An intravascular contrast agent is required to visualize vascular structures in arteriography, venography, and vascular CT (e.g., aorta and pulmonary arteries). Intravascular contrast agent is also required to visualize the urinary tract in an IVU. In such situations, decisions regarding the use of intravascular contrast agents are concerned with whether to perform the examination. Aside from these indications, decisions regarding the use of contrast usually arise in the context of nonvascular CT. Although highly desirable in many situations, contrast enhancement is not absolutely required for nonvascular CT, and may not add much to the ED evaluation in many situations. While the potential imaging benefits versus the risks of contrast-enhanced CT should always be discussed with a radiologist on a case-by-case basis, some general guidelines are offered below (T§.bIe,294-7).
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