Safety First

Silver Creek Radiology commitment to patient safety includes doing the utmost to prevent contrast induced nephropathy and nephrogenic systemic fibrosis in CT and MR, respectively. We adhere to the latest American College of Radiology’s Manual on Contrast Media, Version 9.

Computed Tomography (CT)

For CTs with contrast, renal function tests should be obtained within 90 days for patients with an age >60, diabetes, hypertension, a history of renal disease, or that may have possible renal dysfunction.

For:

• eGFR > 60, a full dose of contrast will be administered.
• eGFR 30-60, pre-scan IV hydration and the use of the lowest possible dose of contrast for an adequate study will be administered.
• eGFR < 30, contrast will not be used due to the significant risk of contrast induced nephropathy.
• Patients in chronic renal failure on dialysis and no reasonable expectation of native renal function, contrast may be used.

Magnetic Resonance Imaging (MRI)

For MRI with contrast, renal function tests should be obtained within 90 days for patients with an age >60, diabetes, hypertension, a history of renal disease, or that may have possible renal dysfunction.

• eGFR > 60, a full dose Dotarem not to exceed 20 cc will be administered
• eGFR 30-60, full dose Dotarem will be administered. Please note Dotarem has never had a nonconfounded case of nephrogenic systemic fibrosis.
• eGFR < 30 or on dialysis,  needs discussion with referrer if absolutely needed to assess if the benefits outweigh the risks, Dotarem will be used and dialysis within 24 hours will be considered.

IV Contrast Allergy Premedication

No Pretreatment Needed

Single, Isolated shellfish allergy not anaphylactic

Premedication Needed

50mg Prednisone PO 13, 7 and 1 hour before injection & 50mg Benadryl PO within 1 hour of injection

• Existing mild reaction to iodinated contrast i.e. hives, nonanaphylactic reaction
• Allergies to multiple entities
• Anaphylaxis to anything other than iodinated contrast

IV Contrast Contraindicated

Prior anaphylaxis to iodinated contrast

MRI Contraindications

MRI IS permitted with

• Orthopedic implanted hardware (joint replacements, spinal fusion, etc.).
• Soft tissue shrapnel (except for within the orbit). 
• Non-intracranial vascular stents.

MRI IS CONTRAINDICATED IF

• Pacemakers or other implanted pump devices.
• Metallic debris in the soft tissues of the orbit.
• Older intracranial vascular aneurysm clips (most modern clips are MRI compatible and can be cleared by our techs if the clip model is identified).