufficient time to take radiograph. Total expulsion from body. PREPRATION OF ELECTIVE CONTRAST STUDIES

Fast the animal and administer a cleansing enema. Sedate or anesthetize patient. Obtain a plain radiograph a day before Administer contrast medium noting the time. Obtain lateral, ventrodorsal/dorsoventral and oblique radiograph at regular time intervals.

TYPE OF CONTRAST MEDIA;

NEGATIVE CONTRAST MEDIA;

Room in air Show location ,size and wall thickness of organ. Luminal filling defects masses or foreign bodies. POSITIVE CONTRAST MEDIA; 1. BARIUM SULPHATE PREPRATIONS 2. IODINE PREPRATIONS. 3. VISCOUS AND OILY PREPARETION

BARIUM SULPHATE PREPRATIONS; 1. Chalky white material-mix water-thick paste or colloidal suspension ,mixed with food some times (shld not be injected). 2. Aspiration may cause pneumonia . 3. May perforate thru leaked gut (cause granuloma and adhesion if remain in mediastinum or peritoneal cavity). 4. BIPS(barium impregnated poly ethylene spheres) may be used for diagnosis of intestinal obstruction and motility disorders. 5. Eg- barium sulphate suspension, powder and paste

IODINE PREPRATIONS; 1. 2. 3. 4. Side effects eg. Nausea or vomiting etc. Shld be care full while I\V as irritant Contraindicated (cardiac or renal failure). Eg ,metrizamide, meglumine, iopamidol, iohexol etc.

NON IONIC, WATER SOLUBLE IODINE CONTRAST MEDIA; a. Tri iodinated benzene rings, not dissociated in solution have low osmotic pressure.(less side effects) b. Mainly used for myelography. c. Safe for cardiac or renal insufficiency, GIT perforations or risk of aspiration d. But expensive.

DOUBLE CONTRAST MEDIA; Use small amount of positive contrast medium to coat the mucosal surfaces of hollow organ eg bladder followed by distension with air( gives much better mucosal detail) VISCOUS AND OILY PREPRATIONS; a. b. c. d. e. Indicated when quick elimination is not required Less irritant. Immiscible in water not suitable for I/V use. Can be used for myelography Eg. Propylidone, iophendylated.

INDICATIONS FOR GASTROINTESTINAL TRACT a. b. c. d. e. f. g. Dilation Stricture plications Filling defects Mucosal pattern Rate of emptying Foreign body

BARIUM MEAL
Used to evaluate the whole GI tract in small animals, also the mucosal surface of intestinal tract 6-12mL/Kg of Barium sulfate suspension BARIUM SWALLOW 1-2mL/Kg of barium paste
After administering the barium, take right and left lateral and VD and DV radiographs of the abdomen. Some authorities recommend serial radiography [taking a lateral and VD radiograph on each occasion] at 15, 30, 45, 60, 90, 180 minutes post administration. This is impractical in many cases, particularly in cats. A more flexible regime is to take sequential films after thirty minutes and again after another thirty or sixty minutes. Your decision about the timing of the thirty and sixty minute radiographs will depend upon the rate at which the stomach is emptying and the barium is moving through the small intestines. Then take radiographs hourly until you have identified contrast material entering the large bowel. Usually you will take a final set of radiographs twelve hours after the barium was administered to check complete gastric and small intestinal evacuation of contrast. The rate of gastric emptying and of small intestinal transit of liquid barium varies greatly among normal cats and dogs. Contrast material may be seen within the large bowel in as little as thirty minutes after administration of barium in some cats but conversely may take as long as six to eight hours in others. As a general rule gastric emptying commences within 20-30 minutes of the meal being administered. In many individuals contrast material will be identified in the duodenum when the first set of radiographs is taken immediately after administration of contrast.

The things you will be looking for when you give an animal a barium contrast study are signs of. excessive gastric distension altered conformation of the gastric silhouette delayed, slow gastric emptying segmental or generalised small bowel dilation any abnormal mucosal pattern normal filling of the large intestine complete evacuation of contrast from the stomach and small intestines

The rate of gastric emptying following liquid barium administration is significant if prolonged. If the stomach is dilated, with evidence of peristaltic activity in the body or the pyloric antrum, a gastric emptying time that is longer than 30-60 minutes is strong evidence of gastric outflow obstruction. Filling defects in the walls of the stomach can indicate infiltrative lesions within the gastric wall. Obvious thickening of the gastric rugae may indicate a chronic hypertrophic disease of the gastric wall. Focal out-pocketing of barium from the lumen of the stomach would suggest the presence of a gastric ulcer.

Within the small intestine the most common abnormalities that you will see following a barium study are signs of segmental or generalised intestinal dilation. Occasionally you will see abnormal mucosal margins, which may indicate inflammatory or infiltrative intestinal disease. A focal, segmental ileus associated with an apple core mucosal pattern is a strong sign of small intestinal neoplasia. When barium enters the large bowel it usually conforms to the shape of the colon, and ultimately forms the shape of faeces. Radiographic variations in the large intestinal mucosal margin and the diameter of the large bowel following a barium meal are variable, and usually not a reliable sign of pathology. To study the large bowel a retrograde contrast study is used.