The use of iodinated contrast hinges on renal function and specific indication. CT with IV contrast is not appropriate for the diagnosis of and determination of the cause of AKI. There is no relevant literature regarding the use of CT abdomen and pelvis with IV contrast in the evaluation of AKI. CT abdomen and pelvis without and with IV contrast is not appropriate for the diagnosis of and determination of the cause of AKI. There is no relevant literature regarding the use of CT abdomen and pelvis without and with IV contrast in the evaluation of AKI. CT Abdomen There is no relevant literature regarding the use of CT abdomen in the evaluation of AKI. CTA Abdomen and Pelvis Contrast-enhanced CTA is very rarely indicated for initial diagnosis of AKI given the potential nephrotoxicity. The risk-benefit ratio should be carefully evaluated if CTA is necessary to diagnose vascular thrombosis or stenosis. The lowest dose of contrast needed for a diagnostic study should be used and supplemented with adequate volume expansion [9]. There is no relevant literature regarding the use of CTA in the evaluation of AKI. CTU There is no relevant literature regarding the use of CTU in the evaluation of AKI. The requirement for IV contrast limits its utility. MRA Abdomen MRA may be considered when there is a high suspicion of a renovascular cause of AKI such as renal artery stenosis, thrombosis, or arterial injury after trauma, all of which are rare [4,17]. However, there is no relevant literature regarding the use of MRA abdomen without and with IV contrast in the evaluation of AKI. If contrast-enhanced MRA is needed after consideration of the risks and benefits, group II contrast agents should be used [9]. Contrast-enhanced MRA has a sensitivity of 93% and a specificity of 93% compared with 85% and 84%, respectively, for Doppler US for diagnosis of >60% stenosis [18]. Unenhanced MRA techniques, such as time-spatial labeling inversion pulse or steady-state free precession, may be considered in AKI.
Renal Failure. The use of iodinated contrast hinges on renal function and specific indication. CT with IV contrast is not appropriate for the diagnosis of and determination of the cause of AKI. There is no relevant literature regarding the use of CT abdomen and pelvis with IV contrast in the evaluation of AKI. CT abdomen and pelvis without and with IV contrast is not appropriate for the diagnosis of and determination of the cause of AKI. There is no relevant literature regarding the use of CT abdomen and pelvis without and with IV contrast in the evaluation of AKI. CT Abdomen There is no relevant literature regarding the use of CT abdomen in the evaluation of AKI. CTA Abdomen and Pelvis Contrast-enhanced CTA is very rarely indicated for initial diagnosis of AKI given the potential nephrotoxicity. The risk-benefit ratio should be carefully evaluated if CTA is necessary to diagnose vascular thrombosis or stenosis. The lowest dose of contrast needed for a diagnostic study should be used and supplemented with adequate volume expansion [9]. There is no relevant literature regarding the use of CTA in the evaluation of AKI. CTU There is no relevant literature regarding the use of CTU in the evaluation of AKI. The requirement for IV contrast limits its utility. MRA Abdomen MRA may be considered when there is a high suspicion of a renovascular cause of AKI such as renal artery stenosis, thrombosis, or arterial injury after trauma, all of which are rare [4,17]. However, there is no relevant literature regarding the use of MRA abdomen without and with IV contrast in the evaluation of AKI. If contrast-enhanced MRA is needed after consideration of the risks and benefits, group II contrast agents should be used [9]. Contrast-enhanced MRA has a sensitivity of 93% and a specificity of 93% compared with 85% and 84%, respectively, for Doppler US for diagnosis of >60% stenosis [18]. Unenhanced MRA techniques, such as time-spatial labeling inversion pulse or steady-state free precession, may be considered in AKI.