An arthrography is a radiographic examination of a joint (such as the knee, shoulder, hip, elbow or wrist) that requires an injection of a contrast medium into the joint space.
For an opaque x-ray arthrography a water-soluble iodinated contrast agent is injected and a series of fluoroscopic controlled images is produced. Magnetic resonance arthrography combines the arthrogram with MRI. A small quantity of gadolinium contrast agent is added to the injection into the joint space. The traditional radiographic images are followed by an MRI of the extremities. A non-invasive possibility is an indirect MR arthrography, which doesn't require the injection into the joint. The dye is given prior to the imaging procedure.
The contrast fluid produces a bright signal and allows evaluation of small defects of the joint capsule, assessment of articular surface and labral cartilage, and in case of an indirect arthrogram also of the surrounding soft tissue. If a gaseous medium is used, this exam is called pneumoarthrography and a combination with liquid contrast is used in double-contrast arthrography.
MR arthrography is often used to evaluate hip and acetabular labrum, shoulder rotator cuff and glenoid labrum (see Shoulder MRI), and less often in wrist and knee MRI studies. Also combinations of CT and nuclear medical techniques with arthrography are available.

(CA) Contrast agents are used to change the imaging characteristics, resulting in additional information about anatomy, morphology or physiology of the human body. Radiocontrast agents (also called photon-based imaging agents) are used to improve the visibility of internal body structures in x-ray and CT procedures. Contrast agents are also used to increase the contrast between different tissues in MRI (magnetic resonance imaging) and ultrasound imaging. The ideal imaging agent provides enhanced contrast with little biological interaction.
First investigations with radiopaque materials are done shortly after the discovery of x-rays. These positive contrast agents attenuate x-rays more than body soft tissues due to their high atomic weight. Iodine and barium have been identified as suitable materials with high radiodensity and are used until today in x-ray and CT contrast agents. Iodine-based contrast agents are water-soluble and the solutions are used nearly anywhere in the body. Iodinated contrast materials are most administered intravenous, but can also be introduced intraarterial, intrathecal, oral, rectal, intravesical, or installed in body cavities. Barium sulfate is only used for opacification of the gastrointestinal tract. Negative contrast agents attenuate x-rays less than body soft tissues, for example gas.

Iodinated contrast media are differentiated in;

Intravascular iodinated contrast agents are required for a large number of x-ray and CT studies to enhance vessels and organs dependent on the blood supply. Injectable contrast agents are diluted in the bloodstream and rapidly distributed throughout the extracellular fluid. The main route of excretion is through the kidneys, related to the poor binding of the agent to serum albumin. The liver (gall bladder) and small intestine provide alternate routes of elimination particularly in patients with severe renal impairment. The use of special biliary contrast agents is suitable for gallbladder CT and cholecystograms because they are concentrated by the liver to be detectable in the hepatic bile.
The introduction of fast multi-detector row CT technology, has led to the development of optimized contrast injection techniques. The amount of contrast enhancement depends on the contrast agent characteristics, such as iodine concentration, osmolality, viscosity, and the injection protocol, such as iodine flux and iodine dose. Adverse reactions are rare and have decreased with the introduction of nonionic contrast agents.
See also Contrast Enhanced Computed Tomography, Abdomen CT, Contrast Media Injector, Single-Head CT Power Injector, Multi-Head Contrast Media Injector, Syringeless CT Power Injector, CT Power Injector.

Contrast media injectors are part of the medical equipment used to deliver fluids in examinations such as CT, MRI, fluoroscopy and angiography. Many of these diagnostic imaging procedures include the administration of intravenous contrast agents to enhance the blood and perfusion in tissues.

Mainly there are two types of injector technology:
See also Single-Head Contrast Media Injector, Dual-Head CT Power Injector, Syringeless CT Power Injector.

The use of x-ray contrast agents in computed tomography (CT) began with a hand injection by the radiologist in the scan room. During its history, CT scanners have made great improvements in speed and image quality. Actual CT systems with multiple detectors allow scan times of a few seconds per body region. Some CT protocols require multiphase scans, where a body region is imaged with a single bolus of contrast in different blood flow phases. Automatic power (pressure) contrast media injectors are required to provide precise control of flow rate, volume and timing of injection. The use of a saline bolus following contrast administration reduces the volume of contrast required.

Most relevant topics for the use of a power injector in medical imaging procedures such as contrast enhanced computed tomography (CECT):
Must have basic injector control options:
Examples of other injector control options:

Contrast-induced nephropathy is a serious complication of intravascular x-ray contrast agents. The osmolality of the contrast medium is an important fact in contrast-induced nephropathy and should ideally be iso-osmolar to blood. Today, nonionic contrast agents are state of the art for vascular use, the ionic contrast agents caused more adverse reactions.
Signs of contrast-induced nephropathy after the application of vascular contrast agents are a serum creatinine increase of 0.5 mg/dL (In the United States, creatinine is typically reported in mg/dL, while in Canada and Europe µmol/L may be used. 1 mg/dL of creatinine is 88.4 µmol/L) or an increase of serum creatinine greater than 25%.

A higher risk of contrast-induced nephropathy is associated with:
The use of a nonionic contrast agent, iso-osmolar to blood and a low dose reduces the risk for contrast-induced nephropathy.

Image quality is an important value of all radiographic imaging procedures. Accurate measures of both image quality and patient radiation risk are needed for effective optimization of diagnostic imaging. Images are acquired for specific purposes, and the result depends on how well this task is performed. The imaging performance is mainly influenced by the imaging procedure, examined object, contrast agents, imaging system, electronic data processing, display, maintenance and the operator. Spatial resolution (sharpness), contrast resolution and sensitivity, artifacts and noise are indicators of image quality.
A high image contrast provides the discrimination between tissues of different densities.
The image resolution states the distinct visibility of linear structures, masses and calcifications.
Noise and artifacts degrade the image quality. In computed tomography (CT), high spatial resolution improves the visibility of small details, but results in increased noise. Increased noise reduces the low contrast detectability. Noise can be reduced by the use of large voxels, increased radiation dose, or an additional smoothing filter, but this type of filter increases blurring.
An image acquisition technique taking these facts into account maximizes the received information content and minimizes the radiation risk or keeps it at a low level.

See also As Low As Reasonably Achievable.