Contrast Media

Enteric Agents
Routine Oral Studies: Barium Sulfate mixture
– Single Contrast Upper GI: Approximately 60% weight/volume (w/v)
– Double Contrast Upper GI: High density mixture (up to 250% w/v)
– Small Bowel Follow Through: at least 500 mL of 40% w/v

Possible Enteric Leak: Water Soluble Contrast
Risk of aspiration: Use Low Osmolar Water Soluble Contrast
Pouchogram/Loopogram: Water Soluble Contrast
Feeding Tube evaluation: Water Soluble Contrast

*Click here for examples of water soluble contrast*

Routine Enema: Barium Sulfate
– Double Contrast BE: 1-2 L of High Density mixture (100% w/v)
– alternatively: Gastrografin 240 mL diluted in 1000 mL water
Enema with Possible Enteric Leak: Water Soluble Contrast

Cystogram: Cystografin Dilute – volume as tolerated by patient

Intrathecal Agents
Isovue-M 200 or 300: 6-10 mL
Omnipaque 300: 6-10 mL

IV CT Agents
Iodinated Contrast: 3-6 g Iodine
– Eg. 100-200 mL of 300 mg/mL concentration

*Click here for examples of iodinated contrast*

Positive Oral CT Contrast Agents
Isoview 370: 15 mL contrast/450 mL water (450-900 mL over 30-90 min)
Isoview 300: 20 mL contrast/450 mL water (450-900 mL over 30-90 min)
Omnipaque 300: 6-9 mg/mL (500-1000 mL total)
Gastrografin: 15 mL contrast/450 mL water (450-900 mL over 30-90 min)
E-Z-CAT DRY (Barium Sulfate powder in 450 mL water): 450 – 900 mL over 30-90 min
Readi-Cat (Barium Sulfate 1.3%): 900 mL over 2 hours

Negative Oral CT Contrast Agents
VoLumen (Barium Sulfate 0.1%): 1200 mL over 90 min
*Whole milk is an alternative option for negative contrast

IV MRI Agents
Intravascular/Blood pool agents: 0.2 mL/kg IV Bolus
Eovist (Hepatobiliary): 0.1 mL/kg IV Bolus

*Click here for examples of gadolinium based contrast media*

Biphasic Oral Contrast
*900-1350 mL as tolerated by patient
Volumen  (Barium Sulfate 0.1%)
Breeza
Water + Polyethelene Glycol

Positive Oral Contrast
Magnevist (Gadopentetate)
Acai, blueberry juices
Manganese Chloride

Negative Oral Contrast
*600-900 mL as tolerated by patient
GastroMARK (Ferumoxsil)
Pineapple juice

Optison Microbubble (IV): 0.5 mL
Definity Microbubble (IV): 10 uL/kg
Lumason Microbubble (IV): 2-4 mL
Water +/- PEG (PO)

Oral Administration:
Routine Studies: Barium Sulfate (40-60% weight/volume)
TEF Esophagram or Possible Enteric Leak: Water Soluble Contrast
Pouchogram/Loopogram: Water Soluble Contrast

*Click here for examples of water soluble contrast*

Enemas:
<2 yrs: Cystografin Dilute
2-5 yrs: 60 mL Gastrografin with 300 mL water
5-10 yrs: 90 mL Gastrografin with 500 mL water
>10 yrs: 240 mL Gastrografin with 1000 mL water

Routine Barium Enema: 300 mL Polibar with 1500 mL water

VCUG/Cystogram:
Cystografin Dilute: volume as tolerated

*Estimated Bladder Capacity (mL)= (Age + 2) x 30

Intrathecal Agents
Myelogram: Omnipaque 180 (volume as needed)

IV CT Agents
Iodinated Contrast: 600 mg Iodine/kg up to 3 g
– Eg. 2 mL/kg of 300 mg/mL concentration

*Click here for examples of iodinated contrast*

Positive Oral Contrast
Optiray 320 (Ioversol): 1 mL contrast/30 mL clear liquid.
Omnipaque 240 (Iohexol): 1 mL contrast/30 mL clear liquid

Approximate Age based volumes below:
– < 1 mo: 45 mL (1.5 oz)
– 1 mo – 1 yr: 60 mL (2 oz)
– 1 yr – 6 yr: 120 mL (4 oz)
– 6 yr – 12 yr: 240 mL (8 oz)
– > 12 yr: 360 mL (12 oz)

Negative/Neutral Oral Contrast
VoLumen  (Barium Sulfate 0.1%)

IV MRI Agents
Gadolinium Based Contrast Agent: 0.1 – 0.2 mL/kg IV Bolus
– Prohance (Gadoteridol) is often preferred due to it’s macrocyclic structure (theoretically, less risk of tissue deposition)

*Click here for examples of gadolinium based contrast media*

Biphasic Oral Contrast
*6-10 mL/kg or up to 900 mL
VoLumen  (Barium Sulfate 0.1%)
Breeza
Water+Polyethylene Glycol

Positive Oral Contrast
*6-10 mL/kg or up to 900 mL
Acai, blueberry juices
Manganese Chloride

Negative/Neutral Oral Contrast
*6-10 mL/kg or up to 900 mL
Pineapple juice

Lumason Microbubble (IV)
– Liver ultrasonography: 0.03 mL/kg up to 2.4 mL
– Urinary tract ultrasonograhy: 1 mL via 6-8 French urinary catheter
5% Glucose Water (Enfamil) (PO)
Water +/- PEG (PO)