FAQs

Chest radiograph and US duplex of lower extremities first. If indicated, CTPA or V/Q scan may be appropriate. CTPA: Higher radiation dose to mother, but less to fetus. This is also highly sensitive and specific. V/Q scan: Lower radiation dose to mother. More likely to be non-diagnostic.

CT with IV contrast is far superior than non-contrast in almost every circumstance. Oral contrast is usually not indicated.

Start with radiographs. MRI is more sensitive. Gadolinium is usually not necessary unless there is high concern for abscess.

CTA is superior for most indications. MRA is rarely useful if CTA has already been acquired. MRA can be done without contrast, making it first line in patients with AKI or low GFR not on dialysis.

CT esophagography is more sensitive, faster, and provides superior anatomic detail compared to fluoroscopy.

With few exceptions, CT high resolution chest is almost exclusively used to evaluate ILD.

Start with ultrasound if first presentation. CT A/P with contrast is important for assessing for complicating features. MRCP with and without contrast may be appropriate (Usually >48-72 hours after symptom onset).

32mg Methylprednisolone P.O. 12 hours and 2 hours prior to exam.

OPTIONAL: 50 mg Diphenhydramine P.O. 1 hour prior to exam.

See other options in EPIC under “contrast allergy panel”

IODINE not recommended if:

-GFR <30 and not on dialysis

-AKI

-Allergic

GADOLINIUM not recommended if:

-Pregnancy

-Allergy

If extenuating clinical circumstances, consider consulting radiologist