Are There Alternatives To Contrast-enhanced CT Scan?

Posted on Mon, 19 Sep 2016

Question: For people who have mast cell activation disorder or allergies to contrast dyes used in CT scans, is there a way to get CT scans without XXXXXXX or using XXXXXXX alternatives? If so, is CT imaging without dyes or using XXXXXXX alternatives of sufficient quality to warrant the radiation exposure from the CT scan?

Answered by Dr. Dr.Arnab (33 minutes later)

Brief Answer:
go for MRI scan..

Detailed Answer:
Hello XXXX, Welcome to HCM,

I've gone through your query and understand your concern,

If you can tell me in details for which purpose CT scan is getting planned, then I'd be able to guide you more specifically (as different conditions warrant different requirements, and also different types of findings)..

However, considering your allergic history as well as radiation exposure concern- I'd simply advice you to go ahead for MRI scan with/without contrast (MRI contrast is much safer compared to the dyes used in CT scan).. also there's no radiation exposure also..

Please discuss this with your treating doctor..

Wish you good health..

Take Care
Kind Regards

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Dr.Arnab (30 minutes later)

Thank you very kindly Dr. Banerjee. At the beginning of XXXXXXX I from California, which is at the lower end of XXXXXXX to XXXXXXX which is at the very top of XXXXXXX Since this move I have been getting severe breathing problems, which have been worsening, and which primarily present as asthma and chest pain which occur throughout every day and every night. I am highly allergic to mold per IgE blood tests, and was exposed to toxic mold in the house I moved to here, as well as all the new outdoor mold antigens relocating to a geographically disparate place. So the primary imaging purpose would be to assess lung functioning in general and hypersensitivity pneumonitis in particular, so as to see how the mold exposure has affected my respiratory system. They may also want to image my heart because of the chest pain, though that can possibly be caused by the respiratory issues.

I did react formerly to an iodine XXXXXXX given in an MRI procedure. To my understanding, MRI exposure is just a different type of radiation exposure, being a high-strength magnetic field I believe. The cumulative toxic mold exposures I have incurred have not only caused mast cell activation disorder, but sensitized me to electromagnetic fields, such that being in close proximity to an electronic appliance with an AC magnetic field of over 100 mG (milligauss) for any duration of time will cause painful heart ectopies. Follow up questions would be these:

I. Would CT imaging w/o contrast suffice for heart and/or lung imaging?
II. Would an MRI w/o contrast suffice for heart and lung imaging?
(I react fine to ultrasound imaging if this would work for either heart or lung organ systems.)
III. Do you know the typical magnetic field strength of an MRI in mG?

Again, thank you so much for your insights.

Answered by Dr. Dr.Arnab (2 hours later)

Brief Answer:
There's NO Radiation risk/exposure in MRI..the 'R' stands for Resonance (R)

Detailed Answer:
Hello XXXX, Welcome back,

Thanks for following up with these details,

First of all, let me assure you that there's no risk of any radiation exposure in MRI simply because it's generated by magnetic resonance imaging, no matter how big or stronger the machine is, the field always remain magnetic..Only contraindication for this is any older generation implants/clips (bone/teeth etc.) in the body or some specific pacemakers..

So the answer to your questionnaire are :

I. CT can be safely substituted by MRI in this regard (with or w/o contrast- the decision of the contrast only comes on table, if there's no conclusive findings in the non-contrast scan/ or any thing dubious for the radiologist to comment on the basis of the non-contrast film)..

It'll give a detail idea of the lung but brief idea of the heart (details of heart structures can be easily done by 2D/3D Echocardiography with color doppler which is nothing but ultrasound of the cardiac structures)..

As for the choice of contrast, Gadolinium can be selected instead of Iodine, and a very small test dose can be administered to check for the allergic response prior to actual testing, it's a much safer option, please discuss them with your doctor..

Also, you'll be needing Pulmonary function testing from time to time as a follow-up for assessing the status of the respiratory passages as well as clinical evaluation done by the Pulmonologist in this regard(Hypersensitivity of the respiratory passages)..

II. Already answered in the previous query, it simply depends on the findings at that specific time and also on the Radiologist reporting based on them..

III. Typical MRI machines vary from 0.5-3 Tesla (1 Tesla = 10,000 gauss), depending on different types of machines and investigation centers, more specific details can only be obtained after talking to the specific place's MRI technician..

I hope now your doubts are resolved, please don't worry about it and go ahead with the necessary investigation..

Take Care
Kind Regards

For future reference you can always get in touch with me, below is my Direct follow-up link through which you can contact me directly anytime anywhere, I'll be happy to help -

http://www.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=71041

Above answer was peer-reviewed by : Dr. Arnab Banerjee