An imaging method in which cross-sectional images obtained by X-rays are enhanced with an iodine-containing contrast agent given through a vein; used to evaluate tumor, vascular and organ pathologies.
Indication
- Detection, staging and follow-up of tumors of the abdominal and intrathoracic organs
- Evaluation of acute conditions such as acute abdominal pain, appendicitis, diverticulitis, intestinal ischemia
- Diagnosis of pulmonary embolism (blockage of the pulmonary artery)
- Characterization of liver, pancreas, kidney and spleen masses
- Screening of internal organ and vascular injuries due to trauma
- Imaging of aortic aneurysm, dissection and other large-vessel diseases
- Assessment of treatment response after cancer therapy (chemotherapy/radiotherapy)
Preparation
- Avoid solid food 4-6 hours before the procedure; water intake is not restricted
- Kidney function tests (creatinine/eGFR) and, when needed, thyroid tests are requested in advance
- If advanced kidney failure is present, metformin-containing diabetes medications are temporarily stopped before the procedure on physician advice
- Patients with a history of allergic reaction to iodinated contrast, severe asthma, or food/drug allergy must report this
- Suspected pregnancy, breastfeeding status and all current medications must be disclosed to the physician
How it's performed
- The patient lies supine on the CT table, with the arms usually placed above the head
- An IV line is established with a thin cannula in the arm
- An unenhanced scan is performed first to obtain reference images
- The iodine-based contrast agent is injected through the IV with an automatic injector at a constant rate
- Repeat scans are performed in phases appropriate to the region (arterial, portal venous, delayed phase)
- Brief breath-hold instructions are given during scanning; total time is 5-15 minutes
Post-procedure
- After the procedure, the patient is kept under observation for 15-30 minutes before the cannula is removed
- Generous fluid intake (oral or intravenous) supports excretion of the contrast agent
- In patients on metformin, the medication is restarted after kidney function is checked (usually after 48 hours)
- Observation is recommended for 1-2 days for delayed reactions such as itching, rash and nausea
- Results are reported by the radiologist and shared with the clinician
Risks
- Allergic reactions related to iodine-based contrast; most are mild (itching, rash) but rarely severe anaphylaxis may develop
- Contrast nephropathy: risk of temporary or permanent impairment of kidney function, especially in advanced age, diabetes and pre-existing kidney failure
- Metformin interaction: in patients with advanced kidney failure, drug management before and after the procedure is required because the risk of lactic acidosis after contrast may increase
- Exposure to ionizing radiation; the indication is evaluated based on the benefit-risk balance
- Contrast extravasation (leakage outside the vessel); may cause swelling and pain at the injection site, rarely skin damage
FAQ
Is the warm sensation in the body during contrast injection normal?
Yes. A widespread warmth, metallic taste in the mouth and the urge to urinate are common at the moment of contrast injection; these are temporary and resolve within a few minutes.
Can the test be performed if I have had a previous contrast allergy?
If a mild-to-moderate reaction occurred in the past, premedication (corticosteroid and antihistamine) and a different contrast agent may be preferred. If there is a history of severe anaphylaxis, alternative imaging methods (MRI, ultrasound) are considered first.
I have diabetes and use metformin, what should I do?
If your kidney function is normal, drug interruption is generally not required. If kidney impairment is present, metformin is stopped before the procedure and resumed after a 48-hour observation period with physician approval.
Can contrast-enhanced CT be performed during pregnancy?
CT is not preferred as the first option during pregnancy; when unavoidable, dose-minimized protocols are used and, when possible, ultrasound or unenhanced MRI is considered as an alternative.
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