Radiographic Procedures and Contrast Media Lecture Notes

Comprehensive vocabulary regarding contrast media reactions, administrative methods, anatomical glands, and specific radiographic projections/procedures for the GI tract and salivary glands.

Psychosomatic Reaction

A mild transient effect associated with patient anxiety, fatigue, and state of dehydration.

Technique Reaction

Includes extravasation with burning pain, hematoma, numbness, and vascular constriction.

Pyrogenic Reaction

A reaction without a known cause that tends to produce a rise in body temperature.

Systemic shock

A sudden drop of blood pressure occurring after the injection of contrast media.

Severe bronchial spasms

A major reaction characterized by prolonged contraction of muscle in the wall of the bronchi.

Viscosity

The quality of a sticky fluid; higher concentration typically leads to greater viscosity.

Miscibility

The property of a contrast medium to easily mix with blood.

Osmolality

A measure of the total number of particles in a solution.

Scleral, Sub-lingual, Intradermal, Intra-venal

The four methods listed for administering a sensitivity test.

Angioedema

A moderate reaction characterized by the swelling of soft tissue.

Severe reaction (vasovagal)

A life-threatening condition where the heart rate drops (Bradycardia $< 50 \text{ beats/min}$) and BP may fall (Hypotension systolic BP $< 80 \text{ min}$).

Intrathecal

A method of introducing contrast media into a sheath.

Parenteral

The method of injecting contrast media into the blood stream (e.g., IV or intra-arterial).

Thin Barium

Contains $1$ part Barium to $1$ part Water, resulting in a $60\%$ weight-to-volume ($w/v$) suspension used for the entire GI Tract.

Thick Barium

Contains $3$ to $4$ parts Barium to $1$ part Water, used for the esophagus and mucosal lining.

Ionic Contrast Agents

High osmolality media with a higher risk of complications, such as Diatrizoate Sodium (Hypaque) and Iothalamate Meglumine (Conray).

Non-ionic Contrast Agents

Low osmolality media with a lower risk of complications, such as Gadodiamide (Omniscan), Iodixanol (Visipaque), Iopamidol (Isovue), and Ioversol (Optiray).

Colloidal Substance

A mixture of barium and water where barium never dissolves, but stays suspended.

Sialography

Radiographic examination of the salivary glands, ducts, and calculi using water-soluble iodinated contrast media delivered by hydrostatic pressure.

Parotitis

Mumps; a viral inflammation and enlargement of the parotid glands that acts as a contraindication for sialography.

Stensen's duct

The duct associated with the Parotid gland.

Wharton's duct

The duct associated with the Submandibular (submaxillary) gland.

Bartholins duct

The duct associated with the Sublingual gland.

Iglauer Method

A maneuver to increase visibility of salivary calculus by depressing the floor of the mouth to displace the submandibular gland.

Palatography

Methods of evaluating suspected tumors of the soft palate or abnormal chewing and swallowing mechanisms in children.

Nasopharyngography

Radiographic examination of the nasopharynx following instillation of contrast media, often indicating hypertrophy of the pharyngeal tonsils/adenoids.

Gunson Method

Synchronizing the exposure with the height of the swallowing act in deglutition to study the pharynx and upper esophagus.

Valsalva maneuver

Forcible exhalation against a closed airway (holding breath and bearing down) to show complete closure of the glottis.

Achalasia

A condition involving abnormal constriction of the Gastroesophageal junction.

Esophageal Varices

Distention of the esophageal veins; demonstrated in AP or PA recumbent positions.

Mueller maneuver

A technique where the patient exhales and then tries to inhale against a closed glottis to test for esophageal reflux.

Body Habitus Classifications

Hypersthenic ($5\%$), Sthenic ($50\%$), Hyposthenic ($35\%$), and Asthenic ($10\%$).

Trichobezoar

A mass of ingested hair trapped in the stomach.

Phytobezoar

A mass of ingested vegetables, fiber, or seeds trapped in the stomach.

Schatzke's ring

A ringlike constriction at the distal esophagus, a radiographic sign of a sliding hiatal hernia.

Peristalsis

Contraction waves propelling contents toward the rectum, normally appearing as $3$ or $4$ waves per minute.

Average emptying time of a normal stomach

$2-3 \text{ hours}$.

Gordon's Maneuver (PA axial)

A prone projection with a CR of $35-45^\circ$ cephalad to demonstrate the pylorus, bulb, and antral portion of a high transverse stomach.

Wolf Method (guglielmo)

A modification of Trendelenpurg using RAO $40-45^\circ$ and CR $10-20^\circ$ caudally to demonstrate sliding gastroesophageal herniations.

Steerhorn stomach

A stomach habitus where the incisura is higher by $1 \text{ cm}$ than the pylorus.

Hypotonic stomach

A stomach habitus where the pylorus is higher than the incisura angularis by $1 \text{ cm}$.

Gugliantini Projection (PA axial)

A projection for infants, prone with a CR of $20-25^\circ$ cephalad to demonstrate the infantile stomach.

Biphasic Study

A gastrointestinal examination incorporating both single-contrast and double-contrast methods on the same day.