Medical College of Georgia at Georgia Health Sciences University, Augusta, GA, USA.
Am Fam Physician. 2013 Sep 1;88(5):312-6.
Family physicians often must determine the most appropriate diagnostic tests to order for their patients. It is essential to know the types of contrast agents, their risks, contraindications, and common clinical scenarios in which contrast-enhanced computed tomography is appropriate. Many types of contrast agents can be used in computed tomography: oral, intravenous, rectal, and intrathecal. The choice of contrast agent depends on route of administration, desired tissue differentiation, and suspected diagnosis. Possible contraindications for using intravenous contrast agents during computed tomography include a history of reactions to contrast agents, pregnancy, radioactive iodine treatment for thyroid disease, metformin use, and chronic or acutely worsening renal disease. The American College of Radiology Appropriateness Criteria is a useful online resource. Clear communication between the physician and radiologist is essential for obtaining the most appropriate study at the lowest cost and risk to the patient.
家庭医生通常必须为患者确定最合适的诊断测试。了解对比剂的类型、风险、禁忌证以及增强 CT 适用的常见临床情况至关重要。许多类型的对比剂可用于 CT：口服、静脉内、直肠和鞘内。对比剂的选择取决于给药途径、所需的组织分化以及疑似诊断。在 CT 中使用静脉内对比剂的可能禁忌证包括对对比剂的反应史、怀孕、甲状腺疾病的放射性碘治疗、二甲双胍使用以及慢性或急性恶化的肾脏疾病。美国放射学院适宜性标准是一个有用的在线资源。医生和放射科医生之间的清晰沟通对于以最低的成本和风险为患者获得最合适的研究至关重要。
