Vicarious contrast media excretion

Dr Luu Hanh and Radswiki et al.

Vicarious contrast media excretion (VCME) is defined as excretion of intravascularly-administered water-soluble contrast media 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 for a hemopericardium 5.

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

History and etymology

Vicarious in everyday English is used to refer to something taking the place of something else. It derives from the Latin word 'vicarius', itself derived from 'vicis' meaning a repeating function or role 7.

CT examinations

Article information

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

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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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  • Case 6: after 8 hours of CT scan
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