Wellstar medical imaging exam prep instructions

WellStar Medical Imaging Exam Prep Instructions
Appointment Date/Time:_____________________ Facility:________________ If you have orders from your physician, please bring them to your appointment and arrive 15 Minutes prior to
appointment time for Registration. Please bring picture ID and Insurance Card.

□ CT Scan Chest/Thorax with Contrast*:
This exam requires IV Contrast which will be injected through a vein during the CT exam. Do not have anything to eat or drink 4
hours prior to your test. You may take medications with a small amount of water if needed.

□ CT Scan Abdomen/Pelvis with Contrast*:
This exam requires oral contrast (barium) as well as IV Contrast which will be injected through a vein during the CT exam. Do not
have anything to eat or drink 4 hours prior to your test. The oral contrast (barium) can be picked up from any WellStar facility
prior to your test. You will need to drink ½ bottle of the barium the night before your exam if it is before 10:00a.m. and ½ bottle 1
hour before your exam. If exam is after 10:00a.m., drink ½ bottle barium 4 hours before exam time and ½ bottle barium 1 hour
before exam. You will be given more barium to drink at the facility.
□ CT Scan Abdomen/Pelvis to evaluate a specific pancreatic abnormality*:
This exam requires IV Contrast which will be injected through a vein during the CT exam. Do not have anything to eat or drink 4
hours prior to your test. No Oral Contrast (Barium) Required.


□ CT Scan Abdomen/Pelvis for Kidney/Renal Stones:
This exam requires no prep. You will not receive IV Contrast or oral contrast (barium).
□ CT Scan Head/Sinuses/Facial Bones/Temporal Bones/Soft Tissue Neck with Contrast* or CT Scan Spine
(Cervical/Thoracic/Lumbar/Extremities) with Contrast*:
This exam requires IV Contrast which will be injected through a vein during the CT exam. Do not have anything to eat or drink 4
hours prior to your test. You may take medications with a small amount of water if needed.
□ CT Enterography (CTE)*:
This exam requires nothing to eat or drink 6 hours prior to exam time. You will need to arrive at facility 1 hour prior to scan time
where you will be given oral contrast to drink. You will be given IV contrast which will be injected during the exam.
□ CT Urogram (CTU)*:
This exam requires IV Contrast which will be injected through a vein during the CT exam. Do not have anything to eat or drink 4
hours prior to your test. No Oral Contrast (Barium) Required.
□ CT Angiography (CTA)*:
This exam requires IV Contrast which will be injected through a vein during the CT exam. Do not have anything to eat or drink 4
hours prior to your test. You may take medications with a small amount of water if needed.

□ Cardiac CT Angiograpy*:
This exam requires IV Contrast which will be injected through a vein during the CT exam. Do not have anything to eat or drink 4
hours prior to your test. You may take medications with a small amount of water except Viagra or Cialis. Do not have any caffeine
or stimulants the night before your exam. Your resting heart rate must be less than 65 beats per minute for this test to be
performed. You may take a beta blocker before the test or be given one if your heart rate is not at this level.
*For IV Contrast CT procedures: If you are allergic to iodine please follow pre-medication instructions. Patients are to be pre-
medicated 24 hours prior to a CT Contrasted procedure. Medications: Methylprednisolone (Two-32 mg tablets) by mouth. One tablet
12 hours prior to CT Scan, one tablet 2 hours prior to CT. Benadryl (One-50mg tablet) by mouth. Take one tablet 1 hour prior to CT
exam. Your ordering physician can give you a prescription for these medications.
**FOR CT or IVP Exams Requiring IV Contrast: For patients with Renal Disease, Dialysis or are over 70, a GFR value (BUN and
Creatinine) is needed before a patient can receive IV Contrast. Labs must be performed within 30 days of the exam. If the GFR level is
30 or below, the radiologist must be consulted before administering the contrast.
□ MRI (Magnetic Resonance Imaging)*: Please arrive 30 minutes prior to your appointment time
This exam requires no special prep unless otherwise instructed. You may not be able to have an MRI if you have a Cardiac
Pacemaker, Aneurysm Clips, Inner Ear Implants, or Metal Fragments in one or both eyes. Some other medical prosthetic devices
may interfere with scanning. An IV injection of contrast, Gadolinium, may be given with your exam which will be administered
with a small needle into a vein in your arm. There should be no side effects and the contrast will not interfere with any medications
you are currently taking.
□ MRA (Magnetic Resonance Angiography)*: Please arrive 30 minutes prior to your appointment time
Some exams require IV Contrast which will be injected through a vein during the MRI exam. MRI restrictions listed above. *FOR MRI Exams Requiring IV Contrast: For patients with Renal Disease, a GFR value (BUN and Creatinine) is needed before a
patient can receive IV Contrast. Labs must be performed within 30 days of the exam. If the GFR level is 30 or below, the radiologist
must be consulted before administering the contrast.
□ Ultrasound Abdominal/Gallbladder/Liver/Pancreas/Aorta:
Do not eat or drink anything 8 hours prior to your test. You may take medications with a small amount of water if needed.

□ Ultrasound Pelvic/Obstetrical (OB):
You will need to drink 32 oz. Of noncarbonated liquid 45-60 minutes prior to your test. You will not be allowed to use the
restroom until after the test due to the exam requiring your bladder to be full.
□ Nuclear Medicine Bone Scan:
There is no special prep required however you should drink plenty of water the day before your test. After the injection you will
have to wait 3-6 hours for your test to begin.
□ Gallbladder/Gastric Emptying/Cardiac Stress Test:
Do not eat anything 6 hours prior to your test. This includes medications. Allow 2 to 4 hours for these tests.
□ Thyroid Scan:
Do not eat anything 6 hours prior to your test. This includes medications. If you have had Iodinated Contrast (x-ray or CT dye) in
the past 6 weeks you will not be able to have this test due to artifact. You may not have had fish, seafood or an antihistamine 1
week prior to this test. Check with your physician about your thyroid medication It is recommended that you not take your
medication 4 weeks prior to this exam.
□ Barium Swallow/Upper Gastrointestinal Tract (UGI):
For a Barium Swallow only, no special preparation is needed. For a Barium Swallow with an UGI you will need to eat a light
dinner the day before your exam. Do not eat or drink anything after midnight before your exam. When you arrive, the radiologists
will give you some CO2 crystals (Alka-Seltzer) to swallow which will be followed by a cup of Barium for you to drink. **
Pediatric patients must not have anything to eat or drink 4 hours before the exam. If infants prefer certain type of nipple, please
have one available.

□ Small Bowel Series:
You will need to eat a light dinner the day before your exam. Do not eat or drink anything after midnight before your exam.
When you are at the facility you will be given a large amount of barium to drink and the technologists will then take images which
will follow the barium in your small bowel system. Please note that this exam may take 3 or more hours to complete. ** Pediatric
patients must not have anything to eat or drink 4 hours before the exam. If infants prefer certain type of nipple, please have one
available.

□ Colon Barium Enema (BE):
Patient is to have clear liquids the entire day prior to the exam. Patients will need to pick up the following over the counter
supplies at a local drug store: 230-250 gram bottle of Miralax, 64 oz. Gatorade/Powerade/or water with Crystal Light. Mix the
drink of your choice with the Miralax. Drink the evening before your scheduled procedure. Patient is not to eat or drink anything
after you have completed the prep until after your procedure.
□ Intravenous Pyelogram (IVP):
Patients will need to pick up the following over the counter supplies at a local drug store. 230-250 gram bottle of Miralax, 64 oz.
Gatorade/Powerade/ or water with Crystal Light. Mix the drink of your choice with the Miralax. Drink the night before your
scheduled procedure. Do not eat or drink anything after you have completed the prep until after your procedure.
This exam requires IV Contrast which will be injected through a vein in your arm. If you are taking Metformin-Glucophage,
Glucovance, Metaglip, Avandamet, Fortament or generics of these medications you will need to discontinue the medication at the
time of the exam. The medication will need to be withheld for 48 hours after the exam and resumed only after renal function has
been re-evaluated and found to be normal. To ensure this is done, the patient must check with their physician for approval before
resuming their medication. (lab requirements for IV contrast on front page)
□ Hysterosalpingogram: (HSG)
This exam should be scheduled between day 6 and day 10 after the onset of your menstrual cycle. You must refrain from any
sexual intercourse from the day you start your menstrual cycle to the day you come in for your exam. You will need to be sure
that there is no chance of pregnancy before the exam is done. This exam involves a catheter being placed into the uterus where a
small amount of contrast (x-ray dye) will be injected so images can be taken. The exam cannot be performed if bleeding is
occurring.

□ Cystogram:
There is no prep for this exam. To view the urinary tract, contrast (x-ray dye) will be administered through a catheter to your
bladder until your bladder is full.
□ Venogram/Arthrogram:
There is no prep for this exam. For a venogram, a small needle will be placed in the hand or foot, contrast (x-ray dye) will be
injected and images taken to visualize the veins. For an Arthrogram, the contrast (x-ray dye) will be injected into the affected joint.

□ CT Myelogram*: Please arrive 1 hour prior to your appointment to be registered
You will need to follow a clear liquid diet the day before the exam. No Tricyclics, Phenothiazines, or Thioxanhenes 48 hours prior
and 48 hours after the exam. No blood thinners for 5 days prior to the exam (for example: Plavix, aspirin, Heparin, Coumadin). If
you are not sure if you are taking one of these medications, contact your physician. You will be checked into the hospital and will
need someone to drive you home. The radiologists will numb the area on your back and insert a needle where contrast (x-ray dye)
will be injected into the spinal canal. Images will be taken of the spine and then you will have a CT Scan for more detailed
images. After the scan, you will go back to your room for 4-6 hours for observation and given written instructions upon discharge.
*If Allergic to Iodine, please see CT Pre-medication instructions on other side.

Source: http://www.wellstar.org/sitecollectiondocuments/practiceforms/medical_imaging_exam_prep_instruction.pdf