Vicarious contrast material excretion

Vicarious contrast material excretion (VCME) defines excretion of water-soluble contrast material in a way other than via normal renal secretion. The most common vicarious excretion of water-soluble contrast material is via the liver, resulting in increased bile density or opacifying the gallbladder. It can also occur via the small bowel or into the ascites fluid 3. It is not uncommon to see high-density pericardial fluid on a non-contrast CT chest performed in patients who underwent recent cardiac catheterisation, and it should not be mistaken with haemopericardium 5. Although commonly associated with obstructive or parenchymal renal pathology, vicarious excretion of contrast may be a normal variant in some individuals and does not in itself indicate renal or hepatobiliary pathology 1.

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