Radiographic contrast agents are substances used to distinguish between internal structures in medical imaging, such as various types of x-rays and magnetic resonance imaging (MRI).
During imaging tests, contrast agents may be used to distinguish one tissue or structure from its surroundings or to provide greater detail.
Contrast agents include
Radiopaque contrast agents (sometimes inaccurately called dyes): Substances that can be seen on x-rays
Paramagnetic contrast agents: Substances that are used in magnetic resonance imaging (MRI)
Radiopaque Contrast Agents
A radiopaque contrast agent absorbs x-rays and thus appears white on x-rays. It is typically used to show the following:
Blood vessels
The interior of the gastrointestinal, biliary, or urinary tract
Blood flow in organs
Usually, the contrast agent is injected into a vein (intravenous contrast), artery (angiography), taken by mouth (oral contrast), inserted through the anus (rectal contrast), or injected into a joint using a needle.
The contrast agent used depends on what type of test is done and which body part is being evaluated:
For blood vessels: Usually contrast agents that contain iodine (iodinated contrast agents)
For the gastrointestinal tract: Contrast agents that contain barium or iodine (gastrografin)
Before a test that uses a contrast agent, people may be asked to refrain from eating for several hours and from drinking for 1 hour. After the test, drinking extra fluids for the rest of the day is recommended.
When some contrast agents are injected, people may feel a warm sensation throughout the body. Other contrast agents may cause a cold sensation at the injection site. Contrast agents taken by mouth may have an unpleasant taste.
Side effects of radiopaque contrast agents
Generally, radiopaque contrast agents are very safe, particularly when given by mouth or into the rectum.
Side effects of injected iodinated contrast agents occur in a few people. They include
Kidney damage, especially when people have a preexisting kidney problem or when large amounts of contrast is used
Allergic-type contrast reactions
Allergic-type contrast reactions vary in severity:
Mild, such as nausea, flushing, or itching
Moderate, such as a rash, vomiting, or chills
Severe and life threatening (anaphylactoid), such as a swollen throat that interferes with breathing, wheezing, very low blood pressure, or an abnormal heart rate
Allergic-type contrast reactions are most likely to occur in people who have one of the following:
Kidney damage
Kidney damage (contrast nephropathy) due to use of a iodinated contrast agent may occur in people with certain conditions:
Impaired kidney function
Age over 70
High blood pressure (hypertension)
Use of medications that can damage the kidneys
In almost all people, the kidney damage causes no symptoms and goes away within 1 week or so. Very rarely, a person has lasting damage, and only a very few of them require kidney dialysis.
Did You Know...
Paramagnetic Contrast Agents
Paramagnetic contrast agents change the magnetic properties of particles in a way that increases the contrast between different tissues, making MRI images clearer. These agents usually contain gadolinium.
Side effects of paramagnetic contrast agents
Usually, no side effects occur. However, in a few people who have severe kidney disease or who are undergoing dialysis, these agents may cause a life-threatening disorder called
Nephrogenic systemic fibrosis
In nephrogenic systemic fibrosis, the skin, connective tissue, and organs thicken. Red or dark patches may develop on the skin. The skin may feel tight, movement is difficult and limited, and organs may malfunction. This disorder is now very rare because doctors use gadolinium paramagnetic contrast agents in people with kidney problems only when necessary, and they use the lowest dose and safest agent possible. Doctors also consider using other imaging tests in people with severe kidney problems.
