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Q: Medically oriented, for radiology tech, radiology transcriber or radiologist ( Answered 5 out of 5 stars,   2 Comments )
Subject: Medically oriented, for radiology tech, radiology transcriber or radiologist
Category: Miscellaneous
Asked by: sweetpeaz-ga
List Price: $5.00
Posted: 26 Aug 2005 13:26 PDT
Expires: 25 Sep 2005 13:26 PDT
Question ID: 560909
This is a question/answer chat room for medical transcribers. I believe answer
is correct but would like documentation. 

Question:     CT eye-minus* of his head shows possible recurrence of
meningioma. I googled CT I-minus but nothing. Help!

Answer: CT, I-minus, (ie, minus iodine "I"), ie without contrast
medium. NM - Margaret 14:27:18 08/26/05 (2)
Subject: Re: Medically oriented, for radiology tech, radiology transcriber or radiologis
Answered By: welte-ga on 11 Sep 2005 09:10 PDT
Rated:5 out of 5 stars
Hi sweetpeaz-ga,

I'm in the radiology field (MD), however, as usual, this is not a
substitute for medical advice or direct medical evaluation.

A CT I-, as suggested in your questions and the posted comments, is a
CT performed without iodinated IV contrast media.  You may also
sometimes see I+/-, which means with and without IV contrast.  This is
a very common shorthand used by both people in radiology and
clinicians who frequently order CT scans.

With regards to meningiomas, benign (meaning they don't generally
spread to other areas) tumors of the meninges of the brain, they can
be seen on non-contrast CT, but are best imaged with IV contrast. 
They tend to enhance strongly and often heterogeneously.  They tend to
cause symptoms by slowly growing and causing a gradual mass effect on
adjacent structures, which can result in focal neurological symptoms,
prompting a (usually noncontrast) screening CT of the brain.

Here is a quote from a good eMedicine article on meningiomas with
regard to imaging findings:

"Contrast-enhanced CT displays moderate-to-strong homogeneous
enhancement in most tumors (see Images 7-8). Steinhoff et al observed
a nodular blush in 97%, a mixed inhomogeneous blush in 0.5%, and a
ring blush in 1.5%. In a study by Naidich of 136 patients, tumor blush
was nodular and nearly homogeneous in 70% of patients, inhomogeneous
in 24% of patients, and ringlike in 2% of patients (see Images 2-4)."

85% of these tumors demonstrate marked enhancement with IV contrast on
CT.  Another useful modality for imaging these tumors is MRI, on which
they show strong enhancement with IV Gadolinium (you may also see Gad,
Gd, Gd+, Gd+/-, IV MRI contrast).  The above article also discusses
MRI imaging findings.

If you're interested, you can find an imaging (CT and MRI) database of
meningiomas at this site:

Search terms
meningioma CT contrast

I hope this information was useful.  Feel free to request any clarification.

sweetpeaz-ga rated this answer:5 out of 5 stars
Thanks Welte for your help, very pleased. Actually, missed your
posting until a few days ago "chuckle" didn't expect two replies. 
Sure glad Google and you are around.  The MTs use google daily on our
chat board which is volunteer helper thing for other MTs having
trouble with dictation. bye sweetpea

Subject: Re: Medically oriented, for radiology tech, radiology transcriber or radiologist
From: pinkfreud-ga on 26 Aug 2005 14:31 PDT
This seems quite plausible, since a noncontrast CT can be used to
visualize a meningioma. I've never seen this exact usage (I-minus),
however, and could find no instance of it online.
Subject: Re: Medically oriented, for radiology tech, radiology transcriber or radiologist
From: sweetpeaz-ga on 26 Aug 2005 18:18 PDT
thank you for your time, however, I was hoping for a person in the
field.  I have no idea who this came from, could be in the field,
though, since noncontrast was mentioned in the answer.  I too could
not find it on-line, thus the question.

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