ABSTRACT. The use of intravenous (iv) contrast media in CT examinations is often of great value in improving diagnostic accuracy. The preferable route of administration is via a peripheral iv cannula, with powered injectors allowing reliable delivery of rapid flow rates. However, many patients with a pre-existing central venous access device may have difficult peripheral access and there is a temptation to use the central device for delivery of contrast media. This review summarises the available evidence for the safe and effective use of these devices to assist the radiologist in balancing the relative risks and benefits of their use for contrast medium injection.
A 63-year-old man presented with weight loss and rectal bleeding. He had no significant medical history and was taking no medications. He complained of some minor left hip pain, which had been attributed to osteoarthritis. Physical examination was normal. The patient's blood count, renal function and liver enzymes were normal. The carcinoembryonic antigen level was elevated. Colonoscopy revealed a small polypoidal tumour in the descending colon. Biopsies were positive for colonic adenocarcinoma. As part of the staging process, CT of the thorax, abdomen and pelvis was performed, which was unable to depict the primary tumour and showed no nodal disease or metastasis. However, the proximal left femur was abnormal. Subsequently, plain radiography and MRI of this region were undertaken (Figures 1-3
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.