Gable Rhoads has an AD in radiography. She is passionate about her family, animals, gardening, and the odd and unusual.
Why Contrast is Used in CT Scans
Contrast is used in CT scans to increase the visibility of various internal tissues in the body. The density of blood vessels, the kidney and ureters, and other organs can be similar to the surrounding tissues, making them hard to visualize on a radiograph.
How Contrast Improves Images
Images using X-rays are formed by the number of x-ray photons which hit a special "detector" in a CT machine. The more X-ray photons that hit the detector, the darker the image will appear. Soft tissues are not dense so more photons hit the detector, resulting in a darker radiographic image without much contrast.
The iodine or barium in contrast dye is very dense and "absorbs" X-ray photons at a greater rate than the body's soft tissues. The body part with the contrast inside will appear lighter on the radiographic image than the surrounding tissue.
The images at the right demonstrate the difference in visibility of the abdominal organs with and without contrast.
The top image shows the abdomen without contrast. The less dense tissues of the liver, kidneys and other organs appear dark, while the denser bones of the vertebra and ribs appear light.
The bottom image shows the abdomen after an IV contrast injection. Notice how the kidneys, veins, and arteries appear much more visible when compared to the first image without contrast.
CT Images: With and Without Contrast
Types of Contrast
CT contrast, Gastrografin, also referred to as contrast "dye," is introduced into a patient's body intravenously (IV), orally, or rectally.
IV contrast is a liquid that is injected into a person's circulatory system. The IV contrast is stored in a sterile container. Tubing is connected to the container, and then the contrast is rapidly pushed through the sterile tubing, through an IV needle, and then into a vein.
Intravenous CT contrast contains very small amounts of iodine. X-rays pass through the surrounding tissue, but they are absorbed by the iodine molecules in the contrast. This provides the different levels of dark and light in a CT image.
Oral contrast will be either a barium sulfate solution or Gastrografin, an iodine-based solution. Both are either swallowed or used as an enema. Barium sulfate, a natural mineral, is a thick, chalky solution, whereas the iodine-based solution is a clear liquid that is lemon-flavored.
The barium, like iodine, is denser than the body's tissues. Barium sulfate acts in a similar way to iodine molecules. It also absorbs more X-ray photons than surrounding tissues, thus providing the contrast needed to see the anatomy of the digestive tract.
The contrast, when taken orally, will be drunk 2-12 hours before the scheduled CT scan.
Adverse reactions to IV contrast
Reactions to IV contrast vary from the mild to life threatening. Certain people are more susceptible to serious reactions to IV contrast. People who are at higher risk include those who have:
- had a past reaction to IV contrast
- are asthmatic
- have a prior history of allergic reactions to things other than contrast dye
- have a history of heart disease
- have a history of kidney disease
- are older
- are diabetic
Possible Side Effects of IV Contrast and Percent of Occurrences
|Mild 5-7%||Moderate 1%||Serious < 0.1%|
Feeling of warmth
People with these prior conditions will be carefully screened to ensure they are healthy enough to receive IV contrast. Blood will be drawn and analyzed, and an antihistamine may be prescribed prior to the next IV injection.
A person who is taking glucophage or metformin must abstain from it for 48 hours after receiving CT IV contrast. They must also return to their doctor to have blood drawn and their creatinine levels checked.
A reaction to IV contrast is not a true allergy. According to the website U.S. Pharmacist, "Reactions to contrast media are not a true allergy, but rather a pseudoallergy... There is no allergic antibody present that causes the reaction.... Contrast media act to directly release histamine and other chemicals from mast cells.... The higher the iodine concentration, the greater the risk of an adverse reaction."
CT Intravenous Contrast Myths
If you have a reaction to the contrast, that means you are allergic to iodine.
According to the website CT Scan Info, "'Iodine allergy' doesn't really exist. Iodine is a substance essential to life and is found throughout your body and within the thyroid hormone."
Iodine is not an allergen. Iodine is a natural element and is essential for the proper functioning of the thyroid. Iodine is found in seafood, dairy products, and some vegetables. If you had a reaction to the contrast, you are allergic to a substance in the contrast itself.
Is it true that if you are allergic to seafood, you cannot have intravenous CT contrast?
Seafood allergies are not related to the iodine found naturally in seafood. People who are allergic to seafood can eat other foods with iodine with no ill effects.
When a person is allergic to shellfish, the body's allergic reaction is to tropomyosin, a protein found in muscles, not the iodine itself.
People who are sensitive to topical solutions containing iodine cannot have IV contrast.
A sensitivity to these topical solutions do not contraindicate the use of IV contrast. According to the website U.S. Pharmacist, "Sensitivity to Betadine and other iodine-containing solutions is unrelated to reactions to iodinated radiographic contrast agents."
- USPharmacist.com > Intravenous Radiocontrast Media: A Review of Allergic Reactions
Depending on the type of contrast material used to enhance imaging, reactions can range from minor to life-threatening.
- The myth of iodine allergy | The Pediatric Insider
Article by Dr. Roy Benaroch.
This content is for informational purposes only and does not substitute for formal and individualized diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed medical professional. Do not stop or alter your current course of treatment. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
Questions & Answers
Question: How is creatinine measured?
Answer: It is measured using a blood sample in a laboratory.
For a more detailed response read: https://www.medicinenet.com/creatinine_blood_test/...
Question: After a CT scan with Contrast, if not much water has been drunk, can contrast dye cause constipation?
Answer: If you were given an oral or rectal contrast with barium, it may cause constipation.
Question: Must I drink 64 ounces of liquid after a CT scan with contrast?
Answer: The extra fluids help flush the contrast from your system which was needed for the CT scan. Drink as much liquid as you can.
Question: What is creatinine level ?
Answer: Creatinine is created by the normal breakdown of muscle tissue in the body. The kidneys remove it as a waste product. If a person's creatinine level is high, it may indicate a problem with kidney function.
Question: Should patients with kidney failure use these contrast mediums for a CT scan?
Answer: The doctor will weigh the risks versus the benefits of using contrast. If you are not comfortable with the decision, seek another opinion.
Gable Rhoads (author) from North Dakota on March 10, 2020:
Jennifer, make sure your doctor is aware of the previous reaction. She will prescribe medicine to counteract the reaction if intravenous contrast is needed and the doctor feels the benefits of the scan outweighs the risk.
Also, make the CT techs aware of your previous reaction.
Jennifer Hughes on March 10, 2020:
I had an anapylaix reaction to the contrast to the CT dye and have to have another CT, is there another alternative to this dye
Gable Rhoads (author) from North Dakota on July 12, 2017:
I appreciate the questions and comments, but I cannot answer specific questions. Please talk to your doctor and/or CT tech. They will have answers suited to your unique situation. Sorry!
CMLER on July 12, 2017:
Is ok to have Ct scan with red dye while taking gleevec chemo for cml leukemia?
Frequency on July 03, 2017:
What is the elapsed time before a patient is given a second dose of IV contrast? One for a scan of the abdominal area and another for the chest?
littleanita90 on October 01, 2016:
I had an allergic reaction 15 years ago when I had a heart cath. The doctor wants to do a CT with contrast. Is there a contrast without iodine
Gable Rhoads (author) from North Dakota on May 04, 2013:
Thank you, Glenn.
I feel the more information people have about medical procedures, the better for the patient and the clinical staff. There is still a lot of disinformation floating around about CT contrast. :)
Glenn Stok from Long Island, NY on May 04, 2013:
I had always wondered what the Contrast Dye is that's used in CT Scans. You hub was very thorough with the information. I didn't realize that thre are so many different types of dyes. I especially found it very interesting that there are so many different allergies that relate to problems with iodine used in contrast dyes. Very educational hub. Voted up.