Vicarious contrast material excretion

Vicarious contrast material excretion (VCME) defines excretion of water-soluble contrast material in a way other than via normal renal excretion. The most common vicarious excretion of water-soluble contrast material is via the liver, resulting in increased bile density seen in the gallbladder. It can also occur via the small bowel or into ascitic fluid 3.

Although commonly associated with obstructive uropathy, parenchymal renal pathology or impaired renal function, vicarious excretion of contrast may be a normal variant in some individuals without an underlying renal impairment and does not in itself indicate renal or hepatobiliary pathology 1. Also, it could normally occur after injecting a high dose of contrast (e.g triphasic CT or angiography).

It is not uncommon to see high-density pericardial fluid on a non-contrast CT chest performed in patients who underwent recent cardiac catheterization, and it should not be mistaken with hemopericardium 5.

Vicarious excretion of iodinated contrast through the kidneys could occur after oral positive contrast studies 6

Physics and imaging technology: CT
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Article information

rID: 12397
Synonyms or Alternate Spellings:
  • Vicarious excrection of contrast material
  • Vicarious excrection of contrast

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Cases and figures

  • Case 1
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  • Case 2: with contrast-induced nephropathy
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  • Case 3
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  • Case 4: after fluoroscopy
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  • Case 5: after oral contrast study
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