Download - To gad or not to gad
To Gad, Or Not To Gad...
Eric M. Baumel, MD
Digital Imaging Diagnostics
CT Brain
No contrast for Bleed
C- for Sinuses, Facial Bones
C+ for Orbits (except trauma)
CT Chest
No Need for Without and With
C+ to Evaluate for Mass (esp. for mediastinal and hilar adenopathy)
C+ for CTA Dissection, CTPA, CCTA
C- for Follow/Up of Nodules, ILD
CT Abdomen and Pelvis
Renal Stone Protocol - No IV or Oral
Oral and IV for Just About Everything Else (and you don’t need C- unless stones are a consideration)
Remember Abdomen stops at Iliac Crest -- Pelvis goes to Symphysis
MRI Extremities
No Gd unless evaluating a mass
MRI Spine
Gd for Lumbar Spines with Prior Surgery
Gd for All Spines for Tumor, Infection, Demyelinating Disease
MRI Brain without and with Gad
Mass
Infection
Demyelinating Disease
Acute / Subacute CVA
MRI without and with Gad
IAC’s
Pituitary
Orbits (ex. r/o Optic Neuritis)
Gad Enhanced MRACircle of Willis
Cervical Carotids
Aortogram and Runoff
(Can do CoW and Carotids w/o if necessary)
No Gd for MRCP
MRI Abdomen
Gd for Mass Evaluation
NSF (Nephrogenic Systemic Fibrosis)
GFR <30 == Contraindication
GFR >60 == No Problem
GRF 30 - 60 == Use Medical Judgement
Thank You!
Eric M. Baumel, M.D.
Digitalrads.com