Here for me, not the child for a change. I’ve got to go for a chest CT next week, and although bod has never required contrast with any of hers, I was hoping to try and get a feel for how often (if ever) contrast is given in adults for a scan of the lungs?
Thanks in advance, as always.
I've only ever had contrast for CT on chest / lungs, I think it is usual, well it has been usual in my case.
Hi Charlie_G
Whether or not you need contrast depends on what they are looking for. Consenting to it is up to you.
I have had many ct scans. All without contrast until 2015, when after being ill with community aquired pneumonia and an empyema, my consultant ordered a ct. To my surprise they put dye in for contrast. I was not happy. I hate anything in my body and had not been warned.
Afterwards I spoke to my consultant who told me that the contrast was to look at blood vessels but for me it wasn’t necessary and that I should refuse it if I wanted to.
Some months later I needed a follow up ct and refused the dye. The nurse in the room was quite nasty and told me that it was required and was now usual for every ct scan. Also that if I refused the dye I could not have the scan. I got off the table and was heading for the door when the radiographer came out and chased after me. He said that it was fine to have the scan without the dye.
So that is my story. You will of course, make up your own mind.
Thanks, LP. The idea of springing anything on anyone outside of an emergency is to me absolutely insane; I’m glad you stood by your right to withold consent.
Basically, I’ve been on methotrexate for 7 months and Leflunomide for 4 following finally getting a diagnosis of inflammatory arthritis: I know better late than never and all that, but ten years is pushing that concept just a *little* bit if you ask me. Anyway, about two months ago, I noticed an almost insidious breathlessness had started creeping in on exertion, and now one flight of stairs can have me heavy breathing like I should be arrested. I recover quickly enough, but my sats are also sometimes dropping to 93%, even at rest, and that’s not normal for me. They want to rule out any kind of lung condition brought on either by the arthritis or the meds, as well as just check it’s not a case of my past bad habit catching up with me. I’m not coughing except for post exercise, which looks a lot like post exercise asthma tbh, although I’ve never had a problem before, but there’s also a fair bit of wet throat clearing required on a daily basis. All of that said, the lef has exacerbated pre-existing post nasal drip and left me near constantly stuffy nosed to the point I bought antihistamines thinking I’d developed hay fever, so the throat clearing could easily be more attributable to that side of things than anything lung related.
As if you didn't have enough to cope with. My experience on this forum has taught me that inflammatory arthritis can lead to lung problems including ncfbe. So it's best that finally they are trying to get to the bottom of your symptoms. Hopefully they will not be lung related. Do keep us up to date.
I had many scans without contrast including last week, but when I had empyema two years ago I had contrast put in. They also thought I might have PE so maybe that's why I had contrast.
Littlepom thats the stuff, remember the NHS was paid for by the honest hard working common people of this country. we are not ther for ther benefit, they are ther for our benefit, after being shunted from pillar to post for14 months l now know how to handle my case . god bless Rodders
It is usual for me to have contrast, I think it depends on what they are looking for. If it is for cancer (I do hope not) then I believe it is always used without fail. Be prepared, it always feels like you have wet yourself, when it goes in. Note: You will not get given contrast if you are allergic to Iodine.
I'm a radiographer, so if you have anything specific in regards to contrast, ask away. But in general, contact us given depending on what is being queried. Its very good for picking up malignancies as contrast is given intravenously and malignant tumours have a blood supply, so if you have a malignant tumor, it will light up light a Christmas tree.
It can make you feel hot and flushed and also as if you have wet yourself- but you don't actually wet yourself. You won't be given it if you have allergies or if you have kidney problems.
In your experience, what are the odds of having contrast when looking for arthritis driven lung conditions (ILD, non cf bronch, OB) and/or lung injury due to methotrexate, and/or COPD?
Whilst the obvious answer would be to just phone the department and clarify from the horse’ mouth, my question actually stems from taking metformin. I’m not diabetic, and the screening booklet says to contact them if you’re diabetic and taking metformin - I’m being pedantic about the wording, but figured if the vast majority on here with those sorts of diagnosis don’t normally have contrast, odds are I won’t either. I’m aware that the concern with metformin is acute nephrotoxicity it it’s taken for the 48 hours post iodine contrast, so am assuming that if they did give me contrast, I could simply withold the metformin for a few days. Am I oversimplifying things?
Having typed all this out, I do now realise how absolutely dysfunctional both myself and the entire scenario looks...oh well. Out there now 🤦♂️😂
So just to clarify a key point here, as a radiographer, my knowledge is limited to radiographic imaging and contrast safety. So I will answer the best I can.
In regards to types of imaging for those specific conditions you mention, they generally wouldn't be done with a contrast CT sequence. The gold standard for those would be HRCT scans as they are performed using thin CT slices in order to visualise the small airways, usually on inspiration and expiration. There is no need for contrast as contrast does not enter the bronchioles.
The contrast is used more to highlight structures, primarily malignancies and to view the pulmonary vessels. It can also highlight any conditions linked to your heart. However, if the conditions you mention are progressed enough, they can be seen using contrast medium.
The things we check prior to administering contrast, are allergies and renal function. The general consensus is, if your asthmatic then you suffer with allergies and in turn are high risk of an asthma attack or anaphylaxis. If your creatinine is high then your GFR is generally high as well which puts you high risk of kidney damage or nephrotoxicity, as you say. Taking metformin, generally implies your diabetic and one of the problems with diabetics is kidney function problems. I don't necessarily believe the metformin itself is an issue with contrast medium. Most, if not all, scans with contrast are less than 100ml which has very low risk of causing harm to the kidneys. If you suffer from any for of kidney issues, that's something that would need to be considered before given contrast.
However, contrast can be given for those conditions if the referrer is looking for comorbidities that are secondary to things such as COPD, like pulmonary vascular disease and is not for viewing the COPD itself.
I hope that made sense and I managed to answer your question. It's 12:15 at the moment and I've had a glass of wine to many so i may have misread your question so sorry if i haven't answered it correctly. Let me know. 😬
I've always had it. It's nothing, trust me. A second of warmth that reaches every part of your body from neck to upper thighs. And I do mean every part. They tell you that you might feel as if you want to pee. Sometimes you do. But that passes in a second too and you definitely don't pee. It's painless and not uncomfortable or anything. So just keep those arms above the head and do what the machine says. Whole lot takes under ten mins. Good luck. Everybody worries about the contrast the first time, but there really is nothing to worry about it.
PS It won't leak out of the canula either. I have the worst veins ever and no problems. Must have had about 20 of these over the years. It's about a teaspoon full anyway. Be over before you notice.
I have an annual review of my (moderate) bronchiectasis annually with a bronchX specialist at Papworth Hospital. In recent years she has usually asked for a CT scan with contrast (often I do the scans here in Thailand and bring a disc with me to the UK). Having read this interesting thread I think I'll ask why next time! I have no problem with it though - I don't seem to get the peeing sensation these days either.
I have had the dye a few times, I must say it is the only time in those cold rooms that I ever feel warm... Man the stuff burns in the most unmentionable places.
But I think to refuse to have the dye would in my mind be silly.
It helps the Consultant and professor to see things in detail and thereby catches things early, so faster treatment.
I have had PE a few times so it is beneficial for me, But it is completely up to yourself as the patient to you make your own mind up.
It is strange to me, why they want to put a DNR on you which you shout out loud...NA thanks... I`m still breathing but you feel "A well having a telescope shoved up me bottom " is OK!! I think the dye is the lesser of the two evils.. apart from an Irate nurse that is.
I had a chest CT scan with contrast in a and e when I had blood clots in my lungs and they put the contrast in your arm and you feel warm and like you are peeing when you aren't when you are in the scanner.
Best of luck with your scan!
The last time I had contrast at Papworth I had an allergic reaction which was very unpleasant,so now I can never have it again, which is a bit troubling...
I had CT with contrast. I didn't even query it as at the time I felt so unwell I would agree to anything they offered! I had no problems with it. xx Moy
I've had CT scan and a high res scan. The hardest bit of both was holding my breath. In both cases the staff on duty were really lovely.
For the high res they injected a small amount of iodine. No problems. I was warned I would feel a 'hot flush' in my neck, then my 'private bits'. In the latter it would feel liked I'd peed. Not to worry I hadn't. (Told politely and lightheartedly).
All true, fleeting feelings as described.
When finished I was helped to slowly, sit up and walk to a chair nearby. Given tea and biscuit, I'd been told I might feel wobbly. Soon felt fine. Dressed and home. No after effects.
It was worth doing as it helped them find the small airways problem.
Hi Charlie, I had one about three weeks ago, first ct scan ever! I was apprehensive when they explained about the hot flush and imaginary peeing, but hardly felt anything! I hadn't thought to enquire why "with contrast", I just assumed it was the norm! Good luck with it xx
You’ve had some very helpful replies which I won’t add to. Just wanted to wish you and the not so small one all the best.
Take care
X
Charlie you have so much on your plate dear man.
Brilliant reply from Lee, despite being on the vino well into the night!
I have had a recent ct scan to see if they are missing anything re my ‘manky’ lungs, with no contrast. I can’t recall having contrast with scans on my lungs. However I have had contrast with scans for other health issues.
The connection with inflammatory arthritis and lung issues appears to be very well known. A former rheumy wondered which came first. I assumed it would be the BE as I’d had it all my life but he said it could be that I had a predisposition for the arth - so we’ll never know. I cannot tolerate hydroxychloraquin or sulphasalazine and a different rheumy said she wouldn’t prescribe methotrexate because of my BE and I told her I wouldn’t take it if she did. One of my resp consultants has been doing a study in inflam arth and lung issues. Not sure if it was restricted to cf/be/pcd or lung issues in general.
I hope your ct goes well whatever decision you make and that they will get to the bottom of your health issues.
Pease let us know how you get on. I hope too you are getting some support. You obviously have support from everyone on here Charlie.
Love cx
Thank you, dear Cof. My frustration with the arthritis is that I must have driven 4 of the GPs at our old practice nuts. I’ve had repeated steroids for knees and toes, complained continuously of bouts of fatigue and back pain, hip pain, knee pain for well over a decade. They diagnosed me with bursitis three times, when in reality it was arthritis, they just wouldn’t accept it because I happen to have a sero-negative form. Even the rheum they eventually referred me to about 6 years ago said he had no idea what was wrong because my anti CCP and RF were normal. Had one of my fingers not swelled up like a sausage last autumn, my new GP admitted she wouldn’t have sent me for a scan either and probably written it off as ‘one of those things’, because at the height of a flare my crp was less than 4 and my esr equally completely normal. Since then, rheum have confirmed that I’ve probably had ‘likely PsA’ since my mid teens and an mri shows that I have spinal involvement; wouldn’t mind, but because of the back pain I get, I had 2 spinal MRIs at the height of my neurology issues looking for a related condition that might explain it and they failed to spot the arthritis 🤦♂️ This chest stuff is completely new, though: fingers crossed the ct is clear, although that will just leave me wondering what’s causing it 🤷♂️
The mtx did nothing on its own, hence the lef. I had a review last week, and it’s still not properly under control by any stretch, so he wanted to increase the lef, but I’m having a terrible time with severe skin outbreaks/cysts/abscesses and post nasal drip with that, so he decided to put the mtx up to max and I have to start self-injecting. I think I’m biologic bound in all honesty. It’s just going to take a few more months for them to come to the same conclusion, although he said the first time we met that he wouldn’t be surprised if that’s ultimately the case.
Interestingly, E has had 2 bouts of large joint swelling in the last 6 months, and they ran a joint panel last admission because her ankle became swollen on the ward for no reason. Everything came back normal, so they said they don’t think it’s cf arthritis/arthritis generally, but I’m keeping an open mind given the links with lung issues; they keep saying that they can’t explain why her imaging doesn’t match her symptomology. Throw in a queried connective tissue disorder, and the bigger picture of her chest may actually make a bit more sense....
Oh it’s such a bugger when you don’t fit into their boxes. Sounds like you are a Zebra like our Katinka and have them scratching their heads, which doesn’t help you much.
I am hoping so much that your lung ct comes back clear but as you say that then leads you wondering. I hope they have some answers for you. I really don’t know how you manage, caring for E so well, when you must feel quite rough yourself.
Sounds like bod has a bit of the Zebra about her too. It must be so difficult. The pain and health issues are just the same but for some reason if you have a label then as least you know what you are dealing with, and indeed how to deal with it.
Please come on here when you find the time Charlie, as we care how you are both getting on.
Love cx
I only had contrast with my first one. All the following ones it wasn't required.
I have had a couple of ct scans and one with contrast and all went well. I am also on methotrexate for rheumatoid arthritis since last August, I am sure my bronchiectasis has become worse since starting this x
Wishing you all the best for your CT scan. It's so frustrating to put it mildly when you're not properly or accurately diagnosed because your case isn't straightforward or doesn't fall into one category. Hopefully this will start to get things sorted out for you.
I can’t really add much more to what has already been said. I’ve had several CTs and most have been with contrast including the HRCT.
When I had a burst brain aneurysm they used contrast for the CT.
Later, when I was supposed to have an MRA with contrast the radiographer said it wasn’t needed (three separate times). If in doubt ask the radiographer on the day.
I was in & out in 10 mins and didn't have dye. Was a repeat one to check on Bronchiectasis
Contrast ct scan + colonoscopy polypectomy biopsy
COPD CT scan with contrast Vs fev1/fev
