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Sample records for iodinated contrast media

  1. Current iodinated contrast media

    International Nuclear Information System (INIS)

    Stacul, F.

    2001-01-01

    The number of scientific papers on iodinated contrast media is declining. Indeed, comparative trials between high-osmolality and low-osmolality agents largely showed the higher safety and tolerability of the latter, and this is no longer a matter of discussion. Only financial constraints could prevent a total conversion to low-osmolality agents. Research comparing low-osmolality (nonionic monomers, ionic dimer) and iso-osmolality contrast media (nonionic dimers) are still ongoing. Both classes of nonionic compounds proved safer than the ionic dimer. The relative merits of nonionic monomers and nonionic dimers are a matter for debate, and criteria for a selective use of different agents for different procedures could be discussed. (orig.)

  2. Iodinated contrast media nephrotoxicity

    International Nuclear Information System (INIS)

    Meyrier, A.

    1994-01-01

    In the late seventies, iodinated contrast agents (ICA) were considered to be a major cause of acute iatrogenic renal failure. Over the last decade new contrast agents have been synthesized, nonionic and less hyperosmolar. The incidence of acute renal failure due to ICAs, varies from 3.7 to 70% of cases according to the series, with an average figure of 10.2%. The pathophysiology of ICA nephrotoxicity was mainly studied in laboratory animal models. Three main factors are involved in an inducing ICA-mediated decrease in glomerular filtration rate: reduction of the renal plasma flow, a direct cytotoxic effect on renal tubular cells and erythrocyte alteration leading to intra-renal sludge. Excluding dysglobulinemias with urinary excretion of immunoglobulin light chains, which represent a special case of maximum nephrotoxicity, 4 main risk factors of renal toxicity have been identified in nondiabetic subjects: previous renal failure with serum creatinine levels greater than 140 μmol per liter, extracellular dehydration, age over 60 and use of high doses of ICA and/or repeated ICA injections before serum creatinine levels return to baseline. Preventive measures for avoiding ICA nephrotoxicity are threefold: maintain or restore adequate hydration with saline infusion, stop NSAID treatment several days before ICA administration, and allow a 5 day interval before repeating contrast media injections. New, nonionic and moderately hyperosmolar contrast agents appear to be much less nephrotoxic than conventional ICAs in laboratory animals and in high-risk patients. It is advisable to select such contrast media for investigating high-risk patients. This approach was recently substantiated in well designed, randomized clinical studies which included more than 2 000 patients. (author)

  3. Anaphylactoid reactions after iodinated contrast media

    International Nuclear Information System (INIS)

    Strejcek, J.; Sehr, A.

    1987-01-01

    A survey is presented of data published in the literature on the incidence of undesirable and especially anaphylactoid reactions to intravenously administered iodinated contrast media used in radiodiagnosis, this with regard to age, sex, allergy in the patient's history, previously administered contrast media, possible previous reaction. A detailed description is presented of the assumed mechanisms of these reactions. There does not exist any reliable premedication. It is always indispensable to consider the indications of the examination using iodinated contrast agents and the possibilities of immediate and qualified resuscitation. (author). 2 tabs., 36 refs

  4. Nonimmediate hypersensitivity reactions to iodinated contrast media.

    Science.gov (United States)

    Gómez, Enrique; Ariza, Adriana; Blanca-López, Natalia; Torres, Maria J

    2013-08-01

    To provide a detailed analysis of the latest findings on the mechanisms underlying the nonimmediate reactions to iodinated contrast media and comment on the recent advances in diagnosis, focusing on the roles of the skin test, drug provocation test (DPT), and lymphocyte transformation test (LTT). Several studies have reported new findings supporting an important role for T-lymphocytes in the nonimmediate reactions to iodinated contrast media. The LTT has been used as an in-vitro tool for diagnosis, but with variable results. However, the inclusion of autologous monocyte-derived dendritic cells as professional antigen-presenting cells has improved the sensitivity of this test. Regarding in-vivo diagnosis, although skin testing has been routine, it has now been shown that its sensitivity and negative predictive value are low. Recent studies have demonstrated that the DPT is a well tolerated and useful procedure that is necessary to confirm the diagnosis of nonimmediate hypersensitivity reactions to iodinated contrast media. Nonimmediate reactions to contrast media are usually T-cell mediated. Diagnosis is based on skin testing, although its sensitivity and negative predictive value are not optimal. Consequently, drug provocation testing is often needed to confirm the diagnosis and also to seek alternative contrast media that can be tolerated.

  5. Neurotoxicity of iodinated radiological contrast media

    International Nuclear Information System (INIS)

    Araujo Pinheiro, R.S. de

    1988-01-01

    We studied during the last ten years the neurotoxicity of artificial iodinated contrast media, with prospective clinical and experimental protocols. The experimental investigation in animals aimed to understand the relationship between the intracarotid injection, the subarachnoid application and the integrity of the blood-brain barrier function. The electro physiologic disturbances and the morphologic observation of pial circulation support the evidence that iodinated artificial contrast media induces significant alterations in brain metabolism and in the autoregulation of the blood flow of the encephalon. Even if many of such phenomena may not be apparent at the clinical level, we supposed that they are always present and that their clinical exteriorization is prevented by the immediate and effective action of homeostatic mechanisms. (author)

  6. Anaphylactic reaction to iodinated contrast media. Review the relevant loterature

    International Nuclear Information System (INIS)

    Kuwashima, Shigeko; Kitajima, Kazuhiro; Kohno, Tatsuo; Kaji, Yasushi; Takahashi, Tetuya; Seki, Masaya; Sakamoto, Tomoyuki

    2007-01-01

    Recently, iodinated contrast media are necessary for CT examinations and they occupy an important position in the radiological diagnosis. Nonionic contrast media significantly reduce the prevalence of all degree of adverse reaction to contrast media rather than ionic contrast media. So, generally, iodinated contrast media are safe and widely used, but adverse reaction after intravenous iodinated contrast media are not uncommon. Severe and potentially life-threatening reaction occur by using the iodinated contrast media practically. Patients at risk must be identified before the contrast media study, and all possible measures must be taken to deal effectively with spontaneous anaphylactic reactions. We report three cases of anaphylactic reactions by iodinated contrast media on CT. (author)

  7. A Review: Radiographic Iodinated Contrast Media-Induced Thyroid Dysfunction

    Science.gov (United States)

    Leung, Angela M.; Braverman, Lewis E.; Brent, Gregory A.; Pearce, Elizabeth N.

    2015-01-01

    Context: Thyroid hormone production is dependent on adequate iodine intake. Excess iodine is generally well-tolerated, but thyroid dysfunction can occur in susceptible individuals after excess iodine exposure. Radiological iodinated contrast media represent an increasingly common source of excess iodine. Objective: This review will discuss the thyroidal response after acute exposure to excess iodine; contrast iodine-induced thyroid dysfunction; risks of iodine-induced thyroid dysfunction in vulnerable populations, such as the fetus, neonate, and patients with impaired renal function; and recommendations for the assessment and treatment of contrast iodine-induced thyroid dysfunction. Methods: Data for this review were identified by searching PubMed, Google Scholar, and references from relevant articles from 1948 to 2014. Conclusions: With the increase in the use of computed tomography scans in the United States, there is increasing risk of contrast-induced thyroid dysfunction. Patients at risk of developing iodine-induced thyroid dysfunction should be closely monitored after receiving iodinated contrast media and should be treated as needed. PMID:25375985

  8. Iodine-based contrast media, multiple myeloma and monoclonal gammopathies

    DEFF Research Database (Denmark)

    Stacul, Fulvio; Bertolotto, Michele; Thomsen, Henrik S

    2018-01-01

    OBJECTIVES: Many radiologists and clinicians still consider multiple myeloma (MM) and monoclonal gammopathies (MG) a contraindication for using iodine-based contrast media. The ESUR Contrast Media Safety Committee performed a systematic review of the incidence of post-contrast acute kidney injury...

  9. [Guideline 'Precautionary measures for contrast media containing iodine'

    NARCIS (Netherlands)

    Dijk Azn, R. van; Wetzels, J.F.M.; Dam, M.A. ten; Aarts, N.J.; Schimmelpenninck-Scheiffers, M.L.; Freericks, M.P.; Said, S.A.M.; Geenen, R.W.; Stuurman, A.; Everdingen, J.J. van

    2008-01-01

    Annually, 0.5-1 million injections of contrast media containing iodine are administered in the Netherlands. Almost all contrast media nowadays are low-osmolar and nonionic. Nevertheless, the development ofcontrast-induced nephropathy is still a relevant clinical problem. Through an initiative by the

  10. Iodinated contrast media nephrotoxicity. Nephrotoxicite des produits de contraste iodes

    Energy Technology Data Exchange (ETDEWEB)

    Meyrier, A. (Hopital Avicenne, 93 - Bobigny (France))

    1994-01-01

    In the late seventies, iodinated contrast agents (ICA) were considered to be a major cause of acute iatrogenic renal failure. Over the last decade new contrast agents have been synthesized, nonionic and less hyperosmolar. The incidence of acute renal failure due to ICAs, varies from 3.7 to 70% of cases according to the series, with an average figure of 10.2%. The pathophysiology of ICA nephrotoxicity was mainly studied in laboratory animal models. Three main factors are involved in an inducing ICA-mediated decrease in glomerular filtration rate: reduction of the renal plasma flow, a direct cytotoxic effect on renal tubular cells and erythrocyte alteration leading to intra-renal sludge. Excluding dysglobulinemias with urinary excretion of immunoglobulin light chains, which represent a special case of maximum nephrotoxicity, 4 main risk factors of renal toxicity have been identified in nondiabetic subjects: previous renal failure with serum creatinine levels greater than 140 [mu]mol per liter, extracellular dehydration, age over 60 and use of high doses of ICA and/or repeated ICA injections before serum creatinine levels return to baseline. Preventive measures for avoiding ICA nephrotoxicity are threefold: maintain or restore adequate hydration with saline infusion, stop NSAID treatment several days before ICA administration, and allow a 5 day interval before repeating contrast media injections. New, nonionic and moderately hyperosmolar contrast agents appear to be much less nephrotoxic than conventional ICAs in laboratory animals and in high-risk patients. It is advisable to select such contrast media for investigating high-risk patients. This approach was recently substantiated in well designed, randomized clinical studies which included more than 2 000 patients. (author).

  11. Effect of contrast media iodine concentration on bolus tracking

    International Nuclear Information System (INIS)

    Ishihara, Toshihiro; Hayashi, Takayuki; Nakaya, Yoshihiro; Naoi, Kuniji; Ikeno, Naoya; Kobayashi, Tatsushi; Satake, Mitsuo

    2006-01-01

    Computer-assisted bolus tracking has been confirmed to be a useful technique in computed tomography (CT) imaging and allows images to be captured with automated timing. The inflow of the contrast medium is monitored, and when the contrast medium reaches a predetermined level, CT image capture starts automatically. However, it has been shown that the preset threshold value of contrast medium is affected by its iodine concentration, which causes variations in image capture times. Greater speed in current multislice CT imaging requires that medical technicians pay more attention to setting the timing of image capture during venous examinations by taking into account the iodine concentration in contrast media. (author)

  12. Effects of iodinated contrast media on blood and endothelium

    International Nuclear Information System (INIS)

    Aspelin, Peter; Stacul, Fulvio; Thomsen, Henrik S.; Morcos, Sameh K.; Molen, Aart J. van der

    2006-01-01

    The aim of the study was to assess the effects of iodinated contrast media on blood components and endothelium based on experimental and clinical studies and to produce clinically relevant guidelines for reducing thrombotic and hematologic complications following the intravascular use of contrast media. A report was drafted after review of the literature and discussions among the members of the Contrast Media Safety Committee of the European Society of Urogenital Radiology. The final report was produced following discussion at the 12th European Symposium on Urogenital Radiology in Ljubljana, Slovenia (2005). Experimental data indicate that all iodinated contrast media produce an anticoagulant effect and that this effect is greater with ionic contrast media. Several of the in vitro and experimental in vivo studies on haematological effects of contrast media have not been confirmed by clinical studies. Low- or iso-osmolar contrast media should be used for diagnostic and interventional angiographic procedures, including phlebography. Meticulous angiographic technique is the most important factor for reducing the thrombotic complications associated with angiographic procedures. Drugs and interventional devices that decrease the risk of thromboembolic complications during interventional procedures minimize the importance of the effects of contrast media. (orig.)

  13. Effects of iodinated contrast media on blood and endothelium

    Energy Technology Data Exchange (ETDEWEB)

    Aspelin, Peter [Karolinska Institute/Huddinge University Hospital, Division of Radiology, Centre for Surgical Sciences, Stockholm (Sweden); Stacul, Fulvio [Institute of Radiology, Trieste (Italy); Thomsen, Henrik S. [Copenhagen University Hospital at Herlev, Department of Diagnostic Radiology 54E2, Herlev (Denmark); Morcos, Sameh K. [Sheffield Teaching Hospitals NHS Trust, Department of Diagnostic Imaging, Northern General Hospital, Sheffield (United Kingdom); Molen, Aart J. van der [Leiden University Medical Centre, Department of Radiology, Leiden (Netherlands)

    2006-05-15

    The aim of the study was to assess the effects of iodinated contrast media on blood components and endothelium based on experimental and clinical studies and to produce clinically relevant guidelines for reducing thrombotic and hematologic complications following the intravascular use of contrast media. A report was drafted after review of the literature and discussions among the members of the Contrast Media Safety Committee of the European Society of Urogenital Radiology. The final report was produced following discussion at the 12th European Symposium on Urogenital Radiology in Ljubljana, Slovenia (2005). Experimental data indicate that all iodinated contrast media produce an anticoagulant effect and that this effect is greater with ionic contrast media. Several of the in vitro and experimental in vivo studies on haematological effects of contrast media have not been confirmed by clinical studies. Low- or iso-osmolar contrast media should be used for diagnostic and interventional angiographic procedures, including phlebography. Meticulous angiographic technique is the most important factor for reducing the thrombotic complications associated with angiographic procedures. Drugs and interventional devices that decrease the risk of thromboembolic complications during interventional procedures minimize the importance of the effects of contrast media. (orig.)

  14. Intravascular enhancement with identical iodine delivery rate using different iodine contrast media in a circulation phantom.

    Science.gov (United States)

    Mihl, Casper; Wildberger, Joachim E; Jurencak, Tomas; Yanniello, Michael J; Nijssen, Estelle C; Kalafut, John F; Nalbantov, Georgi; Mühlenbruch, Georg; Behrendt, Florian F; Das, Marco

    2013-11-01

    Both iodine delivery rate (IDR) and iodine concentration are decisive factors for vascular enhancement in computed tomographic angiography. It is unclear, however, whether the use of high-iodine concentration contrast media is beneficial to lower iodine concentrations when IDR is kept identical. This study evaluates the effect of using different iodine concentrations on intravascular attenuation in a circulation phantom while maintaining a constant IDR. A circulation phantom with a low-pressure venous compartment and a high-pressure arterial compartment simulating physiological circulation parameters was used (heart rate, 60 beats per minute; stroke volume, 60 mL; blood pressure, 120/80 mm Hg). Maintaining a constant IDR (2.0 g/s) and a constant total iodine load (20 g), prewarmed (37°C) contrast media with differing iodine concentrations (240-400 mg/mL) were injected into the phantom using a double-headed power injector. Serial computed tomographic scans at the level of the ascending aorta (AA), the descending aorta (DA), and the left main coronary artery (LM) were obtained. Total amount of contrast volume (milliliters), iodine delivery (grams of iodine), peak flow rate (milliliter per second), and intravascular pressure (pounds per square inch) were monitored using a dedicated data acquisition program. Attenuation values in the AA, the DA, and the LM were constantly measured (Hounsfield unit [HU]). In addition, time-enhancement curves, aortic peak enhancement, and time to peak were determined. All contrast injection protocols resulted in similar attenuation values: the AA (516 [11] to 531 [37] HU), the DA (514 [17] to 531 [32] HU), and the LM (490 [10] to 507 [17] HU). No significant differences were found between the AA, the DA, and the LM for either peak enhancement (all P > 0.05) or mean time to peak (AA, 19.4 [0.58] to 20.1 [1.05] seconds; DA, 21.1 [1.0] to 21.4 [1.15] seconds; LM, 19.8 [0.58] to 20.1 [1.05] seconds). This phantom study demonstrates that

  15. Late adverse reactions to intravascular iodinated contrast media

    International Nuclear Information System (INIS)

    Webb, Judith A.W.; Stacul, Fulvio; Thomsen, Henrik S.; Morcos, Sameh K.

    2003-01-01

    Late adverse reactions to intravascular iodinated contrast media are defined as reactions occurring 1 h to 1 week after contrast medium injection. They have received increasing interest over the past decade, but their prevalence remains uncertain and their pathophysiology is not fully understood. The Contrast Media Safety Committee of the European Society of Urogenital Radiology decided to review the literature and to issue guidelines. An extensive literature search was carried out and summarized in a report. Based on the available information, simple guidelines have been drawn up. The report and guidelines were discussed at the 8th European Symposium on Urogenital Radiology in Genoa. Late adverse reactions after intravascular iodinated contrast medium include symptoms such as nausea, vomiting, headache, itching, skin rash, musculoskeletal pain, and fever. A significant proportion of these reactions is unrelated to the contrast medium; however, allergy-like skin reactions are well-documented side effects of contrast media with an incidence of approximately 2%. Late reactions appear to be commoner after non-ionic dimers. The majority of late skin reactions after contrast medium exposure are probably T-cell-mediated allergic reactions. Patients at increased risk of late skin reactions are those with a history of previous contrast medium reaction and those on interleukin-2 treatment. Most skin reactions are self-limiting and resolve within a week. Management is symptomatic and similar to the management of other drug-induced skin reactions. (orig.)

  16. Effect of iodinated contrast media on thyroid: a brief review

    Directory of Open Access Journals (Sweden)

    Şerife Mehlika Kuşkonmaz

    2016-04-01

    Full Text Available In parallel to the increased use of computed tomography, iodinated contrast agents are increasingly becoming a source of excess iodide. Iodinated contrast agents may induce thyroid dysfunction in exposed patients, especially in the presence of an underlying thyroid disease. Thus, an ordinary dose of the contrast used for the imaging, can induce hyper or hypothyroidism in a patient with subtle thyroid disease. This review will briefly discuss the physiology of iodine and the clinical evaluation of iodine induced thyroid dysfunction.

  17. Renal Safety of Iodinated Contrast Media Depending on Their Osmolarity – Current Outlooks

    International Nuclear Information System (INIS)

    Mruk, Bartosz

    2016-01-01

    Iodinated contrast media (ICM) are commonly administered pharmaceutical agents. Most often they are used intravenously and intraarterially. Although iodinated contrast agents are relatively safe and widely used, adverse events occur and questions remain about their use, safety, and interactions. The most important adverse effects of contrast media include hypersensitivity reactions, thyroid dysfunction, and contrast-induced nephropathy. Radiologists must be aware of the risk factors for reactions to contrast media. Nonionic iodinated contrast agents can be divided into monomeric, low-osmolar, and dimeric, iso-osmolar classes. The osmotic characteristics of contrast media have been a significant focus in many investigations of contrast-induced nephropathy

  18. General toxicity of water soluble iodinated contrast media: pathogenesis

    International Nuclear Information System (INIS)

    Moreau, J.F.; Giwerc, M.; Chabriais, J.; Rotkopf, L.

    1987-01-01

    The accidents related to the general toxicity of the watersoluble iodinated contrast media are unfrequent. They still exist despite the availability of new kinds of low osmolar molecules. Their pathogenesis is not yet clearly defined. An anaphylactic mechanism cannot give a satisfying explanation because specific IgE have been exceptionally found in humans. Two theories are discussed. Lalli has made an emphasis on the role played by stress and anxiety. The other theory is based on the prominent role played by the lesion of the vascular endothelial cells then the activation of factor XII. A vicious circle is created by the liberation of pre- and neo-formated ligands, eventually after the activation of the complement system [fr

  19. Beware of parotitis induced by iodine-containing contrast media.

    Science.gov (United States)

    Kohat, A K; Jayantee, K; Phadke, R V; Muthu, R; Singh, V; Misra, U K

    2014-01-01

    Carotid stenting is being increasingly used for revascularization of the moderate to severe carotid stenosis and thus its complications are increasingly being recognized. We report a rare complication of induced by iodine contrast in a patient undergoing carotid stenting. s. A 51 year old man after the second stenting developed multiple small infarcts in spite of the distal device. He also had painful parotid swelling which improved within a week. One should be aware of iodine parotitis s in the patients undergoing iodinated contrast study.

  20. Comparison of the Safety of Seven Iodinated Contrast Media

    Science.gov (United States)

    Seong, Jong-Mi; Choi, Nam-Kyong; Lee, Joongyub; Chang, Yoosoo; Kim, Ye-Jee; Yang, Bo Ram; Jin, Xue-Mei; Kim, Ju-Young

    2013-01-01

    We aimed to determine the characteristic adverse events (AEs) of iodinated contrast media (IOCM) and to compare the safety profiles of different IOCM. This study used the database of AEs reports submitted by healthcare professionals from 15 Regional Pharmacovigilance Centers between June 24, 2009 and December 31, 2010 in Korea. All reports of IOCM, including iopromide, iohexol, iopamidol, iomeprol, ioversol, iobitridol and iodixanol, were analyzed. Safety profiles were compared between different IOCM at the system organ level using the proportional reporting ratio (PRR) and 95% confidence interval (95% CI). Among a total of 48,261 reports, 6,524 (13.5%) reports were related to the use of IOCM. Iopromide (45.5%), iohexol (16.9%), iopamidol (14.3%) and iomeprol (10.3%) were identified as frequently reported media. 'Platelet, bleeding & clotting disorders' (PRR, 29.6; 95%CI, 1.9-472.6) and 'urinary system disorders' (PRR, 22.3; 95% CI, 17.1-29.1) were more frequently reported for iodixanol than the other IOCM. In conclusion, the frequency of AEs by organ class was significantly different between individual media. These differences among different IOCM should be considered when selecting a medium among various IOCM and when monitoring patients during and after its use to ensure optimum usage and patient safety. PMID:24339697

  1. Physical experiments on the utility of non-iodine-containing contrast media

    International Nuclear Information System (INIS)

    Kirschner, H.; Burmester, U.; Stringaris, K.; Jentsch, F.

    1979-01-01

    Because of the excellent ability of the CT scanner in analyzing absorption, the use of non-iodine-containing contrast media will be discussed. Experimental studies of the chemical elements with the atomic number Z = 1-83 with a scan tension of 120 kV were made to determine how many atoms of a given element are necessary to replace one iodine atom in an iodine-containing contrast medium, whereby the same contrast enhancement in the scan picture as with the iodine-containing contrast medium is produced. (orig.) 891 ORU/orig. 892 MB [de

  2. Iodine-based contrast media, multiple myeloma and monoclonal gammopathies: literature review and ESUR Contrast Media Safety Committee guidelines.

    Science.gov (United States)

    Stacul, Fulvio; Bertolotto, Michele; Thomsen, Henrik S; Pozzato, Gabriele; Ugolini, Donatella; Bellin, Marie-France; Bongartz, Georg; Clement, Olivier; Heinz-Peer, Gertraud; van der Molen, Aart; Reimer, Peter; Webb, Judith A W

    2018-02-01

    Many radiologists and clinicians still consider multiple myeloma (MM) and monoclonal gammopathies (MG) a contraindication for using iodine-based contrast media. The ESUR Contrast Media Safety Committee performed a systematic review of the incidence of post-contrast acute kidney injury (PC-AKI) in these patients. A systematic search in Medline and Scopus databases was performed for renal function deterioration studies in patients with MM or MG following administration of iodine-based contrast media. Data collection and analysis were performed according to the PRISMA statement 2009. Eligibility criteria and methods of analysis were specified in advance. Cohort and case-control studies reporting changes in renal function were included. Thirteen studies were selected that reported 824 iodine-based contrast medium administrations in 642 patients with MM or MG, in which 12 unconfounded cases of PC-AKI were found (1.6 %). The majority of patients had intravenous urography with high osmolality ionic contrast media after preparatory dehydration and purgation. MM and MG alone are not risk factors for PC-AKI. However, the risk of PC-AKI may become significant in dehydrated patients with impaired renal function. Hypercalcaemia may increase the risk of kidney damage, and should be corrected before contrast medium administration. Assessment for Bence-Jones proteinuria is not necessary. • Monoclonal gammopathies including multiple myeloma are a large spectrum of disorders. • In monoclonal gammopathy with normal renal function, PC-AKI risk is not increased. • Renal function is often reduced in myeloma, increasing the risk of PC-AKI. • Correction of hypercalcaemia is necessary in myeloma before iodine-based contrast medium administration. • Bence-Jones proteinuria assessment in myeloma is unnecessary before iodine-based contrast medium administration.

  3. Iodinated contrast media alter immune responses in pro-inflammatory states.

    LENUS (Irish Health Repository)

    O'Donnell, David H

    2010-07-01

    Hypertonic saline causes a transient elevation of blood osmolality and has been shown to alter cellular inflammatory responses in pro-inflammatory states. Intravascular administration of iodine contrast media also causes a transient elevation of blood osmolarity.

  4. The use of iodinated and gadolinium contrast media during pregnancy and lactation

    Energy Technology Data Exchange (ETDEWEB)

    Webb, Judith A.W. [St. Bartholomew' s Hospital, Department of Diagnostic Imaging, London (United Kingdom); Thomsen, Henrik S. [Copenhagen University Hospital at Herlev, Department of Diagnostic Radiology 54E2, Herlev (Denmark); Morcos, Sameh K. [Northern General Hospital, Department of Diagnostic Imaging, Sheffield (United Kingdom)

    2005-06-01

    The use of iodinated or gadolinium-based contrast media in pregnant or lactating women often causes concerns in the radiology department because of the principle of not exposing a fetus or neonate to any drugs. Because of the uncertainty about the use of contrast media during pregnancy and lactation, the Contrast Media Safety Committee of the European Society of Urogenital Radiology decided to review the literature and draw up guidelines. An extensive literature search was carried out and summarized in a report. Based on the limited information available, simple guidelines have been drawn up. The report and guidelines were discussed at the 11th European Symposium on Urogenital Radiology in Santiago de Compostela, Spain. Mutagenic and teratogenic effects have not been described after administration of gadolinium or iodinated contrast media. Free iodide in radiographic contrast medium given to the mother has the potential to depress fetal/neonatal thyroid function. Neonatal thyroid function should be checked during the 1st week if iodinated contrast media have been given during pregnancy. No effect on the fetus has been seen after gadolinium contrast media. Only tiny amounts of iodinated or gadolinium-based contrast medium given to a lactating mother reach the milk, and only a minute proportion entering the baby's gut is absorbed. The very small potential risk associated with absorption of contrast medium may be considered insufficient to warrant stopping breast-feeding for 24 h following either iodinated or gadolinium contrast agents. (orig.)

  5. The use of iodinated and gadolinium contrast media during pregnancy and lactation

    International Nuclear Information System (INIS)

    Webb, Judith A.W.; Thomsen, Henrik S.; Morcos, Sameh K.

    2005-01-01

    The use of iodinated or gadolinium-based contrast media in pregnant or lactating women often causes concerns in the radiology department because of the principle of not exposing a fetus or neonate to any drugs. Because of the uncertainty about the use of contrast media during pregnancy and lactation, the Contrast Media Safety Committee of the European Society of Urogenital Radiology decided to review the literature and draw up guidelines. An extensive literature search was carried out and summarized in a report. Based on the limited information available, simple guidelines have been drawn up. The report and guidelines were discussed at the 11th European Symposium on Urogenital Radiology in Santiago de Compostela, Spain. Mutagenic and teratogenic effects have not been described after administration of gadolinium or iodinated contrast media. Free iodide in radiographic contrast medium given to the mother has the potential to depress fetal/neonatal thyroid function. Neonatal thyroid function should be checked during the 1st week if iodinated contrast media have been given during pregnancy. No effect on the fetus has been seen after gadolinium contrast media. Only tiny amounts of iodinated or gadolinium-based contrast medium given to a lactating mother reach the milk, and only a minute proportion entering the baby's gut is absorbed. The very small potential risk associated with absorption of contrast medium may be considered insufficient to warrant stopping breast-feeding for 24 h following either iodinated or gadolinium contrast agents. (orig.)

  6. Late adverse reactions to intravascular iodine based contrast media

    DEFF Research Database (Denmark)

    Bellin, Marie-France; Stacul, Fulvio; Webb, Judith A W

    2011-01-01

    DEFINITION: Late adverse reactions (LAR) to contrast media (CM) are defined as reactions occurring 1 h to 1 week after exposure. NEED FOR REVIEW: In view of more prospective studies of LAR and new data about their pathophysiology, the Contrast Medium Safety Committee (CMSC) of the European Societ...

  7. Peripheral blood eosinophilia associated with gastrointestinal administration of iodinated contrast media.

    Science.gov (United States)

    Plavsic, Branko M; Newman, Alan C; Reuther, Warren L; Terry, James A; Drnovsek, Valerie H

    2003-03-01

    This study was designed to assess whether gastrointestinal administration of iodinated contrast media results in peripheral blood eosinophilia. We studied 110 patients in a retrospective review. Diatrizoate meglumine and diatrizoate sodium for abdominal CT were administered to 98 of these patients; 22 of the 98 had also been given the same contrast medium administered by enema. The remaining 12 patients were given diatrizoate sodium for gastrointestinal fluoroscopy. A control group of 65 patients underwent single-contrast barium upper gastrointestinal or enema examinations. WBC and eosinophil counts were determined approximately 24 hr before the examination and every 24 hr thereafter, through the ninth day. Eosinophilia was detected in 17 (15.5%) of 110 patients after gastrointestinal administration of iodinated contrast media. The prevalence of eosinophilia after administration of iodinated contrast media was statistically significantly different compared with that in the control group, in which none of the 65 patients had eosinophilia (p contrast agents and lasted through the sixth day, with a peak on the fifth day. The prevalence of eosinophilia was independent of route of application, dose, or type of iodinated contrast medium. Eosinophilia in all cases was clinically asymptomatic. Eosinophilia that is caused by gastrointestinal administration of iodinated contrast media is a transient, clinically silent phenomenon. It may lead to unnecessary workup for known conditions associated with eosinophilia.

  8. Iodinated Contrast Media and the Alleged "Iodine Allergy": An Inexact Diagnosis Leading to Inferior Radiologic Management and Adverse Drug Reactions.

    Science.gov (United States)

    Böhm, Ingrid; Nairz, Knud; Morelli, John N; Keller, Patricia Silva Hasembank; Heverhagen, Johannes T

    2017-04-01

    Purpose  To test the hypothesis that the incomplete diagnosis "iodine allergy" is a possibly dangerous concept for patients under routine radiologic conditions. Materials and Methods  300 patients with a history of an "iodine allergy" were retrospectively screened and compared with two age-, sex-, and procedure-matched groups of patients either diagnosed with a nonspecific "iodine contrast medium (ICM) allergy" or an allergy to a specific ICM agent. For all groups, the clinical symptoms of the most recent past adverse drug reaction (ADR), prophylactic actions taken for subsequent imaging, and ultimate outcome were recorded and analyzed. Results  The diagnosis "iodine allergy" was not otherwise specified in 84.3 % patients. For this group, in most cases, the symptoms of the previous ADRs were not documented. In contrast, the type of ADR was undocumented in only a minority of patients in the comparison groups. In the group of patients with an "iodine allergy" the percentage of unenhanced CT scans was greater than within the other two groups (36.7 % vs. 28.7 %/18.6 %). ADRs following prophylactic measures were only observed in the "iodine allergy" group (OR of 9.24 95 % CI 1.16 - 73.45; p contrast media containing covalently bound iodine.. · There is a clear correlation between the exactness of the diagnosis - from the alleged "iodine allergy" to "contrast media allergy" to naming the exact culprit CM - and the quality of documentation of the symptoms.. · Management of patients diagnosed with "iodine allergy" was associated with uncertainty leading to unenhanced scans and sometimes unnecessary prophylactic actions.. · The term "iodine allergy" should be omitted, because it is potentially dangerous and can decrease the quality of radiology exams.. Citation Format · Böhm Ingrid, Nairz Knud, Morelli John N et al. Iodinated Contrast Media and the Alleged "Iodine Allergy": An Inexact Diagnosis Leading to Inferior Radiologic Management and

  9. Interactions between iodinated contrast media and tissue plasminogen activator: In vitro comparison study.

    Science.gov (United States)

    Vörös, Eszter; Deres, László; Halmosi, Róbert; Várady, Edit; Tóth, Kálmán; Battyáni, István

    2017-01-01

    Iodinated contrast media (Xenetix®, Ultravist®, Omnipaque®, Visipaque® and Iomeron®) used for computed tomography (CT) may decrease fibrinolysis by recombinant tissue plasminogen activator (rt-PA). We hypothesized that receiving iodinated contrast media before rt-PA may impair thrombolysis as measured by a new model system. Whole blood from Wistar Kyoto rats (n = 10) was obtained and allowed to form blood clots. Thrombolysis was performed by placing individually the prepared clots into 15 mL tubes and adding 5 mL saline buffer, 100μg rt-PA and a different contrast media; adjusting the quantity of iodine to either 30 mg or 60 mg. The thrombolytic efficacy was quantified by measuring the optical density (OD415) of the supernatant at different time points, namely at 0, 30, 60, and 90 min. There was a significant decrease in clot lysis efficiency observed in presence of iodine containing contrast media comparing to positive control group. Moreover, when the quantity of iodine was increased from 30 mg to 60 mg; the dissolution rate downturned with additional ∼50%. In conclusion, our study suggests that high dose of iodine potentially could negatively affect the efficiency of the thrombolytic therapy performed by rt-PA.

  10. Acceptability of oral iodinated contrast media: a head-to-head comparison of four media

    Science.gov (United States)

    Ngan-Soo, E; McCoubrie, P

    2013-01-01

    Objective: To assess the palatability of iodinated oral contrast media commonly used in abdominopelvic CT and CT colonography (CTC). Methods: 80 volunteers assessed the palatability of a 20-ml sample of a standard 30 mg ml−1 dilution of Omnipaque® (iohexol; GE Healthcare, Cork, Ireland), Telebrix® (meglumine ioxithalamate; Guerbet, Aulnay-sous-Bois, France), Gastromiro® (iopamidol; Bracco, High Wycombe, UK) and Gastrografin® (sodium diatrizoate and meglumine diatrizoate; Bayer, Newbury, UK) in a computer-generated random order. Results: Gastrografin is rated significantly less palatable than the remaining media (pcontrast media than both Gastromiro and Gastrografin, which has potential implications in compliance with both abdominopelvic CT and CTC. PMID:23564884

  11. Late adverse reactions to intravascular iodine based contrast media

    DEFF Research Database (Denmark)

    Bellin, Marie-France; Stacul, Fulvio; Webb, Judith A W

    2011-01-01

    DEFINITION: Late adverse reactions (LAR) to contrast media (CM) are defined as reactions occurring 1 h to 1 week after exposure. NEED FOR REVIEW: In view of more prospective studies of LAR and new data about their pathophysiology, the Contrast Medium Safety Committee (CMSC) of the European Society...... or delayed reading intradermal). The main risk factors for LAR are a previous reaction to contrast medium, a history of allergy, and interleukin-2 treatment. Most skin reactions are mild or moderate and self-limiting. MANAGEMENT: Management is symptomatic and similar to the management of other drug......-induced skin reactions. To reduce the risk of repeat reactions avoidance of the relevant CM and any cross-reacting agents identified by skin testing is recommended....

  12. Alterations of serum potassium, serum magnesium and adenosine diphosphate due to various contrast media containing iodine

    International Nuclear Information System (INIS)

    Lehrberger, G.

    1979-01-01

    As an introduction of the chemical structure of contrast media is explained. Then follows a survey about the complication rates in examinations with intravascularly applicable iodine-containing contrast media. In the next part clinical symptoms and signs of general and localized contrast media incompatibility reactions, the contrast medium protein reaction and the relationship between allergic reaction and contrast medium are explained. It was tried to attribute the large amount of side-effects to one primary reaction. In this connection the three above-mentioned components were investigated. (orig./MG) [de

  13. Comparison of excretory urographic contrast effects of dimeric and monomeric non-ionic iodinated contrast media in dogs

    International Nuclear Information System (INIS)

    Kishimoto, M.; Yamada, K.; Watanabe, A.; Miyamoto, K.; Iwasaki, T.; Miyake, Y.

    2007-01-01

    In excretory urography, the osmolarity of contrast media has rarely been treated as important in veterinary medicine. In this study, the contrast effect of two contrast media (monomeric iohexol and dimeric iodixanol) in the renal cortex and aorta were compared using computed tomography (CT). Five beagle dogs were used and the study employed a cross-over method for each contrast media. The results showed that there was no difference between the media in the aorta, but iodixanol showed higher CT value and a longer contrast effect than iohexol in the renal cortex, in spite of having the same iodine dosage. It is believed that iodixanol, with its low osmolarity, is diluted less by osmotic diuresis than monomeric iohexol. It is important to consider the osmolarity of the contrast media when evaluating the contrast effect, and it is essential to use the same contrast media for each examination, or the renal excretory speed will be under/overestimated

  14. Iodinated Contrast Media-Induced Thyroid Dysfunction in Euthyroid Nodular Goiter Patients.

    Science.gov (United States)

    Kornelius, Edy; Chiou, Jeng-Yuan; Yang, Yi-Sun; Lo, Shih-Chang; Peng, Chiung-Huei; Lai, Yung-Rung; Huang, Chien-Ning

    2016-08-01

    The risks of thyroid dysfunction after iodinated contrast media exposure in patients with euthyroid nodular goiter are largely unknown. This observational, retrospective cohort study included a random selection of one million people in Taiwan. All patients with iodinated contrast media exposure during this study period were selected. Patients with euthyroid nodular goiter were identified as cases, while patients without thyroid nodule were selected as controls. We followed these patients until the first event of thyroid dysfunction including hyperthyroidism or hypothyroidism after iodinated contrast media exposure. A total of 334 cases and 2672 matched controls were selected in this study. The mean age of cases and controls were 58.6 and 58.4 years old, and mean follow-up durations were 2.1 and 2 years respectively. After adjustment, patients with euthyroid nodular goiter had a higher risk of thyroid dysfunction (hazard ratio 5.43, [confidence interval (CI) 3.01-9.80]) compared with controls after iodinated contrast media exposure. In the subgroup analysis, the risks of hyperthyroidism and hypothyroidism in cases compared with controls were 5.77 [CI 2.64-12.62] and 4.95 [CI 2.15-11.40] respectively. Half of the euthyroid nodular goiter cases developed thyroid dysfunction within one year after iodinated contrast media exposure. Interestingly, all thyroid-related comorbidities and drug prescriptions did not increase the risk of thyroid dysfunction. Presence of euthyroid nodular goiter was associated with higher risk of thyroid dysfunction including hyperthyroidism and hypothyroidism after iodinated contrast media exposure.

  15. Breakthrough reactions of iodinated and gadolinium contrast media after oral steroid premedication protocol.

    Science.gov (United States)

    Jingu, Akiko; Fukuda, Junya; Taketomi-Takahashi, Ayako; Tsushima, Yoshito

    2014-10-06

    Adverse reactions to iodinated and gadolinium contrast media are an important clinical issue. Although some guidelines have proposed oral steroid premedication protocols to prevent adverse reactions, some patients may have reactions to contrast media in spite of premedication (breakthrough reaction; BTR).The purpose of this study was to assess the frequency, type and severity of BTR when following an oral steroid premedication protocol. All iodinated and gadolinium contrast-enhanced radiologic examinations between August 2011 and February 2013 for which the premedication protocol was applied in our institution were assessed for BTRs. The protocol was applied to a total of 252 examinations (153 patients, ages 15-87 years; 63 males, 90 females). Of these, 152 were for prior acute adverse reactions to contrast media, 85 were for a history of bronchial asthma, and 15 were for other reasons. There were 198 contrast enhanced CTs and 54 contrast enhanced MRIs. There were nine BTR (4.5%) for iodinated contrast media, and only one BTR (1.9%) for gadolinium contrast media: eight were mild and one was moderate. No patient who had a mild index reaction (IR) had a severe BTR. Incidence of BTRs when following the premedication protocol was low. This study by no means proves the efficacy of premedication, but provides some support for following a premedication protocol to improve safety of contrast-enhanced examinations when prior adverse reactions are mild, or when there is a history of asthma.

  16. Breakthrough reactions of iodinated and gadolinium contrast media after oral steroid premedication protocol

    International Nuclear Information System (INIS)

    Jingu, Akiko; Fukuda, Junya; Taketomi-Takahashi, Ayako; Tsushima, Yoshito

    2014-01-01

    Adverse reactions to iodinated and gadolinium contrast media are an important clinical issue. Although some guidelines have proposed oral steroid premedication protocols to prevent adverse reactions, some patients may have reactions to contrast media in spite of premedication (breakthrough reaction; BTR). The purpose of this study was to assess the frequency, type and severity of BTR when following an oral steroid premedication protocol. All iodinated and gadolinium contrast-enhanced radiologic examinations between August 2011 and February 2013 for which the premedication protocol was applied in our institution were assessed for BTRs. The protocol was applied to a total of 252 examinations (153 patients, ages 15–87 years; 63 males, 90 females). Of these, 152 were for prior acute adverse reactions to contrast media, 85 were for a history of bronchial asthma, and 15 were for other reasons. There were 198 contrast enhanced CTs and 54 contrast enhanced MRIs. There were nine BTR (4.5%) for iodinated contrast media, and only one BTR (1.9%) for gadolinium contrast media: eight were mild and one was moderate. No patient who had a mild index reaction (IR) had a severe BTR. Incidence of BTRs when following the premedication protocol was low. This study by no means proves the efficacy of premedication, but provides some support for following a premedication protocol to improve safety of contrast-enhanced examinations when prior adverse reactions are mild, or when there is a history of asthma

  17. Anaphylactoid reactions to the nonvascular administration of water-soluble iodinated contrast media.

    Science.gov (United States)

    Davis, Peter L

    2015-06-01

    Anaphylactoidlike reactions occur during the nonvascular administration of iodinated contrast media. Many of these reactions have been severe. These reactions have occurred with many procedures, including gastrointestinal imaging, cystography, sialography, and hysterosalpingography. This article reviews reports of these reactions. It also reviews what the literature recommends concerning how to deal with individuals undergoing these procedures who are at a higher risk for anaphylactoidlike reactions.

  18. An experimental study on renal damage induced by ionic contrast media in relation to iodine concentration

    International Nuclear Information System (INIS)

    Sung, Dong Wook; Yoon, Yup; Lim, Jae Hoon; Yang, Moon Ho

    1990-01-01

    Renal injury caused by iodinated contrast media has been widely known, but there has been few papers regarding the pathological change. A series of kidneys after injection of iodinated contrast media was examined to document pathological change. A total of 80 rats was divided into two groups; those given Urografin-60% by 5ml/kg; those given Urografin-76% by 5ml/kg. The kidneys were removed out 1, 2, 3, 5, 7, 10, 14 and 21 days after injection of contrast media and microscopically examined. The resulted were as follows: 1. Pathological changes induced by ionic contrast media were deposition of proteinaceous materials in the proximal convoluted tubules, congestion of interstitial vessels, and vasa rectae, and epithelial degeneration of collecting ducts. There was no detectable pathological changes in the glomerulus, loop of Henle, and distal convoluted tubules. 2. All pathological changes were severe, as the concentration of contrast media increased. 3. These pathologic changes appeared 1 day after injection of contrast media and persisted at least 3 weeks without improvement. Author concludes that the renal damage induced by ionic contrast media becomes severe with increase in concentration, and pathologic changes are not influence with time interval

  19. Iodinated contrast media and patients with high-risk kidneys. Aiming at rational prevention

    International Nuclear Information System (INIS)

    Fontaine, B.; Frouge, C.; Gagey, N.

    1994-01-01

    Acute renal failure induced by iodinated contrast media (CM) accounts for about 10% of all hospital cases of renal failure, especially in azotemic patients. The specific anatomy and physiology of the inner medulla renalis render it particularly sensitive to even a moderate reduction in blood supply. Renal function will be estimated by measuring serum creatinine levels, before and within 72 hours after administration of the iodinated contrast medium. Hypovolaemia, diabetes mellitus-induced microangiopathy, nephrotoxic drugs and especially dehydratation may provoke renal accidents. Proper hydration, choosing a low osmolality medium and adequately spacing exposures to CM are elementary measures to be adopted to prevent renal failure. (authors)

  20. Use of Iodine-based contrast media in digital full-field mammography - initial experience

    International Nuclear Information System (INIS)

    Diekmann, F.; Diekmann, S.; Taupitz, M.; Bick, U.; Winzer, K.-J.; Huettner, C.; Muller, S.; Jeunehomme, F.; Hamm, B.

    2003-01-01

    Aim: To investigate the use of iodine-based contrast media in digital full-field mammography. Methods: After performing initial phantom studies, seven patients underwent digital mammography (Senographe 2000D, GE Medical Systems, Milwaukee, USA) using a specially filtered beam before as well as 60, 120, and 180 seconds after injection of 80 ml of iodine contrast medium (Ultravist 370, Schering AG, Germany). The precontrast mammograms were then subtracted from the postcontrast mammograms and the resulting images compared with a contrast-enhanced dynamic MRI study, performed on all women. Results: Contrast medium accumulation within the tumors was visualized with a good quality in all cases. The conditions under which successful contrast-enhanced digital mammography can be performed were determined in phantom studies. Conclusions: Contrast-enhanced digital mammography has a potential for improving the visualization of breast tumors in mammography using special beam filtering, adjusted X-ray parameters, proper timing, and suitable subtraction software. (orig.) [de

  1. Prophylaxis and treatment of side effects due to iodinated contrast media relevant to radiological practice

    International Nuclear Information System (INIS)

    Becker, C.

    2007-01-01

    Increased utilization of iodinated contrast media may be associated with increased incidence of adverse events. The most important side effects include contrast-induced nephropathy, anaphylactoid reaction, thyrotoxicosis, and extravasation. In patients with moderate renal dysfunction, saline hydration and reduction of contrast media volume are recommended. No regime to prevent anaphylactoid reactions has yet proven to be efficient. If subclinical hyperthyroidism has been determined, prophylaxis with sodium perchlorate is advised. Contrast-induced nephropathy is commonly transient and needs to be followed over time. Mild general anaphylactoid reactions may be treated with antihistaminic drugs and corticosteroids. Furthermore the choice of the X-ray contrast media might influence the risk of any adverse effects. (orig.) [de

  2. A Comparison of the Use of Contrast Media with Different Iodine Concentrations for Multidetector CT of the Kidney

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Seung Chai; Kim, Seung Hyup; Cho, Jeong Yeon [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2011-11-15

    To determine the optimal iodine concentration of contrast media for kidney multidetector computed tomography (MDCT) by comparing the degree of renal parenchymal enhancement and the severity of the renal streak artifact with contrast media of different iodine concentrations. A 16-row MDCT was performed in 15 sedated rabbits by injection of 2 mL contrast media/kg body weight at a rate of 0.3 mL/sec. Monomeric nonionic contrast media of 250, 300, and 370 mg iodine/mL were injected at 1-week intervals. Mean attenuation values were measured in each renal structure with attenuation differences among the structures. The artifact was evaluated by CT window width/level and three grading methods. The values were compared with iodine concentrations. The 370 mg iodine/mL concentration showed significantly higher cortical enhancement than 250 mg iodine/mL in all phases (p < 0.05). There was however no significant difference in the degree of enhancement between the 300 mg iodine/mL and 370 mg iodine/mL concentrations in all phases. There is a significant difference in attenuation for the cortex-outer medulla between 250 mg iodine/mL and 300 mg iodine/mL (p < 0.05). The artifact was more severe with a medium of 370 mg iodine/mL than with 250 mg iodine/mL by all grading methods (p < 0.05). The 300 mg iodine/mL is considered to be the most appropriate iodine concentration in an aspect of the enhancement and artifact on a kidney MDCT scan.

  3. A Comparison of the Use of Contrast Media with Different Iodine Concentrations for Multidetector CT of the Kidney

    Science.gov (United States)

    Jung, Seung Chai; Cho, Jeong Yeon

    2011-01-01

    Objective To determine the optimal iodine concentration of contrast media for kidney multidetector computed tomography (MDCT) by comparing the degree of renal parenchymal enhancement and the severity of the renal streak artifact with contrast media of different iodine concentrations. Materials and Methods A 16-row MDCT was performed in 15 sedated rabbits by injection of 2 mL contrast media/kg body weight at a rate of 0.3 mL/sec. Monomeric nonionic contrast media of 250, 300, and 370 mg iodine/mL were injected at 1-week intervals. Mean attenuation values were measured in each renal structure with attenuation differences among the structures. The artifact was evaluated by CT window width/level and three grading methods. The values were compared with iodine concentrations. Results The 370 mg iodine/mL concentration showed significantly higher cortical enhancement than 250 mg iodine/mL in all phases (p < 0.05). There was however no significant difference in the degree of enhancement between the 300 mg iodine/mL and 370 mg iodine/mL concentrations in all phases. There is a significant difference in attenuation for the cortex-outer medulla between 250 mg iodine/mL and 300 mg iodine/mL (p < 0.05). The artifact was more severe with a medium of 370 mg iodine/mL than with 250 mg iodine/mL by all grading methods (p < 0.05). Conclusion The 300 mg iodine/mL is considered to be the most appropriate iodine concentration in an aspect of the enhancement and artifact on a kidney MDCT scan. PMID:22043154

  4. Iodinated contrast media and contrast-induced nephropathy: is there a preferred cost-effective agent?

    Science.gov (United States)

    Sharma, Samin K

    2008-05-01

    Over 20 years have passed since the introduction of the tri-iodinated low-osmolar nonionic contrast agents such as iopamidol, iohexol, ioversol and iopromide. During this time, most cardiology practices have switched to these nonionic agents to avoid the nuisance side effects and cardiac adverse events associated with the older ionic contrast agents. Although the improved tolerability of the nonionic agents is generally attributed to their decreased osmolality (approximately half that of the older ionic contrast agents), in fact, these contrast agents also differ from the older agents in their ionicity, viscosity and direct chemotoxicity. The impact of these properties on safety, together with cost differences, should be considered when selecting a contrast agent.

  5. The prevention of anaphylactoid reactions to iodinated radiological contrast media: a systematic review

    Directory of Open Access Journals (Sweden)

    Carter Andrew

    2006-04-01

    Full Text Available Abstract Background Anaphylactoid reactions to iodinated contrast media are relatively common and potentially life threatening. Opinion is divided as to the utility of medications for preventing these reactions. We performed a systematic review to assess regimes for the prevention of anaphylactoid reactions to iodinated contrast media. Methods Searches for studies were conducted in the Medline, EMBASE, CINAHL and CENTRAL databases. Bibliographies of included studies and review articles were examined and experts were contacted. Randomised clinical trials that examined agents given prior to iodinated contrast material for the prevention of anaphylactoid reactions were included in the review. The validity of the included studies was examined using a component approach. Results Six studies met the inclusion criteria, but only one of these fulfilled all of the validity criteria. There were four studies that examined the use of H1 antihistamines, each was used to prevent anaphylactoid reactions to ionic contrast. The random effects pooled relative risk demonstrated a significant reduction in the overall rate of anaphylactoid reactions (RR = 0.4, 95% CI 0.18-0.9, p = 0.027. There were insufficient studies to produce a pooled statistic for the use of corticosteroids, however regimes of steroids (methylprednisolone 32 mg given at least six hours and again two hours prior to the administration of contrast suggested a reduction in the incidence of anaphylactoid reactions. Conclusion In conclusion, there are few high quality randomised clinical trials that have addressed the question of the optimal methods to prevent allergic type reactions to iodinated radiological contrast media. Allowing for these limitations, the results suggest that H1 antihistamines given immediately prior to the administration of ionic contrast may be useful in preventing reactions to ionic contrast and are suggestive of a protective effect of corticosteroids when given in two doses

  6. Microvascular resistance in response to iodinated contrast media in normal and functionally impaired kidneys.

    Science.gov (United States)

    Kurihara, Osamu; Takano, Masamichi; Uchiyama, Saori; Fukuizumi, Isamu; Shimura, Tetsuro; Matsushita, Masato; Komiyama, Hidenori; Inami, Toru; Murakami, Daisuke; Munakata, Ryo; Ohba, Takayoshi; Hata, Noritake; Seino, Yoshihiko; Shimizu, Wataru

    2015-12-01

    Contrast-induced nephropathy (CIN) is considered to result from intrarenal vasoconstriction, and occurs more frequently in impaired than in normal kidneys. It was hypothesized that iodinated contrast media would markedly change renal blood flow and vascular resistance in functionally impaired kidneys. Thirty-six patients were enrolled (32 men; mean age, 75.3 ± 7.6 years) undergoing diagnostic coronary angiography and were divided into two groups based on the presence of chronic kidney disease (CKD), defined as an estimated glomerular filtration rate (eGFR) of contrast media. The APV and the RI were positively and inversely correlated with the eGFR at baseline, respectively (APV, R = 0.545, P = 0.001; RI, R = -0.627, P contrast media administration in the non-CKD group, but not in the CKD group (APV, P = 0.258; RI, P = 0.707). Although renal arterial resistance was higher in patients with CKD, it was not affected by contrast media administration, suggesting that patients with CKD could have an attenuated response to contrast media. © 2015 The Authors. Clinical and Experimental Pharmacology and Physiology Published by Wiley Publishing Asia Pty Ltd.

  7. Contrast enhancement in multidetector-row computed tomography (MDCT) of the abdomen: intraindividual comparison of contrast media containing 300 mg versus 370 mg iodine per ml

    International Nuclear Information System (INIS)

    Behrendt, F.F.; Mahnken, A.H.; Keil, S.; Das, M.; Hohl, C.; Guenther, R.W.; Muehlenbruch, G.; Bauer, D.; Seidensticker, P.; Jost, E.; Wildberger, J.E.

    2008-01-01

    The purpose of this study was to intraindividually evaluate the difference in intraluminal vessel and parenchyma contrast enhancement of two different iodine concentrations in multidetector-row computed tomography (MDCT) of the abdomen. Eighty-three patients underwent baseline and follow-up MDCT-scanning (Somatom Sensation 16; Siemens, Forchheim, Germany) of the abdomen using contrast media containing 370 mg iodine/ml (protocol A; Ultravist 370, Bayer Schering Pharma, Berlin, Germany) and 300 mg iodine/ml (protocol B; Ultravist 300). The total iodine load (37 g iodine) and the iodine delivery rate (1.29 g iodine/s) were identical for both protocols. Contrast enhancement in the portal venous phase was measured in the abdominal aorta, inferior vena cava, portal vein, liver, spleen, pancreas and kidney. Mean attenuation values were compared using paired t-test. Intraindividual comparison revealed no statistically significant differences of the mean attenuation values between protocols A and B for all anatomic sites: abdominal aorta, inferior vena cava, portal vein, liver, spleen, pancreas and kidney (all P > 0.05). Given an injection protocol with constant total iodine load and constant iodine delivery rate, the iodine concentration of contrast media does not significantly influence abdominal contrast enhancement in the portal venous phase. (orig.)

  8. Are referring clinicians aware of patients at risk from intravenous injection of iodinated contrast media?

    International Nuclear Information System (INIS)

    Konen, Eli; Konen, Osnat; Katz, Miriam; Levy, Yair; Rozenman, Judith; Hertz, Marjorie

    2002-01-01

    AIM: The purpose of our study was to assess the level of awareness of referring clinicians to populations at risk for complications of intravascular administration of iodinated contrast media. SUBJECTS AND METHODS: Two hundred and three physicians from three university hospitals completed an anonymous questionnaire regarding risk factors and contraindications to the intravenous administration of iodinated contrast media. The questionnaire included medical conditions with increased risk for anaphylactoid reaction (asthma, hay fever and food allergy) as well as chemotoxic (ischaemic heart disease, phaeochromocytoma and myasthenia gravis) adverse reactions, some with dependence on renal function (metformin treatment, diabetes mellitus and multiple myeloma). Two additional multiple-choice questions addressed pre-medication protocols and risk of nephrotoxicity in diabetic patients. RESULTS: Asthma, food allergy and hay fever were recognized as risk factors by 81·3%, 77·8% and 61·6% of respondents respectively, while ischaemic heart disease, phaeochromocytoma and myasthenia gravis were defined as such only by 9·8%, 30·0% and 28·6% respectively. Metformin treatment, diabetes mellitus and multiple myeloma, in the presence of normal renal function, were considered as risk factors by 46·3%, 38·9% and 58·1% of respondents respectively. One of the generally accepted pre-medication protocols was selected by 89·8%. The risk of nephrotoxicity in a diabetic patient was correctly assessed by 63·5% of respondents. CONCLUSION: We found a relatively high awareness among referring clinicians of a potential anaphylactoid reaction and nephrotoxicity due to iodinated contrast media. However, additional chemotoxic adverse reactions are less well known. Future efforts to improve communication between clinicians and radiologists should be focused in this direction. Konen, E. et al. (2002)

  9. Iodinated contrast media electro-degradation: process performance and degradation pathways.

    Science.gov (United States)

    Del Moro, Guido; Pastore, Carlo; Di Iaconi, Claudio; Mascolo, Giuseppe

    2015-02-15

    The electrochemical degradation of six of the most widely used iodinated contrast media was investigated. Batch experiments were performed under constant current conditions using two DSA® electrodes (titanium coated with a proprietary and patented mixed metal oxide solution of precious metals such as iridium, ruthenium, platinum, rhodium and tantalum). The degradation removal never fell below 85% (at a current density of 64 mA/cm(2) with a reaction time of 150 min) when perchlorate was used as the supporting electrolyte; however, when sulphate was used, the degradation performance was above 80% (at a current density of 64 mA/cm(2) with a reaction time of 150 min) for all of the compounds studied. Three main degradation pathways were identified, namely, the reductive de-iodination of the aromatic ring, the reduction of alkyl aromatic amides to simple amides and the de-acylation of N-aromatic amides to produce aromatic amines. However, as amidotrizoate is an aromatic carboxylate, this is added via the decarboxylation reaction. The investigation did not reveal toxicity except for the lower current density used, which has shown a modest toxicity, most likely for some reaction intermediates that are not further degraded. In order to obtain total removal of the contrast media, it was necessary to employ a current intensity between 118 and 182 mA/cm(2) with energy consumption higher than 370 kWh/m(3). Overall, the electrochemical degradation was revealed to be a reliable process for the treatment of iodinated contrast media that can be found in contaminated waters such as hospital wastewater or pharmaceutical waste-contaminated streams. Copyright © 2014 Elsevier B.V. All rights reserved.

  10. Are referring clinicians aware of patients at risk from intravenous injection of iodinated contrast media?

    Energy Technology Data Exchange (ETDEWEB)

    Konen, Eli; Konen, Osnat; Katz, Miriam; Levy, Yair; Rozenman, Judith; Hertz, Marjorie

    2002-02-01

    AIM: The purpose of our study was to assess the level of awareness of referring clinicians to populations at risk for complications of intravascular administration of iodinated contrast media. SUBJECTS AND METHODS: Two hundred and three physicians from three university hospitals completed an anonymous questionnaire regarding risk factors and contraindications to the intravenous administration of iodinated contrast media. The questionnaire included medical conditions with increased risk for anaphylactoid reaction (asthma, hay fever and food allergy) as well as chemotoxic (ischaemic heart disease, phaeochromocytoma and myasthenia gravis) adverse reactions, some with dependence on renal function (metformin treatment, diabetes mellitus and multiple myeloma). Two additional multiple-choice questions addressed pre-medication protocols and risk of nephrotoxicity in diabetic patients. RESULTS: Asthma, food allergy and hay fever were recognized as risk factors by 81{center_dot}3%, 77{center_dot}8% and 61{center_dot}6% of respondents respectively, while ischaemic heart disease, phaeochromocytoma and myasthenia gravis were defined as such only by 9{center_dot}8%, 30{center_dot}0% and 28{center_dot}6% respectively. Metformin treatment, diabetes mellitus and multiple myeloma, in the presence of normal renal function, were considered as risk factors by 46{center_dot}3%, 38{center_dot}9% and 58{center_dot}1% of respondents respectively. One of the generally accepted pre-medication protocols was selected by 89{center_dot}8%. The risk of nephrotoxicity in a diabetic patient was correctly assessed by 63{center_dot}5% of respondents. CONCLUSION: We found a relatively high awareness among referring clinicians of a potential anaphylactoid reaction and nephrotoxicity due to iodinated contrast media. However, additional chemotoxic adverse reactions are less well known. Future efforts to improve communication between clinicians and radiologists should be focused in this direction. Konen

  11. Non-ionic iodinated contrast media related immediate reactions: A mechanism study of 27 patients.

    Science.gov (United States)

    Zhai, Liqin; Guo, Xiangjie; Zhang, Haoyue; Jin, Qianqian; Zeng, Qiang; Tang, Xiaoxian; Gao, Cairong

    2017-01-01

    The underlying mechanism of non-ionic iodinated contrast media-related immediate reactions was evaluated in this study. Patients presenting at least grade II immediate reactions after non-ionic iodinated contrast media injection were enrolled. Basophil activation was evaluated by flow cytometry. The plasma concentration of human terminal complement complex SC5b-9, as well as concentrations of serum chymase, tryptase, human mast cell carboxypeptidase A3, human prostaglandin D2, and total IgE were measured by enzyme-linked immunosorbent assay. The basophil activation percentage was significantly higher in the study group than in the control group (17.94±21.06% vs 3.45±1.49%). The plasma concentration of human terminal complement complex SC5b-9 and concentrations of serum chymase, human mast cell carboxypeptidase A3, prostaglandin D2, tryptase, and total IgE were also significantly increased (236.99±318.21 vs 49.70±30.41ng/mL, 0.41±0.49 vs 0.09±0.06ng/mL, 1.17±0.67 vs 0.30±0.17ng/mL, 203.52±137.27 vs 102.28±48.72pg/mL, 3.81±0.22 vs 2.70±0.16ng/mL, 102.00±51.84 vs 19.97±2.75ng/mL, respectively). Both mast cells and basophils were activated in non-ionic iodinated contrast media to mediate immediate hypersensitivity, and mast cells may be involved. Different mechanisms, including IgE-dependent, complement-dependent, and direct membrane effects, contributed to mast cell and basophil activation. Individual patients may use a single or combined mechanism involving single or combined mast cells and basophils. Immediate reactions following non-ionic iodinated contrast media injection may be a mechanically heterogenous disease. Copyright © 2016. Published by Elsevier B.V.

  12. Distribution and relevance of iodinated X-ray contrast media and iodinated trihalomethanes in an aquatic environment.

    Science.gov (United States)

    Xu, Zhifa; Li, Xia; Hu, Xialin; Yin, Daqiang

    2017-10-01

    Distribution and relevance of iodinated X-ray contrast media (ICM) and iodinated disinfection byproducts (I-DBPs) in a real aquatic environment have been rarely documented. In this paper, some ICM were proven to be strongly correlated with I-DBPs through investigation of five ICM and five iodinated trihalomethanes (I-THMs) in surface water and two drinking water treatment plants (DWTPs) of the Yangtze River Delta, China. The total ICM concentrations in Taihu Lake and the Huangpu River ranged from 88.7 to 131 ng L -1 and 102-252 ng L -1 , respectively. While the total I-THM concentrations ranged from 128 to 967 ng L -1 in Taihu Lake and 267-680 ng L -1 in the Huangpu River. Iohexol, the dominant ICM, showed significant positive correlation (p < 0.01) with CHClI 2 in Taihu Lake. Iopamidol and iomeprol correlated positively (p < 0.01) with some I-THMs in the Huangpu River. The observed pronounced correlations between ICM and I-THMs indicated that ICM play an important role in the formation of I-THMs in a real aquatic environment. Characteristics of the I-THM species distributions indicated that I-THMs may be transformed by natural conditions. Both DWTPs showed negligible removal efficiencies for total ICM (<20%). Strikingly high concentrations of total I-THMs were observed in the finished water (2848 ng L -1 in conventional DWTP and 356 ng L -1 in advanced DWTP). Obvious transformation of ICM to I-THMs was observed during the chlorination and ozonization processes in DWTPs. We suggest that ICM is an important source for I-DBP formation in the real aquatic environment. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. [Comparison of iodinated and barium-containing contrast media of different viscosity in the detection of pharyngeal perforation].

    Science.gov (United States)

    Keberle, M; Wittenberg, G; Trusen, A; Baumgartner, W; Hahn, D

    2001-08-01

    In contrast to esophageal perforations, the more radiopaque barium-suspensions are not as important as iodinated aqueous contrast agents for the detection of pharyngeal perforations. This study was performed to find out whether the highly different viscosities (of iodinated and barium-containing contrast agents with comparable radiopacities) are a reason for this. Viscosity, subjective difference in contrast, and CT-density of an iodinated aqueous (Telebrix) and a 50 wt/vol% barium-containing contrast agent (Micropaque) were determined. Moreover, to exclude postoperative perforation, 104 patients were prospectively examined by pharyngography using both contrast media. Pharyngographies of patients with perforation were later compared by two independent readers. All patients with perforation were followed up clinically to exclude complications due to barium administration. In-vitro comparison showed comparable radiopacity but the 50 wt/vol% barium-suspension was much more viscous than the iodinated contrast agent. During pharyngography, totally, 14 perforations were clearly delineated with the iodinated aqueous contrast agent. However, two of them were not detected with the barium-suspension. All the other perforations presented equally. Given a sufficient radiopacity, a low viscosity appears to be essential for a contrast agent to detect especially pharyngeal perforations. Thus, we recommend the sole use of an iodinated contrast agent (at suspicion of aspiration as isoosmolar variant) for this purpose.

  14. Reduced iodinated contrast media for abdominal imaging by dual-layer spectral detector computed tomography for patients with kidney disease

    Directory of Open Access Journals (Sweden)

    Hirokazu Saito, MD

    2018-04-01

    Full Text Available Contrast-enhanced computed tomography using iodinated contrast media is useful for diagnosis of gastrointestinal diseases. However, contrast-induced nephropathy remains problematic for kidney diseases patients. Although current guidelines recommended the use of a minimal dose of contrast media necessary to obtain adequate images for diagnosis, obtaining adequate images with sufficient contrast enhancement is difficult with conventional computed tomography using reduced contrast media. Dual-layer spectral detector computed tomography enables the simultaneous acquisition of low- and high-energy data and the reconstruction of virtual monochromatic images ranging from 40 to 200 keV, retrospectively. Low-energy virtual monochromatic images can enhance the contrast of images, thereby facilitating reduced contrast media. In case 1, abdominal computed tomography angiography at 50 keV using 40% of the conventional dose of contrast media revealed the artery that was the source of diverticular bleeding in the ascending colon. In case 2, ischemia of the transverse colon was diagnosed by contrast-enhanced computed tomography and iodine-selective imaging using 40% of the conventional dose of contrast media. In case 3, advanced esophagogastric junctional cancer was staged and preoperative abdominal computed tomography angiography could be obtained with 30% of the conventional dose of contrast media. However, the texture of virtual monochromatic images may be a limitation at low energy. Keywords: Virtual monochromatic images, Contrast-induced nephropathy

  15. Myelography iodinated contrast media. I. Unraveling the atropisomerism properties in solution.

    Science.gov (United States)

    Fontanive, Luca; D'Amelio, Nicola; Cesàro, Attilio; Gamini, Amelia; Tavagnacco, Letizia; Paolantoni, Marco; Brady, John W; Maiocchi, Alessandro; Uggeri, Fulvio

    2015-06-01

    The present work reports a thorough conformational analysis of iodinated contrast media: iomeprol, iopamidol (the world's most utilized contrast agent), and iopromide. Its main aim is the understanding of the complex structural features of these atropisomeric molecules, characterized by the presence of many conformers with hindered rotations, and of the role of atropisomerism in the physicochemical properties of their aqueous solutions. The problem was tackled by using an extensive analysis of (13)C NMR data on the solutions of whole molecules and of simple precursors in addition to FT-IR investigation and molecular simulations. This analysis demonstrated that out of the many possible atropisomers, only a few are significantly populated, and their relative population is provided. The conformational analysis also indicated that the presence of a sterically hindered amidic bond, allowing a significant population of cis forms (E in iopromide and exo in iomeprol), may be the basis for an increased thermodynamic solubility of concentrated solutions of iomeprol.

  16. Which iodinated contrast media is the least cytotoxic to human disc cells?

    Science.gov (United States)

    Kim, Kyung-Hyun; Park, Jeong-Yoon; Park, Hyo-Suk; Kuh, Sung-Uk; Chin, Dong-Kyu; Kim, Keun-Su; Cho, Yong-Eun

    2015-05-01

    Iodinated contrast media (CM) is commonly used for various intradiscal injections such as in discography and endoscopic spinal surgery. However, CM has been shown to be toxic to renal tissue due to its ionic strength and osmolarity and as a result of iodine-induced cytotoxicity, which has raised concern over whether there are similar negative effects on disc cells. This in vitro study was designed to identify the least cytotoxic iodinated CM to the human disc cell among four different physiochemical iodinated contrast dyes. In vitro laboratory study. Intervertebral disc tissue was obtained by discectomy from a total of 10 lumbar disc patients undergoing surgery and disc cells were isolated. The human disc cells were grown in 3D alginate bead culture with 0, 0.1, 10, and 100 mg/mL CM solutions (ionic dimer, ionic monomer, non-ionic dimer, and non-ionic monomer) and mannitol as a control for 2 days. The living cells were analyzed with trypan blue staining. Fluorescence-activated cell sorting analysis was performed using Annexin V and propidium iodide (PI) and 3D alginate bead immunostaining to identify live, apoptotic, and necrotic cells. Human disc cell death was time- and dose-dependent in response to CM and more necrosis was observed than apoptosis. In addition, non-ionic dimeric CM (iodixanol) showed the least toxic effect on human disc cells, followed by non-ionic monomeric (iopromide), ionic dimeric (ioxaglate), and ionic monomeric CM (ioxithalamate). Contrast media is cytotoxic to human disc cells in a dose- and time-dependent manner. This in vitro study revealed that, among four different CM preparations, non-ionic dimeric CM is the least detrimental to human disc cell viability. Careful attention should be paid to the type of CM chosen for discography and endoscopic spinal surgery. It is also necessary to investigate the detrimental effects of CM on disc cells and disc degeneration in further in vivo studies. Copyright © 2015 Elsevier Inc. All rights

  17. Bowel Angioedema Associated With Iodinated Contrast Media: Incidence and Predisposing Factors.

    Science.gov (United States)

    Seo, Nieun; Chung, Yong Eun; Lim, Joon Seok; Song, Mi Kyung; Kim, Myeong-Jin; Kim, Ki Whang

    2017-09-01

    Bowel angioedema is an acute adverse reaction to iodinated contrast media (CM) that involves the gastrointestinal tract. We aimed to investigate the incidence and predisposing factors of iodinated CM-associated bowel angioedema during computed tomography (CT) examinations. This study was approved by our institutional review board, and informed consent was waived due to its retrospective design. From July 2013 to July 2015, adult patients with a history of adverse reactions to iodinated CM during CT (group A, n = 427) and patients without adverse reactions matched for age and sex with the propensity-score matching method (group B, n = 427) were studied. Contrast media-associated bowel angioedema was determined when bowel wall thickness increased after contrast enhancement compared with the precontrast scan. Potential predisposing factors including patient demographics, symptoms and time of adverse reactions, and CM-related factors were compared between patients with and without angioedema in group A. In addition, the incidence of bowel angioedema was compared between groups A and B. The incidence of CM-associated bowel angioedema in group A was 3.3% (14/427) in the per-patient analysis and 2.6% (15/578) in the per-examination analysis. The CM-associated bowel angioedema involved the distal duodenum and/or proximal jejunum and showed long-segmental circumferential bowel wall thickening on CT. None of the studied predisposing factors was different between patients with and without bowel angioedema (P > 0.05). The incidence of CM-associated bowel angioedema in group B was 1.9% (8/427) and 1.7% (8/458) for per-patient and per-examination analyses, respectively, and these rates were not significantly different between groups A and B (P = 0.346 and P = 0.370, respectively). The incidence of CM-associated bowel angioedema during CT was 1.7% to 3.3%, and none of the studied predisposing factors was associated with bowel angioedema.

  18. Intra-individual comparison of different contrast media concentrations (300 mg, 370 mg and 400 mg iodine) in MDCT

    Energy Technology Data Exchange (ETDEWEB)

    Behrendt, Florian F.; Keil, Sebastian; Plumhans, Cedric; Guenther, Rolf W. [RWTH Aachen University, Department of Diagnostic Radiology, University Hospital, Aachen (Germany); Pietsch, Hubertus; Jost, Gregor; Sieber, Martin A.; Seidensticker, Peter [Bayer Schering Pharma AG, Berlin (Germany); Mahnken, Andreas H. [RWTH Aachen University, Department of Diagnostic Radiology, University Hospital, Aachen (Germany); RWTH Aachen University, Applied Medical Engineering, Helmholtz-Institute for Biomedical Engineering, Aachen (Germany)

    2010-07-15

    To compare intra-individual contrast enhancement in multi-detector-row computed tomography (MDCT) using contrast media (CM) containing 300, 370 and 400 mg iodine per ml (mgI/ml). Six pigs underwent repeated chest MDCT using three different CM (iopromide 300, iopromide 370, iomeprol 400). An identical iodine delivery (IDR) rate of 1.5 gI/s and a constant total iodine dose of 300 mg/kg body weight were used. Dynamic CT were acquired at the level of the pulmonary artery, and the ascending and descending aorta. After the time enhancement curves were computed, the pulmonary and aortic peak enhancement, time to peak and plateau time above 300 HU were calculated. Intra-individual peak contrast enhancement was significantly higher for the 300 mgI/ml contrast medium compared with the 370 and 400 mgI/ml media: pulmonary trunk 595 HU vs 516 HU (p = 0.0093) vs 472HU (p = 0.0005), and aorta 505 HU vs 454 HU (p = 0.0008) vs 439 HU (p = 0.0001), respectively. Comparison of time to peaks showed no significant difference. Plateau times were significantly longer for the 300 mgI/ml than for the 370 and 400 mgI/ml CM at all anatomical sites. Given normalised IDR and total iodine burden, the use of CM with a standard concentration with 300 mg iodine/ml provides improved contrast enhancement compared with highly concentrated CM in the chest. (orig.)

  19. Influence of osmolarity of contrast medium and saline flush on computed tomography angiography: Comparison of monomeric and dimeric iodinated contrast media with different iodine concentrations at an identical iodine delivery rate

    International Nuclear Information System (INIS)

    Kishimoto, Miori; Doi, Shoko; Shimizu, Junichiro; Lee, Ki-Ja; Iwasaki, Toshiroh; Miyake, Yoh-Ichi; Yamada, Kazutaka

    2010-01-01

    Purpose: To evaluate the influence of osmolarity of iodinated contrast media and saline flush on the contrast effect in thoracic computed tomography angiography (CTA) at an identical iodine delivery rate (IDR). Materials and methods: Seven beagles were used in a cross-over experiment. The contrast media used were iohexol 350 mgI/ml (IOH350; osmolarity 844 mmol/kg) and iodixanol 320 mgI/ml (IDX320; osmolarity 290 mmol/kg). Each contrast medium was administered to groups with and without saline flush at 40.0 mgI/kg/s for all experiments. Dynamic CT scanning was performed at the ninth thoracic vertebra level. The peak value, area under the curve (AUC), and time to peak (TTP) were calculated from the time attenuation curves of the pulmonary artery and aorta. Results: There was no significant difference between IOH350 and IDX320 with or without saline flush in the peak values for the pulmonary artery and aorta. AUC was significantly higher in groups with saline flush for both contrast media and arteries (p < 0.05) with no significant difference between contrast media. TTP was significantly longer in groups with saline flush than without saline flush for both contrast media and arteries (p < 0.05), with no significant difference between contrast media. Conclusions: There were no significant differences in the contrast effects of monomeric IOH350 and dimeric IDX320 in thoracic CTA when used at an identical IDR. Moreover, saline flush prolonged the peak duration at 600 mgI/kg.

  20. Photodecomposition of iodinated contrast media and subsequent formation of toxic iodinated moieties during final disinfection with chlorinated oxidants.

    Science.gov (United States)

    Allard, Sébastien; Criquet, Justine; Prunier, Anaïs; Falantin, Cécilia; Le Person, Annaïg; Yat-Man Tang, Janet; Croué, Jean-Philippe

    2016-10-15

    Large amount of iodinated contrast media (ICM) are found in natural waters (up to μg.L(-)(1) levels) due to their worldwide use in medical imaging and their poor removal by conventional wastewater treatment. Synthetic water samples containing different ICM and natural organic matter (NOM) extracts were subjected to UV254 irradiation followed by the addition of chlorine (HOCl) or chloramine (NH2Cl) to simulate final disinfection. In this study, two new quantum yields were determined for diatrizoic acid (0.071 mol.Einstein(-1)) and iotalamic acid (0.038 mol.Einstein(-1)) while values for iopromide (IOP) (0.039 mol.Einstein(-1)), iopamidol (0.034 mol.Einstein(-1)) and iohexol (0.041 mol.Einstein(-1)) were consistent with published data. The photodegradation of IOP led to an increasing release of iodide with increasing UV doses. Iodide is oxidized to hypoiodous acid (HOI) either by HOCl or NH2Cl. In presence of NOM, the addition of oxidant increased the formation of iodinated disinfection by-products (I-DBPs). On one hand, when the concentration of HOCl was increased, the formation of I-DBPs decreased since HOI was converted to iodate. On the other hand, when NH2Cl was used the formation of I-DBPs was constant for all concentration since HOI reacted only with NOM to form I-DBPs. Increasing the NOM concentration has two effects, it decreased the photodegradation of IOP by screening effect but it increased the number of reactive sites available for reaction with HOI. For experiments carried out with HOCl, increasing the NOM concentration led to a lower formation of I-DBPs since less IOP are photodegraded and iodate are formed. For NH2Cl the lower photodegradation of IOP is compensated by the higher amount of NOM reactive sites, therefore, I-DBPs concentrations were constant for all NOM concentrations. 7 different NOM extracts were tested and almost no differences in IOP degradation and I-DBPs formation was observed. Similar behaviour was observed for the 5 ICM

  1. Assessment of DNA double-strand breaks induced by intravascular iodinated contrast media following in vitro irradiation and in vivo, during paediatric cardiac catheterization.

    Science.gov (United States)

    Gould, Richard; McFadden, Sonyia L; Horn, Simon; Prise, Kevin M; Doyle, Philip; Hughes, Ciara M

    2016-01-01

    Paediatric cardiac catheterizations may result in the administration of substantial amounts of iodinated contrast media and ionizing radiation. The aim of this work was to investigate the effect of iodinated contrast media in combination with in vitro and in vivo X-ray radiation on lymphocyte DNA. Six concentrations of iodine (15, 17.5, 30, 35, 45, and 52.5 mg of iodine per mL blood) represented volumes of iodinated contrast media used in the clinical setting. Blood obtained from healthy volunteers was mixed with iodinated contrast media and exposed to radiation doses commonly used in paediatric cardiac catheterizations (0 mGy, 70 mGy, 140 mGy, 250 mGy and 450 mGy). Control samples contained no iodine. For in vivo experimentation, pre and post blood samples were collected from children undergoing cardiac catheterization, receiving iodine concentrations of up to 51 mg of iodine per mL blood and radiation doses of up to 400 mGy. Fluorescence microscopy was performed to assess γH2AX-foci induction, which corresponded to the number of DNA double-strand breaks. The presence of iodine in vitro resulted in significant increases of DNA double-strand breaks beyond that induced by radiation for ≥ 17.5 mg/mL iodine to blood. The in vivo effects of contrast media on children undergoing cardiac catheterization resulted in a 19% increase in DNA double-strand breaks in children receiving an average concentration of 19 mg/mL iodine to blood. A larger investigation is required to provide further information of the potential benefit of lowering the amount of iodinated contrast media received during X-ray radiation investigations. Copyright © 2015 John Wiley & Sons, Ltd.

  2. The haemodynamic effects of iodinated water soluble radiographic contrast media: a review

    International Nuclear Information System (INIS)

    Morcos, S.K.; Dawson, P.; Pearson, J.D.; Jeremy, J.Y.; Davenport, A.P.; Yates, M.S.; Tirone, P.; Cipolla, P.; Haeen, C. de; Muschick, P.; Krause, W.; Refsum, H.; Emery, C.J.; Liss, Per; Nygren, A.; Haylor, J.; Pugh, N.D.; Karlsson, J.O.G.

    1998-01-01

    All classes of iodinated water-soluble radiographic contrast media (RCM) are vasoactive with the iso-osmolar dimers inducing the least changes in the vascular tone. The mechanisms responsible for RCM-induced changes in the vascular tone are not fully understood and could be multifactorial. A direct effect on the vascular smooth muscle cells causing alterations in the ion exchanges across the cell membrane is thought to be an important factor in RCM-induced vasodilatation. The release of the endogenous vasoactive mediators adenosine and endothelin may also play a crucial role in the haemodynamic effects of RCM particularly in the kidney. In addition, the effects of RCM on blood rheology can cause a reduction in the blood flow in the microcirculation. The purpose of this review is to discuss the pathophysiology of the haemodynamic effects of RCM and to offer some insight into the biology of the endothelium and vascular smooth muscle cells as well as the pharmacology of the important vasoactive mediators endothelin and adenosine

  3. Safe use of iodinated and gadolinium-based contrast media in current practice in Japan: a questionnaire survey.

    Science.gov (United States)

    Tsushima, Yoshito; Ishiguchi, Tsuneo; Murakami, Takamichi; Hayashi, Hiromitsu; Hayakawa, Katsumi; Fukuda, Kunihiko; Korogi, Yukunori; Sugimoto, Hideharu; Takehara, Yasuo; Narumi, Yoshifumi; Arai, Yasuaki; Kuwatsuru, Ryohei; Yoshimitsu, Kengo; Awai, Kazuo; Kanematsu, Masayuki; Takagi, Ryo

    2016-02-01

    To help establish consensus on the safe use of contrast media in Japan. Questionnaires were sent to accredited teaching hospitals with radiology residency programs. The reply rate was 45.4% (329/724). For contrast-induced nephropathy (CIN), chronic and acute kidney diseases were considered a risk factor in 96.7 and 93.6%, respectively, and dehydration in 73.9%. As preventive actions, intravenous hydration (89.1%) and reduction of iodinated contrast media dose (86.9%) were commonly performed. For nephrogenic systemic fibrosis (NSF), chronic and acute kidney diseases were considered risk factors in 98.5 and 90.6%, respectively, but use of unstable gadolinium-based contrast media was considered a risk factor in only 55.6%. A renal function test was always (63.5% in iodinated; 65.7% in gadolinium) or almost always (23.1; 19.8%) performed, and estimated glomerular filtration rate (eGFR) was the parameter most frequently used (80.8; 82.6%). For the patients with risk factors for acute adverse reaction (AAR), steroid premedication or/and change of contrast medium were frequent preventive actions, but intravenous steroid administration immediately before contrast media use was still performed. Our questionnaire survey revealed that preventive actions against CIN were properly performed based on patients' eGFR. Preventive actions against NSF and AAR still lacked consensus.

  4. Iodinated contrast media induce neutrophil apoptosis through a mitochondrial and caspase mediated pathway.

    LENUS (Irish Health Repository)

    Fanning, N F

    2012-02-03

    Iodinated contrast media (ICM) can induce apoptosis (programmed cell death) in renal, myocardial and endothelial cells. Following intravascular injection, circulating immune cells are exposed to high concentrations of ICM. As neutrophils constitutively undergo apoptosis we hypothesized that ICM may adversely affect neutrophil survival. Our aim was to investigate the effect of ICM on neutrophil apoptosis. Neutrophils were isolated from healthy subjects and cultured in vitro with ionic (diatrizoate and ioxaglate) and non-ionic (iohexol and iotrolan) ICM. The effect of ICM on neutrophil apoptosis in both unstimulated and lipopolysaccharide-stimulated neutrophils was determined by annexin V flow cytometry. The influence of physicochemical properties of the different ICM on apoptosis of neutrophils was also studied. We further investigated the effects of ICM on key intracellular signal pathways, including p38 mitogen-activated protein kinase (MAPK) by Western blotting, and mitochondrial depolarization and caspase activity by flow cytometry. Isoiodine concentrations (20 mg ml(-1)) of ionic (diatrizoate 69.6+\\/-2.9%; ioxaglate 58.9+\\/-2.0%) and non-ionic (iohexol 57.3+\\/-2.9%; iotrolan 57.1+\\/-2.6%) ICM significantly induced neutrophil apoptosis over control levels (47.7+\\/-1.4%). The apoptotic effect of ICM was influenced by their chemical structure, with ionic ICM having a more significant (p<0.01) apoptotic effect than non-ionic ICM (p<0.05). Furthermore, ICM reversed the anti-apoptotic effect of lipopolysaccharide (1000 ng ml(-1)) treated neutrophils to control levels (23.0+\\/-3.5% to 61.2+\\/-5.3%; n=4; p<0.05). These agents induce apoptosis through a p38 MAPK independent pathway that results in mitochondrial depolarization, and is dependent on caspase activation. As neutrophils play a central role in host response to infection and injury, ICM, through induction of neutrophil apoptosis, could have a significant deleterious effect on host immune defence and

  5. Radiographic contrast media

    International Nuclear Information System (INIS)

    Golman, K.; Holtz, E.; Almen, T.

    1987-01-01

    Contrast media are used in diagnostic radiology to enhance the X-ray attenuation between a body structure of interest and the surrounding tissue. A detail becomes perceptible on a roentgenogram only when its contrast exceeds a minimum value in relation to the background. Small areas of interest must have higher contrast than the background. The contrast effect depends on concentration of the contrast media with the body. A high contrast media concentration difference thus gives rise to more morphological details in the radiographs. Contrast media can be divided into negative contrast media such as air and gas which attenuate X-rays less than the body tissues, and positive contrast materials which attenuate X-rays more than the body tissues. The positive contrast media all contain either iodine (atomic number 53) or barium (atomic number 56) and can be divided into water-insoluble and water-soluble contrast media

  6. Changes in risk of immediate adverse reactions to iodinated contrast media by repeated administrations in patients with hepatocellular carcinoma.

    Directory of Open Access Journals (Sweden)

    Naoto Fujiwara

    Full Text Available BACKGROUND: To elucidate whether repeated exposures to iodinated contrast media increase the risk of adverse reaction. MATERIALS AND METHODS: We retrospectively reviewed 1,861 patients with hepatocellular carcinoma who visited authors' institution, a tertiary referral center, between 2004 and 2008. We analyzed cumulative probability of adverse reactions and risk factors. We categorized all symptoms into hypersensitivity reactions, physiologic reactions, and other reactions, according to the American College of Radiology guidelines, and evaluated each category as an event. We estimated the association between hazard for adverse reactions and the number of cumulative exposures to contrast media. We also evaluated subsequent contrast media injections and adverse reactions. RESULTS: There were 23,684 contrast media injections in 1,729 patients. One hundred and thirty-two patients were excluded because they were given no contrast media during the study period. Adverse reactions occurred in 196 (0.83% patients. The cumulative incidence at 10(th, 20(th, and 30(th examination was 7.9%, 15.2%, and 24.1%, respectively. Presence of renal impairment was found to be one of risk factors for adverse reactions. The estimated hazard of overall adverse reaction gradually decreased until around 10(th exposure and rose with subsequent exposures. The estimated hazard of hypersensitivity showed V-shaped change with cumulative number of exposures. The estimated hazard of physiologic reaction had a tendency toward decreasing and that of other reaction had a tendency toward increasing. Second adverse reaction was more severe than the initial in only one among 130 patients receiving subsequent injections. CONCLUSION: Repeated exposures to iodinated contrast media increase the risk of adverse reaction.

  7. Changes in risk of immediate adverse reactions to iodinated contrast media by repeated administrations in patients with hepatocellular carcinoma.

    Science.gov (United States)

    Fujiwara, Naoto; Tateishi, Ryosuke; Akahane, Masaaki; Taguri, Masataka; Minami, Tatsuya; Mikami, Shintaro; Sato, Masaya; Uchino, Koji; Uchino, Kouji; Enooku, Kenichiro; Kondo, Yuji; Asaoka, Yoshinari; Yamashiki, Noriyo; Goto, Tadashi; Shiina, Shuichiro; Yoshida, Haruhiko; Ohtomo, Kuni; Koike, Kazuhiko

    2013-01-01

    To elucidate whether repeated exposures to iodinated contrast media increase the risk of adverse reaction. We retrospectively reviewed 1,861 patients with hepatocellular carcinoma who visited authors' institution, a tertiary referral center, between 2004 and 2008. We analyzed cumulative probability of adverse reactions and risk factors. We categorized all symptoms into hypersensitivity reactions, physiologic reactions, and other reactions, according to the American College of Radiology guidelines, and evaluated each category as an event. We estimated the association between hazard for adverse reactions and the number of cumulative exposures to contrast media. We also evaluated subsequent contrast media injections and adverse reactions. There were 23,684 contrast media injections in 1,729 patients. One hundred and thirty-two patients were excluded because they were given no contrast media during the study period. Adverse reactions occurred in 196 (0.83%) patients. The cumulative incidence at 10(th), 20(th), and 30(th) examination was 7.9%, 15.2%, and 24.1%, respectively. Presence of renal impairment was found to be one of risk factors for adverse reactions. The estimated hazard of overall adverse reaction gradually decreased until around 10(th) exposure and rose with subsequent exposures. The estimated hazard of hypersensitivity showed V-shaped change with cumulative number of exposures. The estimated hazard of physiologic reaction had a tendency toward decreasing and that of other reaction had a tendency toward increasing. Second adverse reaction was more severe than the initial in only one among 130 patients receiving subsequent injections. Repeated exposures to iodinated contrast media increase the risk of adverse reaction.

  8. Effects of iodinated contrast media on renal function in patients with multiple myeloma

    International Nuclear Information System (INIS)

    Jacob, H.M.

    1980-01-01

    Case histories of 89 patients with definite myoloma of the years 1959 to 1974 were investigated in a retrospective study. 41 intravenous urographies were carried out in 31 of these patients. There was no correlation between deterioration of the renal function and contrast medium application. Relevant literature on the subject has been compiled. By 1979, 19 case studies and 5 general studies had been published which have been summarized in tables in the present study. Analyses of these case histories have shown that acute renal failure was often due to other causes and not to contrast medium application. If these cases are left out of account 8 cases remain in which lethal renal failure occurred after intravenous urography of myeloma patients. The diiodinated contrast media formerly used was less well tolerated than the present triiodinated contrast media. Further risk factors were dehydratation and/or abdominal compression. Both measures are no longer employed in intravenous urography. (orig./MG) [de

  9. Myelography in the dog with non-ionic contrast media at different iodine concentrations

    International Nuclear Information System (INIS)

    Fatone, G.; Lamagna, F.; Pasolini, M.P.; Potena, A.; Brunetti, A.

    1997-01-01

    Image quality and side effects were evaluated retrospectively in a series of 183 myelographic studies performed with two non-ionic contrast media (iohexol and iopamidol) at different concentrations. Side effects during and following the procedure were recorded. Image quality was assessed using an arbitrary scoring system and statistical analysis was performed with the cross-tabulation test (4 times 2 table) by comparing two groups receiving contrast medium at higher and lower concentrations. No significant differences in side effects were observed between the two groups but the ratings for image quality were significantly higher in the group receiving contrast medium at the higher concentration than in the group receiving the lower concentration. The results suggest that a high concentration of non-ionic contrast media can safely be used in dogs and may improve image quality

  10. Torsten Almén (1931-2016): the father of non-ionic iodine contrast media.

    Science.gov (United States)

    Nyman, Ulf; Ekberg, Olle; Aspelin, Peter

    2016-09-01

    The Swedish radiologist Torsten Almén is the first clinical radiologist ever to have made a fundamental contribution to intravascular contrast medium design, the development of non-ionic contrast media. He became emotionally triggered by the patients' severe pain each time he injected the ionic "high-osmolar" contrast media when performing peripheral arteriographies in the early 1960s. One day he got a flash of genius that combined the observation of pain, a pathophysiological theory and how to eliminate it with suitable contrast media chemistry. After self-studies in chemistry he developed the concept of iodine contrast media not dissociating into ions in solution to reduce their osmolality and even reach plasma isotonicity. He offered several pharmaceutical companies his concept of mono- and polymeric non-ionic agents but without response, since it was considered against the chemical laws of that time. Contrast media constructed as salts and dissociating into ions in solution was regarded an absolute necessity to achieve high enough water solubility and concentration for diagnostic purposes. Finally a small Norwegian company, Nyegaard & Co., took up his idea 1968 and together they developed the essentially painless "low-osmolar" monomeric non-ionic metrizamide (Amipaque) released in 1974 and iohexol (Omipaque) in 1982 followed by the "iso-osmolar" dimeric non-ionic iodixanol (Visipaque) released in 1993. This has implied a profound paradigm shift with regard to reduction of both hypertonic and chemotoxic side effects, which have been a prerequisite for the today's widespread use of contrast medium-enhanced CT and advanced endovascular interventional techniques even in fragile patients. © The Foundation Acta Radiologica 2016.

  11. Immediate hypersensitivity to iodinated contrast media: diagnostic accuracy of skin tests and intravenous provocation test with low dose.

    Science.gov (United States)

    Sesé, L; Gaouar, H; Autegarden, J-E; Alari, A; Amsler, E; Vial-Dupuy, A; Pecquet, C; Francès, C; Soria, A

    2016-03-01

    The diagnosis of HSR to iodinated contrast media (ICM) is challenging based on clinical history and skin tests. This study evaluates the negative predictive value (NPV) of skin tests and intravenous provocation test (IPT) with low-dose ICM in patients with suspected immediate hypersensitivity reaction (HSR) to ICM. Thirty-seven patients with suspected immediate hypersensitivity reaction to ICM were included retrospectively. Skin tests and a single-blind placebo-controlled intravenous provocation test (IPT) with low-dose iodinated contrast media (ICM) were performed. Skin tests with ICM were positive in five cases (one skin prick test and five intradermal test). Thirty-six patients were challenged successfully by IPT, and only one patient had a positive challenge result, with a grade I reaction by the Ring and Messmer classification. Ten of 23 patients followed up by telephone were re-exposed to a negative tested ICM during radiologic examination; two experienced a grade I immediate reaction. For immediate hypersensitivity reaction to ICM, the NPV for skin tests and IPT with low dose was 80% (95% CI 44-97%). © 2016 John Wiley & Sons Ltd.

  12. Stability of iodinated contrast media in UV-laser irradiation and toxicity of photoproducts

    International Nuclear Information System (INIS)

    Groenewaeller, E.F.; Kehlbach, R.; Claussen, C.D.; Duda, S.H.; Wahl, H.G.; Rodemann, H.P.

    1998-01-01

    Purpose: In XeCl-Excimer laser angioplasty, unintended and possibly harmful interaction of the UV-laser light and the contrast media may occur due to the high concentration of contrast medium proximal to the occlusion or subtotal stenosis. Methods: One ml of three nonionic monomeric contrast agents (iopromide, iomeprol, iopamidol), one nonionic dimetric (jotrolane), and one ionic monomeric (amidotrizoate) X-ray contrast agent were irradiated with a XeCl excimer laser (λ=308 nm, pulse duration 120 ns, 50 Hz) using a 9 French multifiber catheter (12 sectors). Up to 20 000 pulses (106 J) were applied. Using high performance liquid chromatography the amount of liberated iodide as well as the fraction of unchanged contrast media were measured. Cytotoxicity of the photoproducts was tested in a colony formation assay of human skin fibroblasts. The contrast agents were irradiated with 2000 pulses/ml (5.3 mJ/pulse; 10.6 J) and then added to the cell cultures for a period of three hours in a concentration of 10%. Results: Excimer laser irradiation induced iodide liberation of up to 3.3 mg iodide/ml. Up to 19% of the contrast agents changed their original molecular structure. Incubation of irradiated contrast agents resulted in a significantly decreased potential for colony formation (p values ranging from 0.0044 to 0.0102) with significantly higher toxicity of amidotrizoate and iomeprol in comparison to iopromide, iotrolan, and iopamidol. Discussion: Due to the cytotoxic photoproducts and the high level of liberated iodide, it is recommended to flush the artery with physiological saline solution before applying a pulsed excimer laser in human arterial obstructions in order to reduce the contrast agent concentration at the site of irradiation. (orig.) [de

  13. Effects of viscosity on power and hand injection of iso-osmolar iodinated contrast media through thin catheters.

    Science.gov (United States)

    Zhang, James J; Hogstrom, Barry; Malinak, Jiri; Ikei, Nobuhiro

    2016-05-01

    It can be challenging to achieve adequate vessel opacification during percutaneous coronary interventions when using thin catheters, hand injection, and iso-osmolar contrast media (CM) such as iodixanol (Visipaque™). To explore these limitations and the possibility to overcome them with iosimenol, a novel CM. Three X-ray contrast media with different concentrations were used in this study. A series of in vitro experiments established the relationship between injection pressure and flow rate in angiography catheters under various conditions. The experiments were conducted with power and hand injections and included a double-blind evaluation of user perception. By using hand injection, it was generally not possible to reach a maximum injection pressure exceeding 50 psi. The time within which volunteers were able to complete the injections, the area under the pressure-time curve (AUC), and assessment of ease of injection all were in favor of iosimenol compared with iodixanol, especially when using the 4F thin catheter. Within the pressure ranges tested, the power injections demonstrated that the amount of iodine delivered at a fixed pressure was strongly related to viscosity but unrelated to iodine concentration. There are substantial limitations to the amount of iodine that can be delivered through thin catheters by hand injection when iso-osmolar CM with high viscosity is used. The only viable solution, besides increasing the injection pressure, is to use a CM with lower viscosity, since the cost of increasing the concentration, in terms of increased viscosity and consequent reduction in flow, is too high. Iosimenol, an iso-osmolar CM with lower viscosity than iodixanol might therefore be a better alternative when thinner catheters are preferred, especially when the radial artery is used as the access site. © The Foundation Acta Radiologica 2015.

  14. Outcome Differences between Intra-Arterial Iso- and Low-Osmolality Iodinated Radiographic Contrast Media in the Interventional Management of Stroke III Trial.

    Science.gov (United States)

    Tomsick, T A; Foster, L D; Liebeskind, D S; Hill, M D; Carrozella, J; Goyal, M; von Kummer, R; Demchuk, A M; Dzialowski, I; Puetz, V; Jovin, T; Morales, H; Palesch, Y Y; Broderick, J; Khatri, P; Yeatts, S D

    2015-11-01

    Intracarotid arterial infusion of nonionic, low-osmolal iohexol contrast medium has been associated with increased intracranial hemorrhage in a rat middle cerebral artery occlusion model compared with saline infusion. Iso-osmolal iodixanol (290 mOsm/kg H2O) infusion demonstrated smaller infarcts and less intracranial hemorrhage compared with low-osmolal iopamidol and saline. No studies comparing iodinated radiographic contrast media in human stroke have been performed, to our knowledge. We hypothesized that low-osmolal contrast media may be associated with worse outcomes compared with iodixanol in the Interventional Management of Stroke III Trial (IMS III). We reviewed prospective iodinated radiographic contrast media data for 133 M1 occlusions treated with endovascular therapy. We compared 5 prespecified efficacy and safety end points (mRS 0-2 outcome, modified TICI 2b-3 reperfusion, asymptomatic and symptomatic intracranial hemorrhage, and mortality) between those receiving iodixanol (n = 31) or low-osmolal contrast media (n = 102). Variables imbalanced between iodinated radiographic contrast media types or associated with outcome were considered potential covariates for the adjusted models. In addition to the iodinated radiographic contrast media type, final covariates were those selected by using the stepwise method in a logistic regression model. Adjusted relative risks were then estimated by using a log-link regression model. Of baseline or endovascular therapy variables potentially linked to outcome, prior antiplatelet agent use was more common and microcatheter iodinated radiographic contrast media injections were fewer with iodixanol. Relative risk point estimates are in favor of iodixanol for the 5 prespecified end points with M1 occlusion. The percentage of risk differences are numerically greater for microcatheter injections with iodixanol. While data favoring the use of iso-osmolal iodixanol for reperfusion of M1 occlusion following IV rtPA are

  15. Contrast media: future aspects

    International Nuclear Information System (INIS)

    Weinmann, H.J.; Platzek, J.; Schirmer, H.; Pietsch, H.; Carretero, J.; Harto, J.; Medina, J.; Riefke, B.; Martin, J.

    2005-01-01

    In spite of the dramatic development in CT, there was no major breakthrough in the iodinated contrast media development. New agents based on hybrid between MRI and CT compounds may be a new innovative alternative. This new approach may also open new indications such as radiotherapy. (orig.)

  16. Combined use of contrast media containing iodine and gadolinium for imaging and intervention. A hitherto widely ignored topic in radiological practice

    International Nuclear Information System (INIS)

    Golder, W.

    2012-01-01

    The synchronous use of chemically different contrast media in the same body compartment is a challenge for the radiologist, whether it is scheduled or unexpected. However, to inject contrast media containing iodine and gadolinium at the same time can be a prerequisite for the examination of several organs or organ systems. Unlike other topics of contrast-enhanced imaging procedures, the difficulties encountered with double contrast injections have been widely ignored in the literature. In the absence of reliable data from experimental and clinical studies the radiologist is dependent on case reports, information provided by the contrast media manufacturers, personal communications, mostly scanty personal experiences and a skilful time management, in order to overcome the situation. Only the combination of X-ray, computed tomography and magnetic resonance arthrography can be performed without another thought. However, the more or less synchronous vascular application of contrast media containing iodine and gadolinium requires vigilance. The more seriously ill the patient is, the more caution is advised even if the decision on the combined administration has to be reached urgently. The following overview gives a description of the properties of contrast media containing iodine and gadolinium as far as interactions following simultaneous administration are concerned. Subsequently, the clinically relevant situations and constellations are outlined and analyzed. (orig.) [de

  17. Contrast media

    International Nuclear Information System (INIS)

    Decazes, Ph.

    2004-01-01

    The Guerbet firm, which holds 69% of the capital on the contrast media for medical imagery, could sale about 20% of this capital in order to accelerate its development in the United States, one of its next market with the Japan. (O.M.)

  18. Comparison of iodinated contrast media for the assessment of atherosclerotic plaque attenuation values by CT coronary angiography: Observations in an ex vivo model

    NARCIS (Netherlands)

    L. la Grutta (Ludovico); M. Galia (Massimo); G. Gentile; G. Lo Re (G.); E. Grassedonio (Emanuele); F. Coppolino; E. Maffei (Erica); E. Maresi (E.); A. Lo Casto (A.); F. Cademartiri (Filippo); M. Midiri (Massimo)

    2013-01-01

    textabstractObjective: To compare the influence of different iodinated contrast media with several dilutions on plaque attenuation in an ex vivo coronary model studied by multislice CT coronary angiography. Methods: In six ex vivo left anterior descending coronary arteries immersed in oil, CT

  19. Sensation of smell and taste during intravenous injection of iodinated contrast media in CT examinations

    Science.gov (United States)

    Yamaguchi, Naoto; Yamaguchi, Aiko; Nagasawa, Naoki; Taketomi-Takahashi, Ayako; Suto, Takayuki; Tsushima, Yoshito

    2017-01-01

    Objective: To assess the incidence and types of sensation of smell and taste during i.v. injection of five kinds of contrast media (CM) in CT examinations. Methods: 735 patients who underwent contrast-enhanced CT (CE-CT) between 14 March 2016 and 5 April 2016 were enrolled. Medical staff asked patients whether they felt heat sensation and sensation of smell and taste during i.v. injection of CM (one of the following: iopromide, iomeprol, iopamidol, iohexol and ioversol) after their CE-CT. If the patients stated having felt the sensation of smell or taste, they were also asked what kind of smell or taste they sensed. Next, 30 ml of each CM was poured into high-purity pet cups for radiological technologists to smell directly. Radiological technologists were asked whether or not each CM had any smell. Results: The sensations of smell and taste incidence for iopromide were 24.3% and 18.9%, respectively, which were significantly higher than those for other CM (p < 0.05). The highest incidence of the sensation of smell was medicine-ish, and the most frequently noted taste was bitterness. All radiological technologists could directly smell only iopromide, which has an ether group on a side chain and fewer hydroxyl groups. Conclusion: Iopromide showed a higher incidence of sensation of smell and taste than other CM. Advances in knowledge: This was the first investigation of sensation of smell and taste during i.v. injection of CM, and a specific CM showed a higher incidence, which is suspected to be due to its chemical structure. PMID:27805431

  20. Successful transfemoral aortic Edwards(®) SAPIEN(®) bioprosthesis implantation without using iodinated contrast media in a woman with severe allergy to contrast agent.

    Science.gov (United States)

    Leroux, Lionel; Dijos, Marina; Dos Santos, Pierre

    2013-12-01

    Severe anaphylactoid reaction after the use of iodinated contrast media are rare but can contraindicate the use of contrast agent. It was the case of a 53-year-old woman suffering from symptomatic severe aortic stenosis, recused for cardiac surgery because of deleterious effects of chest-wall irradiation, with porcelain aorta. We decided to implant a 23-mm Edwards(®) SAPIEN(®) transcatheter aortic valve via a femoral route without using any contrast media. The implantation was successful after surgical approach of the femoral artery, transesophageal echocardiography guiding, and localization of native leaflets and coronary trunk with catheters. Immediate and one month post-interventional follow-up was favorable and echocardiography showed a good functioning of the aortic bioprosthesis. Although conventional angiography is the best way to visualize the good positioning of the valve before deployment, our case suggests that, in special situations, transfemoral implantation of an Edwards(®) SAPIEN(®) aortic bioprosthesis is feasible without any contrast injection. Copyright © 2012 Wiley Periodicals, Inc.

  1. A phantom test of proton-induced dual-energy X-ray angiography using iodinated contrast media

    International Nuclear Information System (INIS)

    Oguri, Y.; Hasegawa, J.; Ogawa, M.; Kaneko, J.; Sasa, K.

    2007-01-01

    Characteristic-line radiation from heavy metal targets bombarded by MeV proton beams has been tested as an X-ray source for dual-energy K-edge subtraction imaging for human angiography (blood vessel imaging) based on iodinated contrast media. To utilize the strong absorption by iodine (Z=53) at its K-absorption edge (33.2 keV), we used K α -line of La (lanthanum, Z=57) at 33.4 keV. As a reference, also K α X emission of Sn (tin, Z=50) at 25.2 keV was employed. Metallic plates of La and Sn were irradiated by 7-MeV protons to produce these characteristic X-rays. Energy-subtraction method was tested using Lucite phantoms which contain aqueous solutions of KI (potassium iodide) with different concentrations. Also Ca(H 2 PO 4 ) 2 powder was stuffed in these phantoms to simulate bones. The transmission images of the phantoms were recorded on imaging plates. During the exposure, the energy spectra of the X-rays were monitored by a CdTe detector. We found that the contrast of images of iodide solutions taken with La X-rays was higher than that with Sn X-rays. Also the energy subtraction procedure was successfully applied to reduce the graphical noise due to the bones and inhomogeneity of the soft tissue. However, to apply the present method to actual clinical use, the X-ray intensity must be increased by several orders of magnitude. Also the transmission of the 'lower-energy' photons has to be a few orders higher for imaging of objects as thick as human chest. (author)

  2. Dialysis and contrast media

    International Nuclear Information System (INIS)

    Morcos, Sameh K.; Thomsen, Henrik S.; Webb, Judith A.W.

    2002-01-01

    In a previous survey we revealed uncertainty among responders about (a) whether or not to perform hemodialysis in patients with severely reduced renal function who had received contrast medium; and (b) when to perform hemodialysis in patients on regular treatment with hemodialysis or continuous ambulatory dialysis who received contrast medium. Therefore, the Contrast Media Safety Committee of The European Society of Urogenital Radiology decided to review the literature and to issue guidelines. The committee performed a Medline search. Based on this, a report and guidelines were prepared. The report was discussed at the Ninth European Symposium on Urogenital Radiology in Genoa, Italy. Hemodialysis and peritoneal dialysis safely remove both iodinated and gadolinium-based contrast media. The effectiveness of hemodialysis depends on many factors including blood and dialysate flow rate, permeability of dialysis membrane, duration of hemodialysis and molecular size, protein binding, hydrophilicity, and electrical charge of the contrast medium. Generally, several hemodialysis sessions are needed to removal all contrast medium, whereas it takes 3 weeks for continuous ambulatory dialysis to remove the agent completely. There is no need to schedule the dialysis in relation to the injection of iodinated or MR contrast media or the injection of contrast agent in relation to the dialysis program. Hemodialysis does not protect poorly functioning kidneys against contrast-medium-induced nephrotoxicity. Simple guidelines are given. (orig.)

  3. Influence of different iodinated contrast media on the induction of DNA double-strand breaks after in vitro X-ray irradiation.

    Science.gov (United States)

    Deinzer, Christoph K W; Danova, Daniela; Kleb, Beate; Klose, Klaus J; Heverhagen, Johannes T

    2014-01-01

    The objective of this work was to examine differences in DNA double-strand break induction in peripheral blood lymphocytes after in vitro X-ray irradiation between iodinated contrast agents. Four different iodinated X-ray contrast agents--three of them with two different iodine concentrations--and mannitol (negative control; concentration of 150 mg mannitol per ml blood) were pipetted into blood samples so that there was a concentration of 0, 7.5 or 15 mg of iodine per ml blood in the samples. Negative controls without contrast medium (0 mg of iodine per ml blood) were also processed for every irradiation dose. The tubes were exposed to 0, 20 or 500 mGy in vitro X-ray irradiation. After that, the lymphocytes were separated by using density-gradient centrifugation. Fluorescence microscopy was applied to determine the average number of γH2AX-foci per lymphocyte in the presence or absence of different contrast media or mannitol. Differences in the number of γH2AX-foci were statistically analysed by one-way ANOVA and post-hoc Tukey's honestly significant difference test. Iodinated contrast agents led to a statistically significant increase in DNA double-strand breaks after in vitro irradiation. This effect increased statistically significant with rising radiation dose and appeared independent of the contrast agent used (iopromid, iodixanol, iomeprol, iopamidol). A statistically significant difference in DNA damage between the different tested contrast agents was not found. Therefore, the increase in DNA double-strand breaks depends solely on the amount of iodine applied. For evaluation of clinical consequences, our findings could be tested in further animal studies. Copyright © 2014 John Wiley & Sons, Ltd.

  4. Influence of iodinated contrast media on the activities of histamine inactivating enzymes diamine oxidase and histamine N-methyltransferase in vitro.

    Science.gov (United States)

    Kuefner, M A; Feurle, J; Petersen, J; Uder, M; Schwelberger, H G

    2014-01-01

    Iodinated contrast media can cause pseudoallergic reactions associated with histamine release in significant numbers of patients. To clarify whether these adverse reactions may be aggravated by a compromised histamine catabolism we asked if radiographic contrast agents in vitro inhibit the histamine inactivating enzymes diamine oxidase (DAO) and histamine N-methyltransferase (HMT). Nine iodinated contrast agents were tested in vitro. Following pre-incubation of purified porcine kidney DAO and recombinant human HMT with 0.1-10mM of the respective contrast medium (H2O and specific inhibitors of DAO and HMT as controls) enzyme activities were determined by using radiometric micro assays. None of the contrast media irrespective of their structure showed significant inhibition of the activities of DAO and HMT. Pre-incubation of the enzymes with specific inhibitors led to complete inhibition of the respective enzymatic activity. The iodinated contrast media tested in vitro did not exhibit inhibition of histamine converting enzymes at physiologically relevant concentrations. However due to the in vitro character of this study these results do not directly reflect the in vivo situation. Copyright © 2012 SEICAP. Published by Elsevier Espana. All rights reserved.

  5. 64-Slice multidetector row CT angiography of the abdomen: comparison of low versus high concentration iodinated contrast media in a porcine model

    Science.gov (United States)

    Holalkere, N-S; Matthes, K; Kalva, S P; Brugge, W R; Sahani, D V

    2011-01-01

    Objective In this study we aimed to assess the image quality and degree of vascular enhancement using low-concentration contrast media (LCCM) (300 mg I ml–1) and high-concentration contrast media (HCCM) (370 mg I ml–1) on 64-slice multidetector row CT (MDCT) abdominal CT angiography (CTA). In addition, we aimed to study the feasibility of using HCCM with a reduced total iodine dose. Methods CTA of the abdomen on a 64-slice MDCT was performed on 15 anaesthetised pigs. Study pigs were divided into three groups of five each based on the iodine concentration and dose received: Group A (LCCM; 300 mg I ml–1), Group B (HCCM; 370 mg I ml–1) and Group C HCCM with 20% less iodine dose. The total iodine injected was kept constant (600 mg kg–1) in Groups A and B. Qualitative and quantitative analyses were performed to study and compare each group for image quality, visibility of the branch order of the superior mesenteric artery (SMA), artefacts, degree of enhancement in the aorta and main stem arteries and uniformity of enhancement in the aorta. Groups were compared using the analysis of variance test. Results The image quality of 64-slice MDCT angiography was excellent with a mean score of 4.63 and confident visualisation of the third to fifth order branches of the SMA in all groups. Group B demonstrated superior vascular enhancement, as compared with Groups A and C (p≤0.05). Uniform aortic enhancement was achieved with the use of LCCM and HCCM with 20% less iodine dose. Conclusion 64-slice MDCT angiography of the abdomen was of excellent quality. HCCM improves contrast enhancement and overall CTA image quality and allows the iodine dose to be reduced. PMID:21081582

  6. Adding the power of iodinated contrast media to the credibility of mammography in breast cancer diagnosis.

    Science.gov (United States)

    Tsigginou, Alexandra; Gkali, Christina; Chalazonitis, Athanasios; Feida, Eleni; Vlachos, Dimitrios Efthymios; Zagouri, Flora; Rellias, Ioannis; Dimitrakakis, Constantine

    2016-11-01

    Dual-energy contrast-enhanced spectral mammography (CESM) represents a relatively new diagnostic tool adjunct to mammography. The aim of this study was to strengthen the breast imaging-reporting and data system (BIRADS) classification score in order to improve early breast cancer diagnosis. For this reason, we propose a sum score, termed malignancy potential score (MPS), incorporating the standard BIRADS score and our proposed CESM score. From September 2014 to September 2015, 216 females (age range, 26-85 years; mean age 54.6 years) underwent CESM evaluation of mammographic findings that were primarily assessed as BIRADS 2-5. 10 of these patients had bilateral findings; a total of 226 lesions were examined. High-energy image evaluation was based on the intensity of contrast enhancement of the lesion compared with background enhancement, categorized as Type -1, 0, 1 or 2 enhancement. Histopathology reports were compared with imaging assessment. 98 of 226 lesions were malignant and 128 of 226 lesions were benign. The area under the curve was 0.843, 0.888 and 0.917 for mammographic BIRADS score, CESM score and MPS, respectively, with p-value mammography or CESM alone. MPS empowers the credibility of the digital mammography BIRADS score and our proposed type of enhancement in dual-energy CESM and is a diagnostic tool that increases the accuracy rate in early breast cancer diagnosis.

  7. Adverse effects to iodinated contrast media in interleukin-2 treated patients; Reacciones adversas a los medio de contraste yodados en pacientes tratados con interleuquina 2

    Energy Technology Data Exchange (ETDEWEB)

    Vias, I.; Nicolas, A. I.; Lopez Picazo, J. M.; Elduayen, B.; Delgado, C.; Ano, M.; Fernande-villa, T.; Garcia del Barrio, L.; Velazquez, P.; Bilbao, J. I. [Universidad de Navarra. Pamplona (Spain)

    2000-07-01

    Interleukin-2 (IL-2) is a potent modulator of immune response that provokes tumor regression in cancer patients. IL-2 may induce sensitization to radiological iodinated contrast media (ICM) and this phenomenon has been rarely reported in literature. We report the increased incidence of adverse reactions to ICM patients treated with systemic IL-2, discuss the possible mechanisms of action, and propose patient management strategies. Retrospective study was conducted in 168 patients treated with subcutaneous IL-2 and 544 patients who did not.CT scans were performed with intravenous administration of 80-160 ml of nonionic ICM with a power injector. The incidence of adverse reactions to ICM among our patients was 7.14%. It differs significantly (p<0.001) from that in the control group (1.28%). Thus, patients treated with IL-2 have a relative risk of 5,6 times (CI 95%; 2.2-13.9). The adverse reactions in IL-2 patients were mild and resolved promptly without treatment in 11 patients. In one patient hypotension required intravenous forced hydration. Patients on IL-2 treatment may be at risk of experiencing contrast induced adverse reactions. Potent of the immune system by IL-2 may increase the potential risk for hypersensitivity or other adverse reactions to ICM. Knowledge of this fact may be valuable in clinical decision making and patient follow-up strategies. (Author) 18 refs.

  8. Weight-adapted iodinated contrast media administration in abdomino-pelvic CT: Can image quality be maintained?

    Science.gov (United States)

    Perrin, E; Jackson, M; Grant, R; Lloyd, C; Chinaka, F; Goh, V

    2018-02-01

    In many centres, a fixed method of contrast-media administration is used for CT regardless of patient body habitus. The aim of this trial was to assess contrast enhancement of the aorta, portal vein, liver and spleen during abdomino-pelvic CT imaging using a weight-adapted contrast media protocol compared to the current fixed dose method. Thirty-nine oncology patients, who had previously undergone CT abdomino-pelvic imaging at the institution using a fixed contrast media dose, were prospectively imaged using a weight-adapted contrast media dose (1.4 ml/kg). The two sets of images were assessed for contrast enhancement levels (HU) at locations in the liver, aorta, portal vein and spleen during portal-venous enhancement phase. The t-test was used to compare the difference in results using a non-inferiority margin of 10 HU. When the contrast dose was tailored to patient weight, contrast enhancement levels were shown to be non-inferior to the fixed dose method (liver p contrast dose reduction of 165 ml using the weight-adapted method compared to the fixed dose method, with a mean cost per patient of £6.81 and £7.19 respectively. Using a weight-adapted method of contrast media administration was shown to be non-inferior to a fixed dose method of contrast media administration. Patients weighing 76 kg, or less, received a lower contrast dose which may have associated cost savings. A weight-adapted contrast media protocol should be implemented for portal-venous phase abdomino-pelvic CT for oncology patients with adequate renal function (>70 ml/min/1.73 m 2 ). Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  9. The Incidence, Classification, and Management of Acute Adverse Reactions to the Low-Osmolar Iodinated Contrast Media Isovue and Ultravist in Contrast-Enhanced Computed Tomography Scanning.

    Science.gov (United States)

    Zhang, Bin; Dong, Yuhao; Liang, Long; Lian, Zhouyang; Liu, Jing; Luo, Xiaoning; Chen, Wenbo; Li, Xinyu; Liang, Changhong; Zhang, Shuixing

    2016-03-01

    Some epidemiologic surveillance studies have recorded adverse drug reactions to radiocontrast agents. We aimed to investigate the incidence and management of acute adverse reactions (AARs) to Ultravist-370 and Isovue-370 in patients who underwent contrast-enhanced computed tomography (CT) scanning.Data from 137,473 patients were analyzed. They had undergone enhanced CT scanning with intravenous injection of Ultravist-370 or Isovue-370 during the period of January 1, 2006 to December 31, 2012 in our hospital. We investigated and classified AARs according to the American College of Radiology and the Chinese Society of Radiology (CSR) guidelines for iodinated contrast media. We analyzed risk factors for AARs and compared the AARs induced by Ultravist-370 and Isovue-370.Four hundred and twenty-eight (0.31%) patients experienced AARs, which included 330 (0.24%) patients with mild AARs, 82 (0.06%) patients with moderate AARs, and 16 (0.01%) patients with severe AARs (including 3 cases of cardiac arrest and one case of death). The incidence of AARs was higher with Ultravist-370 than with Isovue-370 (0.38% vs 0.24%, P management, the symptoms and signs of 96.5% of the AARs resolved within 24 hours without sequelae.Ultravist-370 and Isovue-370 are safe for patients undergoing enhanced CT scanning. The incidence of AARs is higher with Ultravist-370 than with Isovue-370, but this difference is limited only to the mild AARs. The incidence of AARs could be affected by multiple factors.

  10. Contrast induced-acute kidney injury following peripheral angiography with carbon dioxide versus iodinated contrast media: A meta-analysis and systematic review of current literature.

    Science.gov (United States)

    Ghumman, Saad S; Weinerman, Jonathan; Khan, Aazib; Cheema, Mubeen S; Garcia, Marlene; Levin, Daniel; Suri, Rajeev; Prasad, Anand

    2017-09-01

    We conducted a meta-analysis to compare the incidence of acute kidney injury (AKI) with carbon dioxide (CO 2 ) versus iodinated contrast media (ICM). Contrast induced-acute kidney injury (CI-AKI) is a known complication following endovascular procedures with ICM. CO 2 has been employed as an alternative imaging medium as it is nontoxic to the kidneys. Search of indexed databases was performed and 1,732 references were retrieved. Eight studies (7 observational, 1 Randomized Controlled Trial) formed the meta-analysis. Primary outcome was AKI. Fixed effect model was used when possible in addition to analysis of publication bias. In this meta-analysis, 677 patients underwent 754 peripheral angiographic procedures. Compared with ICM, CO 2 was associated with a decreased incidence of AKI (4.3% vs. 11.1%; OR 0.465, 95% CI: 0.218-0.992; P = 0.048). Subgroup analysis of four studies that included granular data for patients with chronic kidney disease (CKD) did not demonstrate a decreased incidence of AKI with CO 2 (4.1% vs. 10.0%; OR 0.449, 95% CI: 0.165-1.221, P = 0.117). Patients undergoing CO 2 angiography experienced a higher number of nonrenal events including limb/abdominal pain (11 vs. 0; P = 0.001) and nausea/vomiting (9 vs. 1; P = 0.006). In comparison to ICM, CO 2 use is associated with a modestly reduced rate of AKI with more frequent adverse nonrenal events. In studies that use CO 2 as the primary imaging agent, the average incidence of AKI remained high at 6.2%-supporting the concept that factors other than renal toxicity from ICM may contribute to renal impairment following peripheral angiography. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  11. In-vitro effects of tri-iodinated X-ray contrast media on blood coagulation, fibrinolysis and complement system

    International Nuclear Information System (INIS)

    Blanke, D.

    1982-01-01

    In-vitro experiments with Jodipamid, Jothalamat and Diatrizoat served the purpose of determining influences of contrast media on blood coagulation, fibrinolysis and the complement system. For all three contrast media investigated the effect noted was dose-dependent and was only brought about by concentrations higher than physiological ones. Liver-pathway Jodipamid was seen to have a much stronger effect than the two renal-pathway contrast media Jothalamat and Diatrizoat, which is probably due to the different protein binding capacities. In detail, the results with Jodipamid were as follows: a sharp fall in thrombinogen, a distinct decrease in fibrinogen both in the immunological and functional test, but only delayed decrease in complement factor C 4. Fibrinolytic fission products were found after applying the dose of 30 mM, as compared to 400 mM for the renal-pathway contrast media. Furthermore the functional tests (F I and F II) with Jothalamat and Diatrizoat showed only slight effects, the immunological ones (F I and C 4) none at all. The influence of the contrast media on factors I and II is interpreted by the author as an inhibition of fibrin polymerization. What seems to be the verification of fibrinolytic fission products is explained by a non-specific agglutination reaction, the decrease in C 4 by contrast-medium-induced protein denaturation. (orig./MG) [de

  12. Contrast induced hyperthyroidism due to iodine excess

    OpenAIRE

    Mushtaq, Usman; Price, Timothy; Laddipeerla, Narsing; Townsend, Amanda; Broadbridge, Vy

    2009-01-01

    Iodine induced hyperthyroidism is a thyrotoxic condition caused by exposure to excessive iodine. Historically this type of hyperthyroidism has been described in areas of iodine deficiency. With advances in medicine, iodine induced hyperthyroidism has been observed following the use of drugs containing iodine—for example, amiodarone, and contrast agents used in radiological imaging. In elderly patients it is frequently difficult to diagnose and control contrast related hyperthyroidism, as most...

  13. Are there any differences in acute adverse reactions among five low-osmolar non-ionic iodinated contrast media?

    Energy Technology Data Exchange (ETDEWEB)

    Gomi, Tatsuya; Nagamoto, Masashi; Hasegawa, Makoto; Katoh, Asako; Sugiyama, Miki; Murata, Nozomu; Kunihiro, Toshiyuki; Kohda, Ehiichi [Toho University Ohashi Medical Centre, Department of Radiology, Tokyo (Japan)

    2010-07-15

    The differences regarding adverse reactions in different low-osmolar non-ionic contrast media had not been investigated previously. Thus, the aims of this study were to identify differences in the incidence of adverse reactions in five different low-osmolar non-ionic contrast media. We prospectively recorded all adverse events associated with five different low-osmolar non-ionic contrast media used in 8,931 consecutive patients for CT. Patients were randomly assigned to five groups: iomeprol 300 mgI/ml, iopamidol 300 mgI/ml, iohexol 300 mgI/ml, iopromide 300 mgI/ml and ioversol 320 mgI/ml. Adverse events were observed in 241 patients (2.7%). The incidence of acute adverse reactions was significantly higher in the following groups: (1) iomeprol (3.9%) and iopromide (3.5%) groups, (2) patients aged 59 years or less (4.5%) compared with those aged 60 years or over (1.9%), (3) the first period (3.5%) compared with the late period (2.3%), (4) those with a past history of adverse reactions to contrast media (11.2%), and (5) patients receiving contrast media for the first time (3.3%) compared with those had received it previously (2.0%). The incidence of acute adverse reactions may be reduced in younger patients by using iopamidol, iohexol and ioversol. (orig.)

  14. Are there any differences in acute adverse reactions among five low-osmolar non-ionic iodinated contrast media?

    International Nuclear Information System (INIS)

    Gomi, Tatsuya; Nagamoto, Masashi; Hasegawa, Makoto; Katoh, Asako; Sugiyama, Miki; Murata, Nozomu; Kunihiro, Toshiyuki; Kohda, Ehiichi

    2010-01-01

    The differences regarding adverse reactions in different low-osmolar non-ionic contrast media had not been investigated previously. Thus, the aims of this study were to identify differences in the incidence of adverse reactions in five different low-osmolar non-ionic contrast media. We prospectively recorded all adverse events associated with five different low-osmolar non-ionic contrast media used in 8,931 consecutive patients for CT. Patients were randomly assigned to five groups: iomeprol 300 mgI/ml, iopamidol 300 mgI/ml, iohexol 300 mgI/ml, iopromide 300 mgI/ml and ioversol 320 mgI/ml. Adverse events were observed in 241 patients (2.7%). The incidence of acute adverse reactions was significantly higher in the following groups: (1) iomeprol (3.9%) and iopromide (3.5%) groups, (2) patients aged 59 years or less (4.5%) compared with those aged 60 years or over (1.9%), (3) the first period (3.5%) compared with the late period (2.3%), (4) those with a past history of adverse reactions to contrast media (11.2%), and (5) patients receiving contrast media for the first time (3.3%) compared with those had received it previously (2.0%). The incidence of acute adverse reactions may be reduced in younger patients by using iopamidol, iohexol and ioversol. (orig.)

  15. Intravenous administration of iodinated, non-ionic, low or isoosmolar contrast media: safety aspects; Intravenoese Anwendung von jodiertem, nichtionischem, nieder- bis isoosmolarem Kontrastmittel: Sicherheitsaspekte

    Energy Technology Data Exchange (ETDEWEB)

    Metz-Schimmerl, S.; Metz, V.; Schima, W.; Herold, C. [Universitaetsklinik fuer Radiodiagnostik und Ludwig Boltzmann-Institut fuer Klinische und Experimentelle Radiologie, Wien (Austria); Domanovits, H. [Universitaetsklinik fuer Notfallmedizin Wien, Wien (Austria)

    2002-01-01

    It iss the purpose of this review to provide information about the safe use of intravenously administered, iodinated, non-ionic, low or isoosmolar contrast media for radiological examinations, how to avoid adverse events, and how to react professionally in case of an anaphylactic reaction. Methods of prophylaxis and therapy for anaphylactic and chemotoxic effects of contrast media administration as well as absolute and relative contraindications are discussed. Medico-legal considerations of contrast agent administration, informed consent of patients, and methods of risk management for undesired contrast media reactions are considered in this article. Establishment of administration standards for contrast media is of tremendous importance to standardize radiological procedures. This basic radiological documentation is part of the institutional and individual legal safety management. (orig.) [German] Ziel dieses Artikels ist es, Kenntnisse zur sicheren Anwendung von intravenoes applizierten, jodierten, nichtionischen, nieder- bis isoosmolaren Roentgen-Kontrastmitteln zu vermitteln, um bei deren Verwendung unerwuenschte Wirkungen zu vermeiden oder im Falle eines anaphylaktischen Kontrastmittelzwischenfalls rasch und effektiv zu handeln. Neben Methoden der Verhuetung und Behandlung anaphylaktischer und chemotoxischer Wirkungen der Kontrastmittelgabe werden Einschraenkungen der Anwendung bei unterschiedlichen klinischen Bildern eroertert. Rechtliche Ueberlegungen zur Kontrastmittelanwendung, das Aufklaerungsgespraech und Praeventivmassnahmen zum Risiko-Management unerwuenschter Kontrastmittelwirkungen sind beruecksichtigt. Die Festlegung von Anwendungstandards fuer Kontrastmittel dient der Normierung medizinischen Vorgehens. Eine solche radiologische Basisdokumentation ist teil der institutionellen und individuellen rechtlichen Absicherung. (orig.)

  16. [Comparison of diagnostic quality in hysterosalpingography between iodinated non-ionic contrast media with low and high osmolarity].

    Science.gov (United States)

    Piccotti, K; Guida, D; Carbonetti, F; Stefanetti, L; Macioce, A; Cremona, A; David, V

    Comparison of diagnostic quality in hysterosalpingography between low and high-osmolality contrast media. We performed a retrospective evaluation of two cohorts of patients who underwent HSG using contrast media with different osmolarity: the first group ,47 patients, underwent hysterosalpingography in the period September 2011-December 2012 using Iopromide 370 mg/ml; the second group, 50 patients, underwent HSG from January 2013 to October 2013 using Iomeprol 400 mg/ml. Three radiologists, in consensus reading,, reviewed the radiographs by assessing the following four parameters: opacification of the uterine cavity, uterine profiles definition, Fallopian tubes visualization, contrast media spillage into peritoneum. A score-scale from 0 to 3 was assigned for each of the mentioned parameter (0 = minimum non-diagnostic exam, 1 = sufficient examination; 2 = good quality examination; maximum 3 = high quality images). We documented a statistically significant higher quality in displaying Fallopian tubes among patients studied through high osmolarity contrast medium (Iopromide 370 mg/ml) than what obtained through lower osmolarity contrast medium (Iomeprol 400 mg/ml). The use of high osmolarity contrast medium enabled better visualization of the tubes and a greater number of diagnoses of chronic aspecific salpigintis due to the increased osmolality and viscosity of Iomeprol 400 mg/ml. There were no significant differences between the two contrast agents in the evaluation of intra-uterine pathology and in the evaluation of the tubal patency.

  17. [Treatment with metformin in type 2 diabetes mellitus - new routines when renal function is reduced and in connection with administration of iodine contrast media].

    Science.gov (United States)

    Sterner, Gunnar; Frid, Anders

    2018-04-03

    Metformin is eliminated through glomerular filtration and tubular secretion in the kidneys. New guidelines recommend use of metformin down to a GFR of 30 mL/min under the condition that the dose is adjusted. As the risk of inducing lactic acidosis is very low in connection with administration of iodine contrast media, new recommendations in Sweden say that metformin must be stopped only when GFR is below 45 mL/min. Determination of metformin levels in serum is useful to guide therapeutic dose when GFR is low but also to confirm that lactic acidosis is caused by metformin.

  18. Avaliação do conhecimento de médicos não-radiologistas sobre reações adversas aos contrastes iodados Evaluation of nonradiologist physicians' knowledge about adverse reactions to iodinated contrast media

    Directory of Open Access Journals (Sweden)

    Ronald Trindade

    2007-10-01

    Full Text Available OBJETIVO: Avaliar o conhecimento dos médicos não-radiologistas sobre reações adversas ao meio de contraste iodado, sua prevenção e as condições clínicas que aumentam seu risco. MATERIAIS E MÉTODOS: Estudo transversal com 203 médicos não-radiologistas (assistentes, residentes e estagiários de várias especialidades, utilizando um questionário com dez questões de múltipla escolha abordando profilaxia, fatores de risco e condutas relacionadas ao desenvolvimento de reações adversas aos meios de contraste iodados. Os resultados foram analisados com o programa Statistic Package for Social Sciences, Windows®, versão 12.0. RESULTADOS: Asma, alergia alimentar, ansiedade e doença isquêmica do coração foram considerados fatores de risco por 80,9%, 78,9%, 5,9% e 4,1% dos participantes, respectivamente. Para 23,4% dos médicos, não há contra-indicações absolutas ao uso do meio de contraste iodado. As condutas profiláticas em pacientes com reação prévia ao meio de contraste iodado e em diabéticos em uso de metformina foram corretamente indicadas por 84,5% e 53,7% dos participantes, respectivamente. As questões abordando nefropatia induzida por meio de contraste iodado, uso de anti-sépticos tópicos iodados em pacientes com história de reação adversa ao meio de contraste iodado e ansiedade foram acertadas por 86,1%, 45,5%, e 5,9% dos participantes, respectivamente. CONCLUSÃO: Os médicos não-radiologistas demonstraram conhecimento razoável sobre reações adversas aos meios de contraste iodados. É necessária melhor integração e comunicação entre radiologistas e médicos das demais especialidades.OBJECTIVE: To evaluate the nonradiologist physicians' knowledge about adverse reactions to iodinated contrast media, as well as prevention and associated risk factors. MATERIALS AND METHODS: A transversal study was developed with 203 nonradiologist physicians (assistants, residents and trainees of different specialties

  19. Prophylaxis and treatment of side effects due to iodinated contrast media relevant to radiological practice; Radiologisch praxisrelevante Prophylaxe und Therapie von Nebenwirkungen jodhaltiger Kontrastmittel

    Energy Technology Data Exchange (ETDEWEB)

    Becker, C. [Klinikum Grosshadern der Ludwig-Maximilians-Universitaet Muenchen, Institut fuer Klinische Radiologie, Muenchen (Germany)

    2007-09-15

    Increased utilization of iodinated contrast media may be associated with increased incidence of adverse events. The most important side effects include contrast-induced nephropathy, anaphylactoid reaction, thyrotoxicosis, and extravasation. In patients with moderate renal dysfunction, saline hydration and reduction of contrast media volume are recommended. No regime to prevent anaphylactoid reactions has yet proven to be efficient. If subclinical hyperthyroidism has been determined, prophylaxis with sodium perchlorate is advised. Contrast-induced nephropathy is commonly transient and needs to be followed over time. Mild general anaphylactoid reactions may be treated with antihistaminic drugs and corticosteroids. Furthermore the choice of the X-ray contrast media might influence the risk of any adverse effects. (orig.) [German] Durch den zunehmenden Einsatz jodhaltiger Kontrastmittel in der Radiologie steigt auch die Rate der Nebenwirkungen; zu den wichtigsten gehoeren die kontrastmittelinduzierte Nephropathie, anaphylaktoide Reaktion, thyreotoxische Krise und Extravasation. Bei Patienten mit mittelgradig eingeschraenkter Nierenfunktion wird eine Prophylaxe durch Hydrierung und Reduktion der KM-Menge empfohlen. Bei hochgradig eingeschraenkter Nierenfunktion sollte die Kontrastmittelgabe nur noch kontrolliert im interdisziplinaeren Konsens erfolgen. Eine nachgewiesen wirkungsvolle Prophylaxe anaphylaktoider Reaktionen ist bisher nicht bekannt. Bei Nachweis einer sublatenten Hyperthyreose ist die Gabe von Natriumperchlorat eine sinnvolle Gegenmassnahme. Eine kontrastmittelinduzierte Nephropathie ist meistens transient und sollte mehrfach im Verlauf kontrolliert werden. Leichte allgemeine anaphylaktoide Reaktionen koennen mit Antihistaminika und Kortikosteroiden behandelt werden. Auch die Wahl des Roentgenkontrastmittels koennte Einfluss auf das Risiko von Nebenwirkungen haben. (orig.)

  20. Immediate adverse reactions to intravenous iodinated contrast media in computed tomography Reacciones adversas inmediatas al contraste yodado intravenoso en tomografía computarizada Reações adversas imediatas ao contraste iodado intravenoso em tomografia computadorizada

    Directory of Open Access Journals (Sweden)

    Beatriz Cavalcanti Juchem

    2007-02-01

    Full Text Available This exploratory-descriptive, non-experimental quantitative research aimed to learn about immediate adverse reactions to intravenous iodinated contrast media in hospitalized patients submitted to computed tomography at a teaching hospital in the South of Brazil. During the study period, all adverse reactions showed mild intensity, at a frequency of 12.5% with ionic iodinated contrast media, and 1% with non-ionic contrast agent. The extravasation of contrast occurred in 2.2% of the injections in a peripheral vein without complications in any of the cases. The results are within the limits cited in international literature and suggest that tomography service professionals should know their own rates of adverse reactions to iodinated contrast agent, as well as the conditions in which they occur, in order to obtain evidence to evaluate the respective care delivery processes.Investigación cuantitativa del tipo exploratorio-descriptivo, de carácter no experimental. El objetivo consistía en conocer las reacciones adversas inmediatas al contraste yodado intravenoso en pacientes internados, sometidos a tomografía computarizada en un hospital escuela del sur de Brasil. Durante el período del estudio, todas las reacciones adversas tuvieron intensidad leve y una frecuencia del 12,5% con la utilización del contraste yodado iónico, y 1% con contraste no iónico. La extravasación del contraste ocurrió en un 2,2% de las inyecciones en vena periférica, no ocasionando complicaciones en ninguno de los casos. Los índices evidenciados en el presente estudio se mantuvieron dentro de los límites que constan en la revisión de literatura y, entre las recomendaciones, se sugiere que los servicios de tomografía conozcan los propios índices de reacciones adversas al contraste yodado y las condiciones en que ocurren, con la finalidad de obtener evidencias para evaluación de los respectivos procesos asistenciales.Pesquisa quantitativa, explorat

  1. A sensitive multi-residue method for the determination of 35 micropollutants including pharmaceuticals, iodinated contrast media and pesticides in water.

    Science.gov (United States)

    Valls-Cantenys, Carme; Scheurer, Marco; Iglesias, Mònica; Sacher, Frank; Brauch, Heinz-Jürgen; Salvadó, Victoria

    2016-09-01

    A sensitive, multi-residue method using solid-phase extraction followed by liquid chromatography-tandem mass spectrometry (LC-MS/MS) was developed to determine a representative group of 35 analytes, including corrosion inhibitors, pesticides and pharmaceuticals such as analgesic and anti-inflammatory drugs, five iodinated contrast media, β-blockers and some of their metabolites and transformation products in water samples. Few other methods are capable of determining such a broad range of contrast media together with other analytes. We studied the parameters affecting the extraction of the target analytes, including sorbent selection and extraction conditions, their chromatographic separation (mobile phase composition and column) and detection conditions using two ionisation sources: electrospray ionisation (ESI) and atmospheric pressure chemical ionisation (APCI). In order to correct matrix effects, a total of 20 surrogate/internal standards were used. ESI was found to have better sensitivity than APCI. Recoveries ranging from 79 to 134 % for tap water and 66 to 144 % for surface water were obtained. Intra-day precision, calculated as relative standard deviation, was below 34 % for tap water and below 21 % for surface water, groundwater and effluent wastewater. Method quantification limits (MQL) were in the low ng L(-1) range, except for the contrast agents iomeprol, amidotrizoic acid and iohexol (22, 25.5 and 17.9 ng L(-1), respectively). Finally, the method was applied to the analysis of 56 real water samples as part of the validation procedure. All of the compounds were detected in at least some of the water samples analysed. Graphical Abstract Multi-residue method for the determination of micropollutants including pharmaceuticals, iodinated contrast media and pesticides in waters by LC-MS/MS.

  2. Quantifying the effects of iodine contrast media on standardised uptake values of FDG PET/CT images: an anthropomorphic phantom study.

    Science.gov (United States)

    Abdul Razak, Hairil Rashmizal; Nordin, Abdul Jalil; Ackerly, Trevor; Van Every, Bruce; Martin, Ruth; Geso, Moshi

    2011-09-01

    This study aimed to quantify the amount of change in Standardised Uptake Values (SUVs) of PET/CT images by simulating the set-up as closely as possible to the actual patient scanning. The experiments were conducted using an anthropomorphic phantom, which contained an amount of radioactivity in the form of Fluorodeoxyglucose (FDG) in a primary plastic test tube and one litre saline bags, including the insertion of bony structures and another two test tubes containing different concentrations of iodine contrast media. Standard scanning protocols were employed for the PET/CT image acquisition. The highest absolute differences in the SUVmax and SUVmean values of the saline bags were found to be about 0.2 and 0.4, respectively. The primary test tube showed the largest change of 1.5 in both SUVs; SUV max and SUVmean. However, none of these changes were found to be statistically significant. The clinical literature also contains no evidence to suggest that the changes of this magnitude would change the final diagnosis. Based on these preliminary data, we propose that iodine contrast media can be used during the CT scan of PET/CT imaging, without significantly affecting the diagnostic quality of this integrated imaging modality.

  3. Development of contrast media

    International Nuclear Information System (INIS)

    Krause, W.

    1993-01-01

    Description of all contrast media (ionic and nonionic monomers, ionic and nonionic dimers) was presented. Chemotoxicity, osmolality and viscosity of some contrast agents were analyzed. The main adverse reactions to ionic and nonionic contrast media were described

  4. Do Iodine Contrast Media Compounds Used for Medical Imaging Contribute to the Formation of Iodinated Disinfection By-Products in Drinking Water?

    Science.gov (United States)

    Iodinated disinfection byproducts (DBPs) have recently gained attention due to their cyto- and genotoxicity and increased formation in drinking water treated with chloramine, which has become an increasingly popular disinfectant in the United States. One of these—iodoacetic acid...

  5. Contrast Media: Are There Differences in Nephrotoxicity among Contrast Media?

    Science.gov (United States)

    2014-01-01

    Iodinated contrast agents are usually classified based upon their osmolality—high, low, and isosmolar. Iodinated contrast agents are also nephrotoxic in some but not all patients resulting in loss of glomerular filtration rate. Over the past 30 years, nephrotoxicity has been linked to osmolality although the precise mechanism underlying such a link has been elusive. Improvements in our understanding of the pathogenesis of nephrotoxicity and prospective randomized clinical trials have attempted to further explore the relationship between osmolality and nephrotoxicity. In this review, the basis for our current understanding that there are little if any differences in nephrotoxic potential between low and isosmolar contrast media will be detailed using data from clinical studies. PMID:24587997

  6. Clinical observation of adverse drug reactions to non-ionic iodinated contrast media in population with underlying diseases and risk factors

    Science.gov (United States)

    Li, Xue; Liu, Heng; Zhao, Li; Liu, Junling; Cai, Li; Liu, Lei

    2017-01-01

    Objective: To determine the adverse drug reaction (ADR) profile of non-ionic iodinated contrast media in populations with underlying diseases and risk factors and to provide guidance for more safe and rational use of iodinated contrast media (ICMs) in the clinic. Methods: Data from 120,822 cases who underwent enhanced CT examination in our hospital from January 2014 to March 2016 were collected. A standardized case report form was used for data collection and analysis. Results: The incidence of ADRs was 0.4% and 0.44% in patients with and without underlying diseases, respectively (p = 0.378). Risk factor analysis revealed that patients with asthma had the highest incidence of ADRs, followed by patients with cardiac insufficiency and patients who were aged had the lowest incidence. There was a low incidence of ADRs in patients under metformin (0.36%) and β-adrenaline receptor antagonist (0.20%) medication. The incidence was the highest in patients with previous ADRs to ICMs (7.17%) and the lowest in those with a history of ICM usage but no previous reactions (0.32%). ADRs were more common in patients at high risk at a higher injection dose (≥100 ml; p < 0.01) and speed (≥5 ml s−1; p < 0.01). Conclusion: The incidence of ADRs was extremely low in patients regardless of underlying diseases. Some high-risk factors have certain correlations with the occurrence of ADRs. Particular attention should be given to patients at high risk when performing enhanced CT examination. Advances in knowledge: The correlation between various risk factors and underlying diseases and ADRs was comprehensively analyzed in a large-scale population. PMID:27928926

  7. Effects of iodinated contrast media on common carotid and brachial artery blood flow and wall shear stress

    International Nuclear Information System (INIS)

    Irace, C.; Tamburini, S.; Bertucci, B.; Franceschi, M.S. de; Gnasso, A.

    2006-01-01

    The aim of our study was to evaluate the effect of the intravenous contrast media iomeprol on wall shear stress, blood flow and vascular parameters in the common carotid and brachial artery. Thirty outpatients undergoing thoracic or abdominal spiral CT scans were studied. The internal diameter and flow velocity of the common carotid and brachial artery were evaluated by ultrasound, and blood viscosity was measured before and after low osmolality iomeprol (Iomeron 350) injection. The wall shear stress, blood flow and pulsatility index were calculated. To test the differences between groups, the Wilcoxon rank test and Mann Whitney U test were applied. Blood viscosity decreased slightly, but significantly after contrast media (4.6±0.7 vs. 4.5±0.7 mPa.s, P=0.02). Contrarily, blood flow and wall shear stress did not change in the common carotid artery, but significantly decreased in the brachial artery (0.9±0.4 vs. 0.6±0.3 ml/s, P<0.0001, and 41.5±13.9 vs. 35.3±11.0 dynes/cm2, P<0.002, respectively), whereas the pulsatility index significantly increased in the brachial artery (5.0±3.3 vs. 7.5±5.3, P<0.001). Iomeprol injection causes blood flow and wall shear stress reduction of the brachial artery; the rise in the pulsatility index suggests an increase in peripheral vascular resistance. Further investigation is needed to evaluate whether these modifications can be clinically relevant. (orig.)

  8. Contrast opacification for CT from iodine, gadolinium and ytterbium

    International Nuclear Information System (INIS)

    Zwicker, C.; Langer, M.; Ullrich, V.; Felix, R.

    1993-01-01

    The absorption of the elements iodine, gadolinium und ytterbium in various dilutions was studied in relation to CT. Regression analysis and specific CT density measurements showed that absorption decreases from gadolinium to ytterbium and iodine. These results were confirmed by experiments using ten dogs. Boli of 0.5 molar gadolinium used for angio-CT without table movement showed the largest increase in density in the aorta and liver with an average of 190 HU and 21 HU respectively compared with iodine which gave 157 HU and 12 HU respectively. The animal experimental studies suggest that gadolinium and ytterbium are suitable contrast media for dynamic CT investigations. (orig.) [de

  9. Re-exposure to low osmolar iodinated contrast media in patients with prior moderate-to-severe hypersensitivity reactions: A multicentre retrospective cohort study.

    Science.gov (United States)

    Park, Hye Jung; Park, Jung-Won; Yang, Min-Suk; Kim, Mi-Yeong; Kim, Sae-Hoon; Jang, Gwang Cheon; Nam, Young-Hee; Kim, Gun-Woo; Kim, Sujeong; Park, Hye-Kyung; Jung, Jae-Woo; Park, Jong-Sook; Kang, Hye-Ryun

    2017-07-01

    To evaluate the outcomes of re-exposure to low-osmolar iodinated contrast medium (LOCM) in patients with a history of moderate-to-severe hypersensitivity reaction (HSR). We retrospectively evaluated a cohort comprising all subjects satisfying the following conditions at 11 centres: (1) experienced a moderate-to-severe HSR to LOCM by December 2014, and (2) underwent contrast-enhanced computed tomography after the initial HSR between January 2014 and December 2014. A total of 150 patients with 328 instances of re-exposure were included; the recurrence rate of HSR was 19.5%. Patients with severe initial HSR exhibited a higher recurrence rate of severe HSR compared to patients with moderate initial HSR, despite more intensive premedication. In the multivariate analysis, the independent risk factors for recurrence of HSR were diabetes, chronic urticaria, drug allergy other than to iodinated contrast media (ICM) and severe initial HSR. The risk of recurrent HSR was 67.1% lower in cases where the implicated ICM was changed to another one (odds ratio: 0.329; P = 0.001). However, steroid premedication did not show protective effects against recurrent HSR. In high-risk patients who have previously experienced a moderate-to-severe initial HSR to LOCM, we should consider changing the implicated ICM to reduce recurrence risk. • In patients with moderate-to-severe HSR, steroid premedication only shows limited effectiveness. • Changing the implicated ICM can reduce the recurrence of HSR to ICM. • Diabetes, chronic urticaria and drug allergies increase the risk of ICM HSR.

  10. MRI and CT contrast media extravasation

    Science.gov (United States)

    Heshmatzadeh Behzadi, Ashkan; Farooq, Zerwa; Newhouse, Jeffery H.; Prince, Martin R.

    2018-01-01

    Abstract Background: This systematic review combines data from multiple papers on contrast media extravasation to identify factors contributing to increased extravasation risk. Methods: Data were extracted from 17 papers reporting 2191 extravasations in 1,104,872 patients (0.2%) undergoing computed tomography (CT) or magnetic resonance imaging (MRI). Results: Extravasation rates were 0.045% for gadolinium-based contrast agents (GBCA) and nearly 6-fold higher, 0.26% for iodinated contrast agents. Factors associated with increased contrast media extravasations included: older age, female gender, using an existing intravenous (IV) instead of placing a new IV in radiology, in-patient status, use of automated power injection, high injection rates, catheter location, and failing to warm up the more viscous contrast media to body temperature. Conclusion: Contrast media extravasation is infrequent but nearly 6 times less frequent with GBCA for MRI compared with iodinated contrast used in CT. PMID:29489663

  11. Acute Adverse Reactions to Nonionic Iodinated Contrast Media for CT: Prospective Randomized Evaluation of the Effects of Dehydration, Oral Rehydration, and Patient Risk Factors.

    Science.gov (United States)

    Motosugi, Utaroh; Ichikawa, Tomoaki; Sano, Katsuhiro; Onishi, Hiroshi

    2016-11-01

    The objective of our study was to determine the effects of dehydration and oral rehydration on the incidence of acute adverse reactions to iodinated contrast media administered during abdominal and pelvic CT in outpatients. For our prospective randomized study performed at a single institution, adult outpatients undergoing contrast-enhanced abdominal CT were randomly divided into a rehydration group (n = 2244 patients [1379 men and 865 women]; mean age, 65.2 years; age range, 18-90 years) and a control group (n = 3715 [2112 male patients and 1603 female patients]; mean age, 65.8 years; age range, 17-96 years), which included an age- and sex-matched subgroup (adjusted control group, n = 2244). The rehydration group received an oral rehydration solution (500 mL of liquid in which osmotic pressure is adjusted to enhance gastrointestinal absorption) before abdominal and pelvic CT. Patients were also divided into subclinically dehydrated (n = 997) and hydrated (n = 4962) groups according to their answers to a questionnaire that they completed before the CT examination. The patients were interviewed about contrast-induced adverse reactions before they left the CT room, and the reactions were categorized as allergiclike or physiologic. The incidence of reactions was compared between the rehydration and control groups and between the subclinical dehydration and hydrated groups. The rehydration and control groups were compared with an unpaired t test or a chi-square or Fisher test. The overall incidence of an acute adverse reaction was 4.3% (254/5959); the acute adverse reactions included 136 allergiclike and 118 physiologic reactions. Fourteen allergiclike and nine physiologic reactions were moderate grade, and none was severe. There was no significant difference between the rehydration group and adjusted control group in the overall incidence of adverse reactions (99/2244 [4.4%] vs 100/2244 [4.5%], respectively; p = 0.9422) or between the subclinically dehydrated group

  12. Paediatric cardiac catheterization. Controlled, randomized study of two iodinated contrast media: iopromide 300 and ioxaglate 320 mgI/ml

    International Nuclear Information System (INIS)

    Amiel, M.; Revel, D.

    1989-01-01

    Thirty-one children were included in a prospective randomized trial comparing a new non-ionic contrast medium, iopromide 300 and the ionic low osmolar contrast medium, ioxaglate 320 mgI/ml in pediatric cardiac catheterization. There were fewer adverse effects with iopromide but no statistically significant difference was demonstrated in this small population, with a very low incidence of allergoid reactions; this tendency was confirmed by meta-analysis of the multicentre study [fr

  13. Reducing the risk of iodine-based and MRI contrast media administration: Recommendation for a questionnaire at the time of booking

    International Nuclear Information System (INIS)

    Morcos, Sameh K.; Bellin, Marie-France; Thomsen, Henrik S.; Almen, Torsten; Aspelin, Peter; Heinz-Peer, Gertraud; Jakobsen, Jarl A.; Liss, Per; Oyen, Raymond; Stacul, Fulvio; Molen, Aart J. van der; Webb, Judith A.W.

    2008-01-01

    This paper presents a practical questionnaire to be used when a contrast medium examination is requested. The questionnaire is based on the guidelines from the European Society of Urogenital Radiology. Its aim is to identify patients at increased risk of clinically relevant renal and non-renal adverse reactions to iodine-based and MRI contrast agents. The questionnaire should be completed by the referring physician when the examination is requested

  14. Reducing the risk of iodine-based and MRI contrast media administration: Recommendation for a questionnaire at the time of booking

    Energy Technology Data Exchange (ETDEWEB)

    Morcos, Sameh K. [Department of Diagn. Imaging, Northern General Hospital, Herries Road, Sheffield S5 7AU (United Kingdom)], E-mail: sameh.morcos@sth.nhs.uk; Bellin, Marie-France [Service de Radiologie, Hopital Paul Brousse, 14 Av. Paul Vaillant Couturier, F-94800 Villejuif (France)], E-mail: marie-france.bellin@pbr.ap-hop-paris.fr; Thomsen, Henrik S. [Department of Diagnostic Radiology 54E2, Copenhagen University Hospital Herlev, Herlev Ringvej 75, DK-2730 Herlev (Denmark)], E-mail: hentho01@heh.regionh.dk; Almen, Torsten [Lybska Vaegen 10, S-239 40 Falsterbo (Sweden)], E-mail: torsten.almen@ta-contrast.se; Aspelin, Peter [Diagnostic Radiology, Huddinge University Hospital, S-141 86 Huddinge (Sweden)], E-mail: peter.aspelin@ki.se; Heinz-Peer, Gertraud [Department of Radiology, University Hospital Vienna, AKH, Wahringer Gurtel 18-20, A-1090 Vienna (Austria)], E-mail: gertraud.heinz@meduniwien.ac.at; Jakobsen, Jarl A. [Department of Radiology, Rikshospitalet, N-0027 Oslo (Norway)], E-mail: jarl.jakobsen@rikshospitalet.no; Liss, Per [Department of Radiology, Akademiska sjukhuset, SE-751 85 Uppsala (Sweden)], E-mail: per.liss@akademiska.se; Oyen, Raymond [Department of Radiology, University Hospital Gasthuisberg, Herestraat 46, B-3000 Leuven (Belgium)], E-mail: raymond.oyen@uzleuven.be; Stacul, Fulvio [Institute of Radiology, Ospedale di Cattinara, I-34149 Trieste (Italy)], E-mail: fulvio.stacul@aots.sanita.fvg.it; Molen, Aart J. van der [Department of Radiology, C2-S, Leiden University Medical center, P.O. Box 9600, NL-2300 RC Leiden (Netherlands)], E-mail: aart.vdmolen@planet.nl; Webb, Judith A.W. [3 Sellars Hall Close, Finchley, London N3 1JL (United Kingdom)], E-mail: jawwebb@btopenworld.com

    2008-05-15

    This paper presents a practical questionnaire to be used when a contrast medium examination is requested. The questionnaire is based on the guidelines from the European Society of Urogenital Radiology. Its aim is to identify patients at increased risk of clinically relevant renal and non-renal adverse reactions to iodine-based and MRI contrast agents. The questionnaire should be completed by the referring physician when the examination is requested.

  15. Contrast media. Safety issues and ESUR guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Thomsen, H.S. (ed.) [Copenhagen Univ. Hospital, Herlev (Denmark). Dept. of Diagnostic Radiology 54E2

    2006-07-01

    In 1994 the European Society of Urogenital Radiology (ESUR) set up a committee to consider the safety of the contrast media used in radiology departments. Since then, the committee has questioned members, reviewed the literature, proposed guidelines, and discussed these proposals with participants at the annual symposia on urogenital radiology. This book represents the end result of this hard work. It contains all of the agreed guidelines, updated when necessary, and thereby comprehensively covers the many different safety issues relating to the diverse contrast media: barium contrast media, iodinated contrast media, MR contrast media (both gadolinium-based extracellular and organ-specific) and ultrasound contrast media. The prevention and treatment of both acute and delayed non-renal adverse reactions as well as the renal adverse reactions are covered in detail. The inclusion of all the ESUR guidelines within one book will offer an invaluable, unique and unparalleled resource. (orig.)

  16. Contrast media. Safety issues and ESUR guidelines

    International Nuclear Information System (INIS)

    Thomsen, H.S.

    2006-01-01

    In 1994 the European Society of Urogenital Radiology (ESUR) set up a committee to consider the safety of the contrast media used in radiology departments. Since then, the committee has questioned members, reviewed the literature, proposed guidelines, and discussed these proposals with participants at the annual symposia on urogenital radiology. This book represents the end result of this hard work. It contains all of the agreed guidelines, updated when necessary, and thereby comprehensively covers the many different safety issues relating to the diverse contrast media: barium contrast media, iodinated contrast media, MR contrast media (both gadolinium-based extracellular and organ-specific) and ultrasound contrast media. The prevention and treatment of both acute and delayed non-renal adverse reactions as well as the renal adverse reactions are covered in detail. The inclusion of all the ESUR guidelines within one book will offer an invaluable, unique and unparalleled resource. (orig.)

  17. Practice patterns for the use of iodinated i.v. contrast media for pediatric CT studies: a survey of the Society for Pediatric Radiology.

    Science.gov (United States)

    Callahan, Michael J; Servaes, Sabah; Lee, Edward Y; Towbin, Alexander J; Westra, Sjirk J; Frush, Donald P

    2014-04-01

    There are limited data available on the use of i.v. contrast media for CT studies in the pediatric population. The purpose of this study is to determine the practice patterns of i.v. contrast media usage for pediatric CT by members of the Society for Pediatric Radiology (SPR). SPR members were surveyed regarding the use of i.v. contrast media for pediatric CT studies. Questions pertained to information required before administering i.v. contrast media, types of central catheters for injecting i.v. contrast media, injection rates based on angiocatheter size and study type, and management of i.v. contrast media extravasation. The response rate of 6% (88/1545) represented practice patterns of 26% (401/1545) of the SPR membership. Most respondents thought the following clinical information was mandatory before i.v. contrast media administration: allergy to i.v. contrast media (97%), renal insufficiency (97%), current metformin use (72%), significant allergies (61%), diabetes (54%), and asthma (52%). Most administered i.v. contrast media through nonimplanted central venous catheters (78%), implanted venous ports (78%), and peripherally inserted central catheters (72%). The most common maximum i.v. contrast media injection rates were 5.0 mL/s or greater for a 16-gauge angiocatheter, 4.0 mL/s for an 18-gauge angiocatheter, 3.0 mL/s for a 20-gauge angiocatheter, and 2.0 mL/s for a 22-gauge angiocatheter. For soft-tissue extravasation of i.v. contrast media, 95% elevate the affected extremity, 76% use ice, and 45% use heat. The results of this survey illustrate the collective opinion of a subset of SPR members relating to the use of i.v. contrast media in pediatric CT, providing guidelines for clinical histories needed before i.v. contrast media, maximum i.v. contrast injection rates for standard angiocatheters, contrast media injection rates for specific CT studies, and management of i.v. contrast media soft-tissue extravasation.

  18. Degradation of Iodinated Contrast Media in Aquatic Environment by Means of UV, UV/TiO2 Process, and by Activated Sludge.

    Science.gov (United States)

    Borowska, Ewa; Felis, Ewa; Żabczyński, Sebastian

    Iodinated contrast media (ICM), which are used for radiological visualization of human tissue and cardiovascular system, are poorly biodegradable; hence, new methods of their removal are sought. In this study, the effectiveness of selected X-ray ICM removal by means of UV and UV/TiO 2 pretreatment processes from synthetic hospital wastewater was demonstrated. The following compounds were investigated: iodipamide, iohexol, and diatrizoate. The experiments were as follows: (i) estimated susceptibility of the ICM to decay by UV radiation in different aquatic matrices, (ii) determined an optimal retention time of hospital wastewater in the UV reactor, (iii) determined optimum TiO 2 concentration to improve the effectiveness of the UV pretreatment, and (iv) investigated removal of ICM by combination of the photochemical and biological treatment methods. The quantum yields of selected ICM decay in deionized water (pH = 7.0) were established as 0.006, 0.004, and 0.029 for iohexol, diatrizoate, and iodipamide, respectively. Furthermore, the experiments revealed that diatrizoate and iohexol removal in the UV/TiO 2 process is more efficient than in UV process alone. For diatrizoate, the removal efficiency equaled to 40 and 30 %, respectively, and for iohexol, the efficiency was 38 and 27 %, respectively. No significant increase in iodipamide removal in UV and UV/TiO 2 processes was observed (29 and 28 %, respectively). However, highest removal efficiency was demonstrated in synthetic hospital wastewater with the combined photochemical and biological treatment method. The removal of diatrizoate and iohexol increased to at least 90 %, and for iodipamide, to at least 50 %.

  19. Reductive and oxidative degradation of iopamidol, iodinated X-ray contrast media, by Fe(III)-oxalate under UV and visible light treatment.

    Science.gov (United States)

    Zhao, Cen; Arroyo-Mora, Luis E; DeCaprio, Anthony P; Sharma, Virender K; Dionysiou, Dionysios D; O'Shea, Kevin E

    2014-12-15

    Iopamidol, widely employed as iodinated X-ray contrast media (ICM), is readily degraded in a Fe(III)-oxalate photochemical system under UV (350 nm) and visible light (450 nm) irradiation. The degradation is nicely modeled by pseudo first order kinetics. The rates of hydroxyl radical (OH) production for Fe(III)-oxalate/H2O2/UV (350 nm) and Fe(III)-oxalate/H2O2/visible (450 nm) systems were 1.19 ± 0.12 and 0.30 ± 0.01 μM/min, respectively. The steady-state concentration of hydroxyl radical (OH) for the Fe(III)-oxalate/H2O2/UV (350 nm) conditions was 10.88 ± 1.13 × 10(-14) M and 2.7 ± 0.1 × 10(-14) M for the Fe(III)-oxalate/H2O2/visible (450 nm). The rate of superoxide anion radical (O2(-)) production under Fe(III)-oxalate/H2O2/UV (350 nm) was 0.19 ± 0.02 μM/min with a steady-state concentration of 5.43 ± 0.473 × 10(-10) M. Detailed product studies using liquid chromatography coupled to Q-TOF/MS demonstrate both reduction (multiple dehalogenations) and oxidation (aromatic ring and side chains) contribute to the degradation pathways. The reduction processes appear to be initiated by the carbon dioxide anion radical (CO2(-)) while oxidation processes are consistent with OH initiated reaction pathways. Unlike most advanced oxidation processes the Fe(III)-oxalate/H2O2/photochemical system can initiate to both reductive and oxidative degradation processes. The observed reductive dehalogenation is an attractive remediation strategy for halogenated organic compounds as the process can dramatically reduce the formation of the problematic disinfection by-products often associated with oxidative treatment processes. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. Hypersensitivity to contrast media and dyes.

    Science.gov (United States)

    Brockow, Knut; Sánchez-Borges, Mario

    2014-08-01

    This article updates current knowledge on hypersensitivity reactions to diagnostic contrast media and dyes. After application of a single iodinated radiocontrast medium (RCM), gadolinium-based contrast medium, fluorescein, or a blue dye, a hypersensitivity reaction is not a common finding; however, because of the high and still increasing frequency of those procedures, patients who have experienced severe reactions are nevertheless frequently encountered in allergy departments. Evidence on allergologic testing and management is best for iodinated RCM, limited for blue dyes, and insufficient for fluorescein. Skin tests can be helpful in the diagnosis of patients with hypersensitivity reactions to these compounds. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. Reducing the risk of iodine-based and MRI contrast media administration: Recommendation for a questionnaire at the time of booking

    DEFF Research Database (Denmark)

    Morcos, S.K.; Bellin, M.F.; Almen, T.

    2008-01-01

    This paper presents a practical questionnaire to be used when a contrast medium examination is requested. The questionnaire is based on the guidelines from the European Society of Urogenital Radiology. Its aim is to identify patients at increased risk of clinically relevant renal and non-renal ad......-renal adverse reactions to iodine-based and MRI contrast agents. The questionnaire should be completed by the referring physician when the examination is requested. (C) 2008 Elsevier Ireland Ltd. All rights reserved Udgivelsesdato: 2008/5......This paper presents a practical questionnaire to be used when a contrast medium examination is requested. The questionnaire is based on the guidelines from the European Society of Urogenital Radiology. Its aim is to identify patients at increased risk of clinically relevant renal and non...

  2. Clinical observation of the adverse drug reactions caused by non-ionic iodinated contrast media: results from 109,255 cases who underwent enhanced CT examination in Chongqing, China.

    Science.gov (United States)

    Li, X; Chen, J; Zhang, L; Liu, H; Wang, S; Chen, X; Fang, J; Wang, S; Zhang, W

    2015-03-01

    To analyse the pattern and factors that influence the incidence of adverse drug reactions (ADRs) induced by non-ionic iodinated contrast media and to evaluate their safety profiles. Data from 109,255 cases who underwent enhanced CT examination from 1 January 2008 to 31 August 2013 were analysed. ADRs were classified according to the criteria issued by the American College of Radiology and the Chinese Society of Radiology. A total of 375 (0.34%) patients had ADRs, including 281 mild (0.26%); 80 moderate (0.07%); and 14 severe (0.01%) ADRs; no death was found. 302 (80.53%) of the ADRs occurred within 15 min after examination. Patients aged 40-49 years (204 cases, 0.43%; p contrast media are mainly mild ones, while moderate or severe ADRs are relatively rare, suggesting that enhanced CT examination with non-ionic iodinated contrast media is highly safe, and severe adverse events will seldom occur under appropriate care. The study included 109,255 patients enrolled in various types of enhanced CT examinations, which could reflect ADR conditions and regulations in Chinese population accurately and reliably.

  3. The use of new contrast media agents in radiology

    International Nuclear Information System (INIS)

    Zerbe, M.

    1992-01-01

    The purpose of the document is to present the importance of different categories of contrast media in radiography. Ionic and non-ionic contrast media are presented. Pharmacology and pathophysiology of Iodine contrast media with their effects on special organs of the body like the heart, vessels, lungs and nervous systems are explained. Paramagnetic contrast media used in NMR imaging are presented too. Emphasis is made on contrast media based on Gadolinium like Gd-DTPA, Gd-CL3, Gd-EDTA. Actions of Gd-DTPA applied to images in urography are pointed out

  4. Monte Carlo dosimetry of iodine contrast objects in a small animal microCT

    Energy Technology Data Exchange (ETDEWEB)

    Rodriguez-Villafuerte, M., E-mail: mercedes@fisica.unam.mx [Instituto de Fisica, Universidad Nacional Autonoma de Mexico, A.P. 20-364, 01000 Mexico D.F. (Mexico); Martinez-Davalos, A. [Instituto de Fisica, Universidad Nacional Autonoma de Mexico, A.P. 20-364, 01000 Mexico D.F. (Mexico)

    2011-08-21

    Small animal microcomputed tomography (microCT) studies with iodine-based contrast media are commonly used in preclinical research. While the use of contrast media improves the quality of the images, it can also result in an increase in the absorbed dose to organs with high concentration of the contrast agent, which might cause radiation damage to the animal. In this work we present the results of a Monte Carlo investigation of a microCT dosimetry study using mouse-sized cylindrical water phantoms with iodine contrast insets for different X-ray spectra (Mo and W targets, 30-80 kVp), iodine concentrations (0, 5, 10 and 15 mg mL{sup -1}) and contrast object sizes (3 and 10 mm diameter). Our results indicate an absorbed dose increase in the contrast-inset regions with respect to the absorbed dose distribution within a reference uniform water phantom. The calculated spatial absorbed dose distributions show large gradients due to beam hardening effects, and large absorbed dose enhancement as the mean energy of the beam and iodine concentration increase. We have found that absorbed doses in iodine contrast objects can increase by a factor of up to 12 for a realistic 80 kVp X-ray spectra and an iodine concentration of 15 mg mL{sup -1}.

  5. Comparison of differently viscous iodinated and bariumcontaining contrast agents in the detection of pharyngeal perforation

    International Nuclear Information System (INIS)

    Keberle, M.; Wittenberg, G.; Trusen, A.; Hahn, D.; Baumgartner, W.

    2001-01-01

    Purpose: In contrast to esophageal perforations, the more radiopaque barium-suspensions are not as important as iodinated aqueous contrast agents for the detection of pharyngeal perforations. This study was performed to find out whether the highly different viscosities (of iodinated and barium-containing contrast agents with comparable radiopacities) are a reason for this. Methods: Viscosity, subjective difference in contrast, and CT-density of an iodinated aqueous (Telebrix) and a 50 wt/vol% barium-containing contrast agent (Micropaque) were determined. Moreover, to exclude postoperative perforation, 104 patients were prospectively examined by pharyngography using both contrast media. Pharyngographies of patients with perforation were later compared by two independent readers. All patients with perforation were followed up clinically to exclude complications due to barium administration. Results: In-vitro comparison showed comparable radiopacity but the 50 wt/vol% barium-suspension was much more viscous that the iodinated contrast agent. During pharyngography, totally, 14 perforations were clearly delineated with the iodinated aqueous contrast agent. However, two of them were not detected with the barium-suspension. All the other perforations presented equally. Conclusions: Given a sufficient radiopacity, a low viscosity appears to be essential for a contrast agent to detect especially pharyngeal perforations. Thus, we recommend the sole use of an iodinated contrast agent (at suspicion of aspiration as isoosmolar variant) for this purpose. (orig.) [de

  6. MRI and CT contrast media extravasation: A systematic review.

    Science.gov (United States)

    Heshmatzadeh Behzadi, Ashkan; Farooq, Zerwa; Newhouse, Jeffery H; Prince, Martin R

    2018-03-01

    This systematic review combines data from multiple papers on contrast media extravasation to identify factors contributing to increased extravasation risk. Data were extracted from 17 papers reporting 2191 extravasations in 1,104,872 patients (0.2%) undergoing computed tomography (CT) or magnetic resonance imaging (MRI). Extravasation rates were 0.045% for gadolinium-based contrast agents (GBCA) and nearly 6-fold higher, 0.26% for iodinated contrast agents. Factors associated with increased contrast media extravasations included: older age, female gender, using an existing intravenous (IV) instead of placing a new IV in radiology, in-patient status, use of automated power injection, high injection rates, catheter location, and failing to warm up the more viscous contrast media to body temperature. Contrast media extravasation is infrequent but nearly 6 times less frequent with GBCA for MRI compared with iodinated contrast used in CT.

  7. Urinary Iodine Clearance following Iodinated Contrast Administration: A Comparison of Euthyroid and Postthyroidectomy Subjects

    Directory of Open Access Journals (Sweden)

    Janice D. Ho

    2014-01-01

    Full Text Available Purpose. To compare iodine clearance following iodinated contrast administration in thyroidectomised thyroid cancer patients and euthyroid individuals. Methods. A convenience population (6 thyroidectomised thyroid cancer patients and 7 euthyroid controls was drawn from patients referred for iodinated contrast-enhanced computed tomography (CT studies. Subjects had sequential urine samples collected up to 6 months (50 samples from the thyroidectomised and 63 samples from the euthyroid groups. t-tests and generalised estimating equations (GEE were used to test for group differences in urinary iodine creatinine ratios. Results. Groups had similar urinary iodine creatinine ratios at baseline, with a large increase 2 weeks following iodinated contrast (P=0.005. Both groups had a return of urinary iodine creatinine ratios to baseline by 4 weeks, with no significant group differences overall or at any time point. Conclusions. Thyroidectomised patients did not have a significantly different urinary iodine clearance than euthyroid individuals following administration of iodinated contrast. Both had a return of urinary iodine creatinine ratios to baseline within 4 weeks.

  8. Drugs of abuse, cytostatic drugs and iodinated contrast media in tap water from the Madrid region (central Spain):A case study to analyse their occurrence and human health risk characterization.

    Science.gov (United States)

    Mendoza, A; Zonja, B; Mastroianni, N; Negreira, N; López de Alda, M; Pérez, S; Barceló, D; Gil, A; Valcárcel, Y

    2016-01-01

    This work analyses the presence of forty-eight emerging pollutants, including twenty-five drugs of abuse and metabolites, seventeen cytostatic drugs and six iodinated contrast media, in tap water from the Madrid Region. Analysis of the target compounds in the tap water was performed by means of (on-line or off-line) solid-phase extraction followed by analysis by liquid chromatography-tandem mass spectrometry. A preliminary human health risk characterization was undertaken for each individual compound and for different groups of compounds with a common mechanism of action found in tap water. The results of the study showed the presence of eight out of the twenty-five drugs of abuse and metabolites analysed, namely, the cocainics cocaine and benzoylecgonine, the amphetamine-type stimulants ephedrine, 3,4-methylenedioxymethamphetamine and methamphetamine, the opioid methadone and its metabolite 2-ethylene-1,5-dimethyl-3,3-diphenylpyrrolidine and, finally caffeine at concentrations ranging from 0.11 to 502 ng L(-1). Four out of the six analysed iodinated contrast media, namely, diatrizoate, iohexol, iomeprol and iopromide, were detected in at least one sample, with concentration values varying between 0.4 and 5 ng L(-1). Cytostatic compounds were not detected in any sample. Caffeine was the substance showing the highest concentrations, up to 502 ng L(-1), mainly in the drinking water sampling point located in Madrid city. Among the other drugs of abuse, the most abundant compounds were cocaine and benzoylecgonine, detected at concentrations ranging from 0.11 to 86 ng L(-1) and from 0.11 to 53 ng L(-1), respectively. Regarding iodinated contrast media, iohexol was the most ubiquitous and abundant compound, with a frequency of detection of 100% and concentrations from 0.5 to 5.0 ng L(-1) in basically the same range in all sampling points. Taking into account the results and types of treatment applied, ozonisation plus granular activated carbon filtration appears to be

  9. Properties of conventional contrast media

    International Nuclear Information System (INIS)

    Muetzel, W.

    1981-01-01

    A comprehensive overview is given of the properties of contrast media currently used in computed tomography (CT). The chemical structure of the compounds and the physicochemical properties derived therefrom are described. Emphasis is placed on the importance of the physicochemical properties of contrast media for tolerance and the pharmacokinetic behavior of compounds in the body. An outline is given of the basic ideas governing rational use of contrast media in CT, which result from complex, time-dependent distribution of contrast media in different tissue spaces. (Auth.)

  10. The interaction of radiographic contrast media with immune globulins

    International Nuclear Information System (INIS)

    Bauer, K.

    1983-01-01

    As a special form of contrast medium incidents, various reaction modes between iodinated contrast media and immunoglobulins are described. Theoretical explanations and typical examples are given for each of the four different possible action mechanisms. Diagnostic precautions are proposed in order to avoid unfavourable reactions especially with paraproteins. Special attention is drawn to the antigen-antibody like reaction between iodinated contrast media and IgM paraproteins. Some immunological criteria are recalled to attention, this type of reaction has to meet stringently. Only by this, misinterpretations of inevident conclusions from analogy can be prevented in future similar cases. (orig.) [de

  11. Contrast media in renal insufficiency - risk and prevention

    International Nuclear Information System (INIS)

    Erley, C.M.; Bader, B.D.

    2000-01-01

    The use of iodinated contrast media (CM) continues to be a common cause of hospital-acquired acute renal failure (ARF) and its development increases the in-hospital mortality significantly. Alterations in renal hemodynamics and direct tubular toxicity by contrast media are the primary factors believed to be responsible for contrast media-associated nephrotoxicity. We review recent insights into the pathogenesis of this complication and summarize prophylacttic strategies focussing on hydration, vasoactive pharmacological agents, alternative contrast media and 'prophylactic hemodialysis'. (orig.) [de

  12. Iodinated contrast agent-induced nephropathy

    International Nuclear Information System (INIS)

    Erley, C.

    2007-01-01

    Contrast-induced nephropathy (CIN) is a well-known complication of therapeutic and diagnostic procedures requiring contrast administration and accounts for 10% of acute renal failure in hospitalized patients. Although the incidence of this complication is relatively low, its consequences can be catastrophic. The development of CIN is associated with increased length of hospital stay, an increased requirement for acute dialysis, and an increased risk of death. Preexisting renal dysfunction, age, diabetes, congestive heart failure, and volume of administered contrast are all associated with a risk of developing CIN. Despite a large number of clinical trials that have evaluated prophylaxis strategies for CIN, no uniform strategies have been developed so far. The use of N-acetyl-L-cysteine (NAC) or theophylline in specific subgroups of patients has been shown to reduce dialysis requirement and mortality in patients undergoing angiographic procedures. Hemofiltration has also shown positive results. In this review we will discuss the epidemiology and the risk factors for CIN and the evidence for commonly employed prophylaxis strategies, and we will provide general recommendations with respect to CIN prevention and management. A practicable strategy to prevent CIN includes: correct identification of individuals at greatest risk, thorough evaluation of whether other diagnostic maneuvers could be employed instead (i.e., sonography), application of low-osmolar contrast media at the minimum acceptable dose, stopping potential nephrotoxic drugs (NSAID), hydration with sodium chloride 0.9% 1 ml/kg per h i.v. 12 h before and after CM application, administration of acetylcysteine 600 mg twice the day before and after (in cases of emergency investigation and high-risk patients 1200 mg i.v.), and theophylline (250-350 mg) the day before and the day after CM application (in cases of emergency investigation 5 mg/kg i.v.). (orig.) [de

  13. Gadolinium-containing contrast media for radiographic examinations: a position paper

    International Nuclear Information System (INIS)

    Thomsen, Henrik S.; Almen, Torsten; Morcos, Sameh K.

    2002-01-01

    Recently, it has been suggested that gadolinium-based contrast media could be used for radiological examinations in patients with significant renal impairment, previous severe generalized reaction to iodinated contrast media or thyroid disease about to undergo radioactive iodine treatment; however, the indications for and risks of using gadolinium agents in this way are not well known; hence, the Contrast Media Safety Committee of The European Society of Urogenital Radiology reviewed the literature to issue a position paper on this subject. A comprehensive literature review was performed and the resulting report was discussed at the Ninth European Symposium on Urogenital Radiology in Genoa, Italy, June 2002. Review of the literature indicates that according to experimental data on animals gadolinium-based contrast media have more nephrotoxic potential than iodinated contrast media in equivalent X-ray attenuating doses; therefore, gadolinium-based contrast media should not replace iodinated contrast media in patients with renal insufficiency for radiographic examinations. For patients with previous severe generalized reactions to iodinated contrast media, and in patients about to undergo thyroid treatment with radioactive iodine gadolinium-based contrast media in approved intravenous doses, up to 0.3 mmol/kg body weight will not give diagnostic radiographic information in most cases. Gadolinium-based contrast media are not approved for radiographic examinations. (orig.)

  14. Longitudinal study of iodine in toenails following IV administration of an iodine-containing contrast agent

    International Nuclear Information System (INIS)

    Spate, V.L.; Morris, J.S.; Nichols, T.A.; Baskett, C.K.; Mason, M.M.; Horsman, T.L.; McDougall, I.R.

    1998-01-01

    The literature on the relationship between diet and thyroid cancer (TC) risk and the higher incidence of TC among Asian immigrants to the US compared to second and third generation subgroups has prompted epidemiologists to hypothesize that increased levels of iodine consumption may be associated with TC risk, particularly among persons with a history of clinical or subclinical thyroid dysfunction. At the University of Missouri Research Reactor (MURR), we have applied epiboron neutron activation analysis to investigate human nails as a dietary monitor for iodine. Preliminary studies have indicated a positive correlation between dietary iodine intake and the concentration of iodine in toenails. However, these studies are confounded by high iodine levels (up to 30 ppm) in approximately 5% of the nails studied. We hypothesize that, in the subjects we have studied, the high iodine levels may be due to iodine-containing medications, in particular contrast-agents containing iopamidol. This paper will report on longitudinal studies using contrast agent subjects who where followed-up for almost two years compared to a longitudinal control and a population mean. Based on this study, we suggest that iodine-containing contrast agents contaminate nail samples via non-specific binding in the short term followed by incorporation in the nail as a result of absorption. (author)

  15. Adriamycin nephrosis and contrast media

    International Nuclear Information System (INIS)

    Thomsen, H.S.; Golman, K.; Hemmingsen, L.; Larsen, S.; Skaarup, P.; Koebenhavns Amts Sygehus, Herlev; Koebenhavns Amts Sygehus, Herlev; Centralsygehuset, Nykoebing Falster; Malmoe Allmaenna Sjukhus

    1990-01-01

    Urine profiles (albumin, glucose, NAG, LDH, GGT and sodium) were followed for 9 days after intravenous injection of either diatrizoate, iohexol, or saline in 27 Wistar rats with nephrosis induced by Adriamycin 42 days before. Another 9 rats exposed to neither Adriamycin nor contrast media served as controls. None of the contrast media caused further increased albuminuria of significance, whereas both induced significantly increased excretion of all 5 tubular components. The excretion of NAG and sodium was significantly higher following diatrizoate than following iohexol. From 24 h post injection there was no significantly greater excretion of any of the components after either diatrizoate or iohexol than after saline among the rats given Adriamycin. At the end of day 9 after contrast medium injection neither serum sodium, potassium, glucose, urea, creatinine, nor albumin revealed any contrast media related changes. Kidney histology showed quantitatively larger lesions in kidneys exposed to Adriamycin and contrast media than in kidneys exposed to Adriamycin and saline. There were no differences between the two contrast media groups. It is thus concluded, that both high osmolar ionic and low osmolar non-ionic contrast media cause temporary tubular dysfunction but no further glomerular dysfunction in rats with nephrosis induced by Adriamycin. The histologic findings indicate that both media may worsen non-reversible renal lesions. (orig.)

  16. Potential dependent superiority of gold nanoparticles in comparison to iodinated contrast agents

    International Nuclear Information System (INIS)

    Jackson, Price A.; Rahman, Wan Nordiana W. Abd.; Wong, Christopher J.; Ackerly, Trevor; Geso, Moshi

    2010-01-01

    Purpose: To identify the benefits in image contrast enhancement using gold nanoparticles (AuNPs) compared to conventional iodinated contrast media. Materials and methods: Gold nanoparticles and iodinated contrast media were evaluated for contrast enhancement at various X-ray tube potentials in an imaging phantom. Iopromide and AuNP suspension were equalized according to molar concentration of radiopaque element (0.5077 Mol/L). Contrast-to-noise ratio is used to quantify contrast enhancement. Both projectional radiographic (40-80 kVp) and computed tomography (CT) (80-140kVp) imaging modalities were examined. Results and conclusions: Findings indicate 89% improvement in CNR at low energies near the mammographic range (40 kVp). However, as expected no significant difference in enhancement was observed at potentials commonly used for angiography (around 80 kVp) probably due to the k-edge influence for iodine. At the highest energies typically available in computed tomography, significant improvement in contrast enhancement using gold nanoparticles is obtained, 114% greater CNR than that produced by iodine at 140 kVp. Experimental findings for 70-120 kVp spectra correlate well with the theoretical calculations based on linear attenuation coefficients. Superior attenuation of gold nanoparticles at low and high kVp potentials support their further (pre)clinical evaluation.

  17. X-ray fluorescence camera for imaging of iodine media in vivo.

    Science.gov (United States)

    Matsukiyo, Hiroshi; Watanabe, Manabu; Sato, Eiichi; Osawa, Akihiro; Enomoto, Toshiyuki; Nagao, Jiro; Abderyim, Purkhet; Aizawa, Katsuo; Tanaka, Etsuro; Mori, Hidezo; Kawai, Toshiaki; Ehara, Shigeru; Sato, Shigehiro; Ogawa, Akira; Onagawa, Jun

    2009-01-01

    X-ray fluorescence (XRF) analysis is useful for measuring density distributions of contrast media in vivo. An XRF camera was developed for carrying out mapping for iodine-based contrast media used in medical angiography. Objects are exposed by an X-ray beam from a cerium target. Cerium K-series X-rays are absorbed effectively by iodine media in objects, and iodine fluorescence is produced from the objects. Next, iodine Kalpha fluorescence is selected out by use of a 58-microm-thick stannum filter and is detected by a cadmium telluride (CdTe) detector. The Kalpha rays are discriminated out by a multichannel analyzer, and the number of photons is counted by a counter card. The objects are moved and scanned by an x-y stage in conjunction with a two-stage controller, and X-ray images obtained by iodine mapping are shown on a personal computer monitor. The scan pitch of the x and y axes was 2.5 mm, and the photon counting time per mapping point was 2.0 s. We carried out iodine mapping of non-living animals (phantoms), and iodine Kalpha fluorescence was produced from weakly remaining iodine elements in a rabbit skin cancer.

  18. Clinical survey on adverse reaction of contrast media, final report

    International Nuclear Information System (INIS)

    Katayama, Hitoshi; Ishida, Osamu; Osawa, Tadashi

    1988-01-01

    This report is a final analysis of adverse reactions to iodinated contrast media examined in 33,440 patients from 11 hospitals during the period from October 1983 through June 1986. Adverse reactions, such as nausea, exanthema and vomiting, to contrast media occurred in 2,523 patients (7.5 %), with the higher number occuring in patients aged 40 - 60, irrespective of sex. There were no significant alternations in vital signs. Patients positive for pretesting and having a history of allergy had higher incidences of adverse reactions (48 % and 52 %, respectively). A history of allergy is the most potential predictor for adverse reactions to contrast media. There was no definitive correlation between prior medication of contrast media and the occurrence of their adverse reactions. The relationship between the occurrence of adverse reactions and both kinds and dosage of contrast media was unknown. (Namekawa, K.)

  19. Risk Stratification of iodine-induced thyrotoxicosis before contrast agent application

    International Nuclear Information System (INIS)

    Fricke, E.

    2004-01-01

    Today, examinations using iodine containing contrast media are rather frequent. Even though in modern contrast agents the content of free iodine is low, in vivo deiodination results in a non physiologic high iodine load of the thyroid gland. Whilst in normal thyroid tissue iodine metabolism and hormone production are self-regulating in spite of the variable iodine load, those mechanisms are disturbed in autonomous thyroid tissue. Clinical studies displayed low risk of iodine induced thyrotoxicosis after application of contrast agent. Nonetheless the clinician has to assess the risk of thyrotoxicosis for each individual patient and he has to decide how to cope with this risk. Thyroid scintigraphy using Tc-99m-pertechnetate with quantitative measurement of the thyroidal uptake (TcTU) has been shown to be a useful tool in this question, especially when performed under suppression of the non-autonomous tissue (TcTUs). In particular patients with pre-existing suppression of the TSH secretion should be selected for this investigation. Also at risk are elderly persons and those with diffuse or nodular goitres. In spite of the high frequency of contrast agent applications, data on scintigraphy for risk evaluation of thyrotoxicosis and on efficacy of prophylactic medication are scarce. Based on own results and on a review of literature, the risk of thyrotoxicosis seems to be negligible in patients with a TcTUs of less than 1% even in case of preexistent latent hyperthyroidism. If a suppressed TSH level is known and TcTUs is higher than 1%, prophylactic medication should be given. There is evidence for a combination therapy inhibiting both iodine uptake and metabolism, i.e. with perchlorate and thiamazole, being more efficient than monotherapy, particularly in patients with high risk of thyrotoxicosis. (orig.)

  20. Risk Stratification of iodine-induced thyrotoxicosis before contrast agent application; Prognosebeurteilung bei geplanter Kontrastmittelexposition

    Energy Technology Data Exchange (ETDEWEB)

    Fricke, E. [Inst. fuer Molekulare Biophysik, Radiochemie und Nuklearmedizin, Herz- und Diabeteszentrum, Nordrheinwestfalen, Bad Oeynhausen (Germany)

    2004-06-01

    Today, examinations using iodine containing contrast media are rather frequent. Even though in modern contrast agents the content of free iodine is low, in vivo deiodination results in a non physiologic high iodine load of the thyroid gland. Whilst in normal thyroid tissue iodine metabolism and hormone production are self-regulating in spite of the variable iodine load, those mechanisms are disturbed in autonomous thyroid tissue. Clinical studies displayed low risk of iodine induced thyrotoxicosis after application of contrast agent. Nonetheless the clinician has to assess the risk of thyrotoxicosis for each individual patient and he has to decide how to cope with this risk. Thyroid scintigraphy using Tc-99m-pertechnetate with quantitative measurement of the thyroidal uptake (TcTU) has been shown to be a useful tool in this question, especially when performed under suppression of the non-autonomous tissue (TcTUs). In particular patients with pre-existing suppression of the TSH secretion should be selected for this investigation. Also at risk are elderly persons and those with diffuse or nodular goitres. In spite of the high frequency of contrast agent applications, data on scintigraphy for risk evaluation of thyrotoxicosis and on efficacy of prophylactic medication are scarce. Based on own results and on a review of literature, the risk of thyrotoxicosis seems to be negligible in patients with a TcTUs of less than 1% even in case of preexistent latent hyperthyroidism. If a suppressed TSH level is known and TcTUs is higher than 1%, prophylactic medication should be given. There is evidence for a combination therapy inhibiting both iodine uptake and metabolism, i.e. with perchlorate and thiamazole, being more efficient than monotherapy, particularly in patients with high risk of thyrotoxicosis. (orig.)

  1. RCR audit of compliance with UK guidelines for the prevention and detection of acute kidney injury in adult patients undergoing iodinated contrast media injections for CT.

    Science.gov (United States)

    Cope, L H; Drinkwater, K J; Howlett, D C

    2017-12-01

    To determine radiology departmental compliance with current UK guidance on contrast-induced acute kidney injury (CI-AKI) and to provide data on the incidence of clinically significant post-contrast AKI (PC-AKI) in computed tomography (CT) practice. A questionnaire was sent to all UK acute National Health Service (NHS) providers (NHS boards in Scotland, local health boards in Wales, NHS trusts in England and health and social care trusts in Northern Ireland) to assess compliance of provider protocols with current UK guidelines for the prevention, recognition, and management of CI-AKI. Audit data were collected for 40 consecutive fit outpatients and 40 consecutive acutely unwell patients/inpatients from hospitals within each participating provider to assess clinical compliance. Eighty-nine of 172 (52%) health service providers responded, and data on 7,159 contrast-enhanced CT examinations were provided. Compliance with guidelines was poor with wide variation in clinical practice. The observed incidence of clinically significant (requiring treatment or resulting in death) PC-AKI was zero in 3,590 outpatients, although two patients developed AKI due to other causes (sepsis and progressive malignancy). Fourteen out of 3,569 (0.4%) patients in the inpatient group developed clinically significant PC-AKI, and a further 17 patients were identified who met the Kidney Disease Improving Global Outcomes (KDIGO) definition of AKI (Electronic Supplementary Material Appendix S1), but did not require active treatment, giving an overall incidence of AKI of 0.9%. In patients at high risk due to impaired renal function prior to the scan, there was no difference in the median serum creatinine (SCr) before and after contrast medium administration in either group. Health service provider protocols and clinical practice demonstrate poor compliance with current UK guidance on CI-AKI. A very low incidence of PC- AKI was demonstrated. Copyright © 2017 The Royal College of Radiologists

  2. Ionic versus nonionic contrast media

    International Nuclear Information System (INIS)

    Zylak, C.J.; Gafni, A.

    1988-01-01

    The efficacy and effectiveness of the nonionic contrast media have been established. Widespread usage has been hampered because of the approximate tenfold increase in cost compared with the ionic media. An economic evaluation considering costs and consequences of both interventions (ionic vs nonionic contrast media) was performed; it is a cost effectiveness (CEA) and a cost-benefit analysis (CBA) for the Canadian experience. The results of the CEA demonstrate a value per life-year saved within an acceptable range when compared with value for quality-adjusted life years for programs such as treatment of severe (diastolic≥ 105 mm Hg) and mild (diastolic 95-104 mm Hg) hypertension in men aged 40. The CBA showed a net cost to society when benefits were measured as future treatment costs saved plus productivity gained. However, if people are willing to pay a small amount for the comfort of the new intervention, this will result in a break-even situation

  3. Intravenous digital subtraction angiography contrast media time-concentration curves

    International Nuclear Information System (INIS)

    Burbank, F.H.; Brody, W.R.

    1985-01-01

    At any specified radiation dose and system signal-to-noise ratio, temporal (masked-mode) intravenous digital subtraction angiography (IV-DSA) image quality is dependent upon the shape of the arterial time-concentration curve produced by the intravenous injection of iodinated contrast media. If contrast media appears in the arterial circulation as a compact bolus and reaches a high peak, images containing low or no iodine (the mask image or images) and high iodine concentration (the enhanced image or images) can be obtained close together in time, maximizing contrast media enhancement and minimizing the potential for spatial movement (misregistration). However, if the contrast media bolus is broad, rising slowly to a low concentration peak, sufficient time may pass for movement to occur and the opacification difference between the mask image and the enhanced image may be too small to visualize vessels of interest. Consequently, knowledge of the rules which govern the formation of time-concentration curves is central to IV-DSA

  4. Radiographic contrast media, function and future reassessed

    International Nuclear Information System (INIS)

    Sovak, M.

    1988-01-01

    A brief review is given of the use of radiographic contrast media in cholecysto- and cholangiography, central nervous system imaging, urography and angiography. Other aspects briefly discussed are the use of large i.v. doses of contrast media for CT contrast enhancement and the design theory for improved water soluble contrast media. (U.K.)

  5. Liver imaging with MDCT and high concentration contrast media

    International Nuclear Information System (INIS)

    Spielmann, Audrey L.

    2003-01-01

    Liver imaging has advanced greatly over the last 10 years with helical CT capability and more recently the addition of multidetector-row CT (MDCT). Multidetector CT technology facilitates imaging at faster speeds with improved image quality and less breathing artifact [Abdom. Imaging 25 (2000) 643]. Exquisite three-dimensional data sets can be obtained with thin collimation providing improved lesion detection, multiplanar imaging, and the ability to perform CT angiography of the liver and mesenteric vessels. New challenges arise with this advance in technology including safety considerations. The radiation dose to the patient has increased with MDCT and this is compounded by the ability to perform multi-phase liver imaging. Furthermore, issues of contrast media administration require reconsideration including optimal timing and rate of administration, the total volume of contrast needed and the ideal iodine concentration of the contrast media. Recently, the use of high concentration contrast media (HCCM) has been explored and study results to date will be reviewed

  6. Effect of X-ray Contrast Media, Chlorination, and Chloramination on Zebrafish Development

    Science.gov (United States)

    Effect of X-ray Contrast Media, Chlorination, and Chloramination on Zebrafish Development Little is known about the vertebrate developmental toxicity of chlorinated or chloraminated drinking water (DW), iodinated X-ray contrast media (ICM, a common contaminate of DW) or how the c...

  7. Acute Kidney Injury by Radiographic Contrast Media: Pathogenesis and Prevention

    Science.gov (United States)

    Faga, Teresa; Pisani, Antonio; Michael, Ashour

    2014-01-01

    It is well known that iodinated radiographic contrast media may cause kidney dysfunction, particularly in patients with preexisting renal impairment associated with diabetes. This dysfunction, when severe, will cause acute renal failure (ARF). We may define contrast-induced Acute Kidney Injury (AKI) as ARF occurring within 24–72 hrs after the intravascular injection of iodinated radiographic contrast media that cannot be attributed to other causes. The mechanisms underlying contrast media nephrotoxicity have not been fully elucidated and may be due to several factors, including renal ischaemia, particularly in the renal medulla, the formation of reactive oxygen species (ROS), reduction of nitric oxide (NO) production, and tubular epithelial and vascular endothelial injury. However, contrast-induced AKI can be prevented, but in order to do so, we need to know the risk factors. We have reviewed the risk factors for contrast-induced AKI and measures for its prevention, providing a long list of references enabling readers to deeply evaluate them both. PMID:25197639

  8. Viscosity of iodinated contrast agents during renal excretion

    International Nuclear Information System (INIS)

    Jost, Gregor; Lengsfeld, Philipp; Lenhard, Diana C.; Pietsch, Hubertus; Huetter, Joachim; Sieber, Martin A.

    2011-01-01

    Objective: Modern iodinated non-ionic contrast agents (CAs) can be classified based on their molecular structure into monomeric and dimeric CAs and have at comparable iodine concentrations a different viscosity and osmolality. During their renal excretion, CAs are concentrated in the renal tubuli which might enhance the viscosity difference between monomeric and dimeric CAs. The viscosity of a CA might have an underestimated importance for renal safety, as suggested by recent publications. In this study, we investigated the viscosities of CAs at the concentrations expected to be present in renal tubules. This concentration process was simulated in vitro using dialysis. Furthermore, we investigated urine viscosity and urine flow in rodents after administration of several non-ionic monomeric and dimeric CAs. Materials and methods: To estimate the viscosity of the CAs in vivo, we performed an in vitro dialysis of monomeric and dimeric CAs at various physiological osmolalities of the renal tubulus (290, 400, 500, 700 and 1000 mOsm/kg H 2 O). Following the dialysis, the iodine concentrations and the viscosities of the CAs were determined. Furthermore, to investigate the concentration process in vivo, we measured the urine viscosity and the urine flow in Han Wister rats after the administration of Iopromide, Iohexol, Ioversol, Iomeprol, Iodixanol, and Iosimenol at comparable iodine concentrations. As a control, saline was injected at the same volume. Results: In vitro dialysis of the dimeric CA increased the iodine concentration and strongly increased the viscosity at all tested osmolalities. In contrast, for the monomeric agents an increase in concentration and viscosity was observed only at 700 as well 1000 mOsm/kg H 2 O but to a lesser extent. In summary, dialysis strongly enhanced the viscosity differences between the non-ionic monomeric and dimeric CAs. The administration of dimeric CAs leads to a strong increase in urine viscosity; this was not observed for the

  9. Viscosity of iodinated contrast agents during renal excretion

    Energy Technology Data Exchange (ETDEWEB)

    Jost, Gregor, E-mail: Gregor.Jost@bayer.com [TRG Diagnostic Imaging, Bayer Schering Pharma AG, Berlin (Germany); Lengsfeld, Philipp, E-mail: Philipp.Lengsfeld@bayer.com [Global Medical Affairs Diagnostic Imaging, Bayer Schering Pharma AG, Berlin (Germany); Lenhard, Diana C., E-mail: Diana.Lenhard@bayer.com [TRG Diagnostic Imaging, Bayer Schering Pharma AG, Berlin (Germany); Pietsch, Hubertus, E-mail: Hubertus.Pietsch@bayer.com [TRG Diagnostic Imaging, Bayer Schering Pharma AG, Berlin (Germany); Huetter, Joachim, E-mail: Joachim.Huetter@bayer.com [TRG Diagnostic Imaging, Bayer Schering Pharma AG, Berlin (Germany); Sieber, Martin A., E-mail: Martin.Sieber@bayer.com [TRG Diagnostic Imaging, Bayer Schering Pharma AG, Berlin (Germany)

    2011-11-15

    Objective: Modern iodinated non-ionic contrast agents (CAs) can be classified based on their molecular structure into monomeric and dimeric CAs and have at comparable iodine concentrations a different viscosity and osmolality. During their renal excretion, CAs are concentrated in the renal tubuli which might enhance the viscosity difference between monomeric and dimeric CAs. The viscosity of a CA might have an underestimated importance for renal safety, as suggested by recent publications. In this study, we investigated the viscosities of CAs at the concentrations expected to be present in renal tubules. This concentration process was simulated in vitro using dialysis. Furthermore, we investigated urine viscosity and urine flow in rodents after administration of several non-ionic monomeric and dimeric CAs. Materials and methods: To estimate the viscosity of the CAs in vivo, we performed an in vitro dialysis of monomeric and dimeric CAs at various physiological osmolalities of the renal tubulus (290, 400, 500, 700 and 1000 mOsm/kg H{sub 2}O). Following the dialysis, the iodine concentrations and the viscosities of the CAs were determined. Furthermore, to investigate the concentration process in vivo, we measured the urine viscosity and the urine flow in Han Wister rats after the administration of Iopromide, Iohexol, Ioversol, Iomeprol, Iodixanol, and Iosimenol at comparable iodine concentrations. As a control, saline was injected at the same volume. Results: In vitro dialysis of the dimeric CA increased the iodine concentration and strongly increased the viscosity at all tested osmolalities. In contrast, for the monomeric agents an increase in concentration and viscosity was observed only at 700 as well 1000 mOsm/kg H{sub 2}O but to a lesser extent. In summary, dialysis strongly enhanced the viscosity differences between the non-ionic monomeric and dimeric CAs. The administration of dimeric CAs leads to a strong increase in urine viscosity; this was not observed for

  10. Evaluation of contrast media submitted to ionizing radiation

    International Nuclear Information System (INIS)

    Pinho, Katia Elisa Prus; Gewehr, Pedro Miguel; Soboll, Danyel Scheidegger; Silva, Caroline Werner Pereira da; Barison, Andersson; Tilly Junior, Joao Gilberto

    2009-01-01

    Objective: the purpose of the present study was to investigate the influence of ionizing radiation from x-rays and gamma rays on the molecular structure stability of several radiologic contrast media employed in diagnostic imaging by means of 1 H and 1 3C nuclear magnetic resonance spectroscopy. Materials and methods: eight different types of iodinated contrast media (three ionic and five non-ionic) were exposed to x-rays and gamma rays irradiation. Subsequently, the 1 H and 1 3C{ 1 H} nuclear magnetic resonance spectra of these contrast media were collected. Results: the 1 H and 1 3C{ 1 H} nuclear magnetic resonance spectra of both ionic and non-ionic contrast media irradiated by x-rays or gamma rays demonstrated the absence of any alteration of the contrast media chemical composition. Conclusion: there is no problem in keeping contrast media inside examination rooms or close to radiological equipment. It is important to mention that, during the tests, the samples were directly irradiated, while in a radiology examination room, the irradiation is not direct and, therefore, radiation levels in these cases are much lower than those employed in the present study. (author)

  11. Radiographic, MR or ultrasound contrast media in pregnant or breast-feeding women. What are the key issues?

    International Nuclear Information System (INIS)

    Froehlich, J.M.; Kubik-Huch, Rahel A.

    2013-01-01

    The use and the safety of radiographic, MR- or ultrasound contrast media in the diagnostic work-up of pregnant or lactating patients is a frequently discussed question. As only sparse clinical data is available, a careful benefit-risk assessment must contain physico-chemical properties, preclinical data including teratogeneity and embryotoxicity, as well as maternal and foetal exposure. With consideration to the individual risks, iodinated contrast media, macrocyclic MR contrast media with increased stability or sulphur hexafluoride ultrasound contrast media may, if clinically justified, be administered in the smallest possible doses throughout pregnancy. After parental administration of an iodinated contrast medium after the 12th week of pregnancy, the neonate's thyroidal function should be checked during the first week after birth. After parental administration of iodinated, stable macrocyclic, gadolinium or ultrasound contrast media, lactation can be continued normally. In any case, contrast media should be used with caution and only if the benefits outweigh the risk. (orig.)

  12. Combined use of contrast media containing iodine and gadolinium for imaging and intervention. A hitherto widely ignored topic in radiological practice; Kombinierter zeitnaher Einsatz jod- und gadoliniumhaltiger Kontrastmittel in der diagnostischen und interventionellen Radiologie. Ein bisher vernachlaessigtes Kapitel der radiologischen Praxis

    Energy Technology Data Exchange (ETDEWEB)

    Golder, W.

    2012-02-15

    The synchronous use of chemically different contrast media in the same body compartment is a challenge for the radiologist, whether it is scheduled or unexpected. However, to inject contrast media containing iodine and gadolinium at the same time can be a prerequisite for the examination of several organs or organ systems. Unlike other topics of contrast-enhanced imaging procedures, the difficulties encountered with double contrast injections have been widely ignored in the literature. In the absence of reliable data from experimental and clinical studies the radiologist is dependent on case reports, information provided by the contrast media manufacturers, personal communications, mostly scanty personal experiences and a skilful time management, in order to overcome the situation. Only the combination of X-ray, computed tomography and magnetic resonance arthrography can be performed without another thought. However, the more or less synchronous vascular application of contrast media containing iodine and gadolinium requires vigilance. The more seriously ill the patient is, the more caution is advised even if the decision on the combined administration has to be reached urgently. The following overview gives a description of the properties of contrast media containing iodine and gadolinium as far as interactions following simultaneous administration are concerned. Subsequently, the clinically relevant situations and constellations are outlined and analyzed. (orig.) [German] Die kombinierte Gabe zweier chemisch verschiedener Kontrastmittel stellt fuer den Radiologen eine Herausforderung dar. Der mehr oder weniger zeitgleiche Einsatz jod- und gadoliniumhaltiger Kontrastmittel kann sowohl geplant sein als auch bei der Untersuchung einer Reihe von Organen/Organsystemen unvorhergesehen notwendig werden. Im Gegensatz zu anderen Themen der kontrastverstaerkten Diagnostik ist dem Problem der Doppelinjektion in der Literatur bisher wenig Aufmerksamkeit geschenkt worden

  13. Interference of medical contrast media on laboratory testing.

    Science.gov (United States)

    Lippi, Giuseppe; Daves, Massimo; Mattiuzzi, Camilla

    2014-01-01

    The use of contrast media such as organic iodine molecules and gadolinium contrast agents is commonplace in diagnostic imaging. Although there is widespread perception that side effects and drug interactions may be the leading problems caused by these compounds, various degrees of interference with some laboratory tests have been clearly demonstrated. Overall, the described interference for iodinate contrast media include inappropriate gel barrier formation in blood tubes, the appearance of abnormal peaks in capillary zone electrophoresis of serum proteins, and a positive bias in assessment of cardiac troponin I with one immunoassay. The interference for gadolinium contrast agents include negative bias in calcium assessment with ortho-cresolphthalein colorimetric assays and occasional positive bias using some Arsenazo reagents, negative bias in measurement of angiotensin converting enzyme (ACE) and zinc (colorimetric assay), as well as positive bias in creatinine (Jaffe reaction), total iron binding capacity (TIBC, ferrozine method), magnesium (calmagite reagent) and selenium (mass spectrometry) measurement. Interference has also been reported in assessment of serum indices, pulse oximetry and methaemoglobin in samples of patients receiving Patent Blue V. Under several circumstances the interference was absent from manufacturer-supplied information and limited to certain type of reagents and/or analytes, so that local verification may be advisable to establish whether or not the test in use may be biased. Since the elimination half-life of these compounds is typically lower than 2 h, blood collection after this period may be a safer alternative in patients who have received contrast media for diagnostic purposes.

  14. Preclinical Studies of a Kidney Safe Iodinated Contrast Agent.

    Science.gov (United States)

    Rowe, Elizabeth S; Rowe, Vernon D; Biswas, Sangita; Mosher, Gerold; Insisienmay, Lovella; Ozias, Marlies K; Gralinski, Michael R; Hunter, John; Barnett, James S

    2016-09-01

    Contrast-induced acute kidney injury (CI-AKI) is a serious complication of the use of iodinated contrast agents. This problem is particularly acute in interventional neurology and interventional cardiology, probably due to the intra-arterial route of injection, high contrast volumes, and preexisting risk factors of these patients. In an attempt to develop a contrast agent that is less damaging to the kidneys, we have studied the effects of adding a small amount of the substituted cyclodextrin, sulfobutyl-ether-β-cyclodextrin (SBECD), to iohexol in rodent models of renal toxicity. Renally compromised mice and rats were injected with iohexol and iohexol-SBECD via the tail vein. The renal pathology, creatinine clearance, and survival benefits of iohexol-SBECD were studied. The safety of direct intra-arterial injection of the iohexol-SBECD formulation was studied in a dog heart model system. Mechanism of action studies in cell culture model using a human kidney cell line was performed using flow cytometry. Nephrotoxicity was significantly reduced using iohexol-SBECD compared to iohexol alone, at mole ratios of iohexol:SBECD of 1:0.025. SBECD increased survival from 50% to 88% in a rat survival study. In the dog heart model, iohexol-SBECD was safe. Cell culture studies suggest that SBECD interferes with the early stages of contrast-induced apoptosis in a human renal cell line. We have shown that the addition of a small amount of SBECD (one molecule of SBECD per 40 iohexol molecules) significantly protects rodent kidneys from CI-AKI. Further development of this new formulation of iodinated contrast is warranted. © 2016 The Authors. Journal of Neuroimaging published by Wiley Periodicals, Inc. on behalf of American Society of Neuroimaging.

  15. Nephropathy after administration of iso-osmolar and low-osmolar contrast media

    DEFF Research Database (Denmark)

    Biondi-Zoccai, Giuseppe; Lotrionte, Marzia; Thomsen, Henrik S

    2014-01-01

    BACKGROUND/OBJECTIVES: Contrast-induced nephropathy (CIN) may be a severe complication to the administration of iodine-based contrast media for diagnostic or interventional procedure using radiation exposure. Whether there is a difference in nephrotoxic potential between the various agents...... is uncertain. We aimed to perform a systematic review and network meta-analysis of randomized trials on iodine-based contrast agents. METHODS: Randomized trials of low-osmolar or iso-osmolar contrast media were searched in CENTRAL, Google Scholar, MEDLINE/PubMed, and Scopus. Risk of CIN was appraised within...... a hierarchical Bayesian model computing absolute rates (AR) and odds ratios (OR) with 95% credibility intervals, and probability of being best (Pbest) for each agent. RESULTS: A total of 42 trials (10048 patients) were included focusing on 7 different iodine-based contrast media. Risk of CIN was similarly low...

  16. Contrast media. Safety issues and ESUR guidelines. 2. rev. ed.

    Energy Technology Data Exchange (ETDEWEB)

    Thomsen, Henrik S. [Copenhagen University Hospital, Herlev (Denmark). Dept. of Diagnostic Radiology; Copenhagen Univ., Herlev (Denmark). Dept. of Diagnostic Sciences; Webb, Judith A.W. (eds.) [St. Bartholomew' s Hospital London Univ. (United Kingdom). Dept. of Radiology

    2009-07-01

    In 1994 the European Society of Urogenital Radiology (ESUR) set up a committee to consider the safety of contrast media used for diagnostic imaging. Subsequently the committee questioned members, reviewed the literature, proposed guidelines and discussed these proposals with participants at the annual symposia of the society. The end result of this work was the successful first edition of this book, published in 2006. This second edition not only updates the previous edition, but also contains some completely new chapters, for example on gadolinium-based contrast agents, meta-analyses in contrast media research and various regulatory issues. Comprehensive consideration is given to the many different safety issues relating to iodinated, MR, ultrasound and barium contrast media. The text includes chapters on both acute and delayed non-renal adverse reactions and on renal adverse reactions. All those questions frequently raised in radiological practice are addressed, and the well-known ESUR guidelines on contrast media are included. This book, presented in a handy, easy to use format, provides an invaluable, unique and unparalleled source of information on the safety issues relating to contrast media. (orig.)

  17. Contrast media. Safety issues and ESUR guidelines. 2. rev. ed.

    International Nuclear Information System (INIS)

    Thomsen, Henrik S.; Copenhagen Univ., Herlev; Webb, Judith A.W.

    2009-01-01

    In 1994 the European Society of Urogenital Radiology (ESUR) set up a committee to consider the safety of contrast media used for diagnostic imaging. Subsequently the committee questioned members, reviewed the literature, proposed guidelines and discussed these proposals with participants at the annual symposia of the society. The end result of this work was the successful first edition of this book, published in 2006. This second edition not only updates the previous edition, but also contains some completely new chapters, for example on gadolinium-based contrast agents, meta-analyses in contrast media research and various regulatory issues. Comprehensive consideration is given to the many different safety issues relating to iodinated, MR, ultrasound and barium contrast media. The text includes chapters on both acute and delayed non-renal adverse reactions and on renal adverse reactions. All those questions frequently raised in radiological practice are addressed, and the well-known ESUR guidelines on contrast media are included. This book, presented in a handy, easy to use format, provides an invaluable, unique and unparalleled source of information on the safety issues relating to contrast media. (orig.)

  18. On electrochemical sensor for determining elemental iodine in gas media

    International Nuclear Information System (INIS)

    Goffman, V.G.; Shajmerdinov, B.U.; Kotelkin, I.M.; Mikhajlova, A.M.; Dobrovol'skij, Yu.A.

    1993-01-01

    The possibility to use solid electrolyte cells of Ag, AgI/AgI/Au as sensors for determining concentration of element iodine in gaseous media was studied. Independent character of sensor parameters on oxygen content and radiation burden at different humidity was ascertained

  19. An electrochemical sensor for determining elemental iodine in gas media

    Energy Technology Data Exchange (ETDEWEB)

    Goffman, V.G.; Shaimerdinov, B.U.; Kotelkin, I.M. [Institute of New Chemical Problems, Moscow (Russian Federation)] [and others

    1993-12-01

    The possibility of using solid-electrolyte Ag, AgI/AgI/Au cells as sensors for determining the concentration of elemental iodine in gas media is investigated. It is established that the sensor parameters are independent of oxygen content and radiation dose at different relative humidities.

  20. Effects of radiographic contrast media on the serum complement system

    International Nuclear Information System (INIS)

    Tirone, P.; Boldrini, E.

    1983-01-01

    The authors explored the activation of the complement system produced by a nonionic organic iodine compound, namely iopamidol, which is proposed as a contrast medium for radiographic examination by intravenous and intra-arterial injection. The study was conducted in vitro versus established ionic contrasts (diatrizoate, iothalamate, acetrizoate) and a nonionic compound (metrizamide). The adopted experimental model was the immunohemolytic detector system, in which the immune complex consisted of goat erythrocytes sensitized with the corresponding antibody (hemolysin), and complement (C') was supplied by guinea pig serum. All the products caused complement activation. The results show that nonionic contrast media produce less activation of the complement system than the traditional ionic contrast. Thus the use of nonionic contrast for radiological procedures necessitating the introduction of contrast material into the blood compartment would imply a reduced risk of anaphylactoid reactions. (orig.)

  1. Evaluation of the minimum iodine concentration for contrast-enhanced subtraction mammography

    International Nuclear Information System (INIS)

    Baldelli, P; Bravin, A; Maggio, C Di; Gennaro, G; Sarnelli, A; Taibi, A; Gambaccini, M

    2006-01-01

    Early manifestation of breast cancer is often very subtle and is displayed in a complex and variable pattern of normal anatomy that may obscure the disease. The use of dual-energy techniques, that can remove the structural noise, and contrast media, that enhance the region surrounding the tumour, could help us to improve the detectability of the lesions. The aim of this work is to investigate the use of an iodine-based contrast medium in mammography with two different double exposure techniques: K-edge subtraction mammography and temporal subtraction mammography. Both techniques have been investigated by using an ideal source, like monochromatic beams produced at a synchrotron radiation facility and a clinical digital mammography system. A dedicated three-component phantom containing cavities filled with different iodine concentrations has been developed and used for measurements. For each technique, information about the minimum iodine concentration, which provides a significant enhancement of the detectability of the pathology by minimizing the risk due to high dose and high concentration of contrast medium, has been obtained. In particular, for cavities of 5 and 8 mm in diameter filled with iodine solutions, the minimum concentration needed to obtain a contrast-to-noise ratio of 5 with a mean glandular dose of 2 mGy has been calculated. The minimum concentrations estimated with monochromatic beams and K-edge subtraction mammography are 0.9 mg ml -1 and 1.34 mg ml -1 for the biggest and smallest details, respectively, while for temporal subtraction mammography they are 0.84 mg ml -1 and 1.31 mg ml -1 . With the conventional clinical system the minimum concentrations for the K-edge subtraction mammography are 4.13 mg ml -1 (8 mm diameter) and 5.75 mg ml -1 (5 mm diameter), while for the temporal subtraction mammography they are 1.01 mg ml -1 (8 mm diameter) and 1.57 mg ml -1 (5 mm diameter)

  2. Recent hot topics in contrast media

    DEFF Research Database (Denmark)

    Thomsen, Henrik S

    2011-01-01

    This editorial reviews the way in which the facts related to the safety of iodinated and gadolinium based contrast agents have emerged over the last two decades. This is especially important given their ever increasing usage in modern computed tomographic (CT) and Magnetic resonance imaging (MRI)...

  3. Recent hot topics in contrast media

    DEFF Research Database (Denmark)

    Thomsen, Henrik S

    2011-01-01

    This editorial reviews the way in which the facts related to the safety of iodinated and gadolinium based contrast agents have emerged over the last two decades. This is especially important given their ever increasing usage in modern computed tomographic (CT) and Magnetic resonance imaging (MRI...

  4. Contrast media are helpful in computerized tomography

    International Nuclear Information System (INIS)

    Anon.

    1987-01-01

    Contrast media very often can decisively improve the image contrasts, and thus contribute to making the differential diagnosis more specific. This survey of a symposium on the current status of CT refers particularly to the lectures that discussed the use of contrast media for neuroradiology, and the risks involved. (orig.) [de

  5. Effects of iodinated contrast agent, xylocaine and gadolinium concentration on the signal emitted in magnetic resonance arthrography: a samples study

    Directory of Open Access Journals (Sweden)

    Yvana Lopes Pinheiro da Silva

    2015-04-01

    Full Text Available Objective: To investigate the effects of dilution of paramagnetic contrast agent with iodinated contrast and xylocaine on the signal intensity during magnetic resonance arthrography, and to improve the paramagnetic contrast agent concentration utilized in this imaging modality. Materials and Methods: Samples specially prepared for the study with three different concentrations of paramagnetic contrast agent diluted in saline, iodinated contrast agent and xylocaine were imaged with fast spin echo T1-weighted sequences with fat saturation. The samples were placed into flasks and graphical analysis of the signal intensity was performed as a function of the paramagnetic contrast concentration. Results: As compared with samples of equal concentrations diluted only with saline, the authors have observed an average signal intensity decrease of 20.67% for iodinated contrast agent, and of 28.34% for xylocaine. However, the increased gadolinium concentration in the samples caused decrease in signal intensity with all the dilutions. Conclusion: Minimizing the use of iodinated contrast media and xylocaine and/or the use of a gadolinium concentration of 2.5 mmol/L diluted in saline will improve the sensitivity of magnetic resonance arthrography.

  6. Formation of potential antigens from radiographic contrast media

    International Nuclear Information System (INIS)

    Nilsson, R.; Ehrenberg, L.; Fedorcsak, I.

    1987-01-01

    The use of radiographic contrast media is occasionally accompanied by more or less serious adverse effects, evidently of complex etiology, following intravascular administration. Some of these reactions are suspected of having an allergic basis. The in vitro and in vivo formation of iodinated serum proteins following gamma irradiation in the presence of two commonly used radiographic contrast media is demonstrated. Non-toxic concentrations of ascorbate present during the irradiation is shown to prevent the formation of such iodo-proteins in vitro as well as in vivo. The amounts of potentially antigenic iodoprotein formed during radiographic procedures will certainly be very small, but this quantity may be sufficient to elicit a hypersensitivity reaction in cases when an individual has been previously sensitized to immunologically similar iodo-proteins, a mechanism that could account for certain rare and unpredictable reations. The radiation induced formation of iodo-proteins may also serve as a model for the formation of iodine containing antigens mediated by a free radical mechanism, i.e. in the metabolism of iodinated compounds like erythrosine, a widely used colouring agent for certain foods. (orig.)

  7. A case report on a severe anaphylaxis reaction to Gadolinium-based MR contrast media

    Energy Technology Data Exchange (ETDEWEB)

    Park, Juil; Kim, Tae Hyung; Park, Chang Min; Yoon, Soon Ho; Lee, Whal; Kang, Hye Ryun; Choi, Young Hun [Seoul National University Hospital, Seoul (Korea, Republic of)

    2017-02-15

    Acute hypersensitivity reactions to gadolinium-based magnetic resonance (MR) contrast media have been shown to have a much lower incidence and they are generally milder in terms of severity than acute adverse reactions associated with the use of iodinated contrast media for computed tomography scans. However, even though it is rare, a severe hypersensitivity reaction to MR contrast media can occur. Here we present the case of a 66-year-old woman who experienced a severe hypersensitivity reaction after administration of gadolinium-based contrast media without a previous history of allergies.

  8. Severe reactions to iodinated contrast agents: is anaphylaxis responsible?

    International Nuclear Information System (INIS)

    Dewachter, P.; Mouton-Faivre, C.

    2001-01-01

    The etiology of severe reactions following injection of iodinated contrast agent is the subject of controversy. No consensus has been established regarding the management of patients at risk, risk factors and pre-medication because in most cases published no diagnostic exploration has been carried out on patients who have experienced a severe reaction. Diagnosis of drug anaphylaxis is based on clinical history, proof of mediator release and drug specific IgE antibodies (when the technique is available) or cutaneous tests (when direct technique is not available). This approach has been adopted for etiologic diagnosis of 5 clinical cases of severe anaphylactoid reactions (including one death) following the injection of ionic and non ionic contrast agents. Clinical symptoms, biology and cutaneous tests are consistent with anaphylaxis. Any patient who has had a severe anaphylactoid reaction following injection of a contrast agent should undergo an allergology assessment to confirm the diagnosis and identify the culprit contrast agent. Indeed, no pre-medication has proved efficient for the prevention of subsequent allergic reactions. (author)

  9. In Vivo Differentiation of Complementary Contrast Media at Dual-Energy CT

    Science.gov (United States)

    Mongan, John; Rathnayake, Samira; Fu, Yanjun; Wang, Runtang; Jones, Ella F.; Gao, Dong-Wei

    2012-01-01

    Purpose: To evaluate the feasibility of using a commercially available clinical dual-energy computed tomographic (CT) scanner to differentiate the in vivo enhancement due to two simultaneously administered contrast media with complementary x-ray attenuation ratios. Materials and Methods: Approval from the institutional animal care and use committee was obtained, and National Institutes of Health guidelines for the care and use of laboratory animals were observed. Dual-energy CT was performed in a set of iodine and tungsten solution phantoms and in a rabbit in which iodinated intravenous and bismuth subsalicylate oral contrast media were administered. In addition, a second rabbit was studied after intravenous administration of iodinated and tungsten cluster contrast media. Images were processed to produce virtual monochromatic images that simulated the appearance of conventional single-energy scans, as well as material decomposition images that separate the attenuation due to each contrast medium. Results: Clear separation of each of the contrast media pairs was seen in the phantom and in both in vivo animal models. Separation of bowel lumen from vascular contrast medium allowed visualization of bowel wall enhancement that was obscured by intraluminal bowel contrast medium on conventional CT scans. Separation of two vascular contrast media in different vascular phases enabled acquisition of a perfectly coregistered CT angiogram and venous phase–enhanced CT scan simultaneously in a single examination. Conclusion: Commercially available clinical dual-energy CT scanners can help differentiate the enhancement of selected pairs of complementary contrast media in vivo. © RSNA, 2012 PMID:22778447

  10. Capture of Aerosols by Iodinated Fiber Media

    Science.gov (United States)

    2004-09-15

    fibrous media if provided with 70-80% relative humidity and atmospheric dust (Maus et al., 2000). Spore -forming bacteria such as Bacillus anthracis are...States. The anthrax spores sent out during these attacks were classified as being highly concentrated and processed to be disseminated and inhaled...media, and produce more undesirable bioaerosols. This phenomenon has been reported in many studies in heating, ventilation, and air conditioning ( HVAC

  11. Persistent neurological deficit from iodinated contrast encephalopathy following intracranial aneurysm coiling. A case report and review of the literature.

    LENUS (Irish Health Repository)

    Leong, S

    2012-03-01

    Neurotoxicity from iodinated contrast agents is a known but rare complication of angiography and neurovascular intervention. Neurotoxicity results from contrast penetrating the blood-brain barrier with resultant cerebral oedema and altered neuronal excitability. Clinical effects include encephalopathy, seizures, cortical blindness and focal neurological deficits. Contrast induced encephalopathy is extensively reported as a transient and reversible phenomenon. We describe a patient with a persistent motor deficit due to an encephalopathy from iodinated contrast media administered during cerebral aneurysm coiling. This observation and a review of the literature highlights that contrast-induced encephalopathy may not always have a benign outcome and can cause permanent deficits. This potential harmful effect should be recognised by the angiographer and the interventionalist.

  12. Influence of radiographic contrast media on phagocytosis

    International Nuclear Information System (INIS)

    Rasmussen, F.; Georgsen, J.; Grunnet, N.; Aalborg Sygehus

    1988-01-01

    To evaluate the influence of radiographic contrast media (CM) on human polymorphonuclear leucocytes (PML), the ability of these cells to ingest latex particles after in vitro exposure to five different radiographic contrast media was investigated. All CM inhibited the phagocytic properties of PML. The inhibition was dose dependent. The inhibitory effect was partly due to hyperosmolality but CM specific inhibition was also evident. (orig.)

  13. Adverse reactions to intravascularly administered contrast media

    International Nuclear Information System (INIS)

    Olin, T.

    1986-01-01

    A hypothesis is formulated about the mechanisms causing adverse reactions to contrast media. Contrast media act in two ways. They stimulate the mast cells to release histamine and leukotrienes, and they inhibit the enzymes which otherwise degrade leukotrienes. Thus individuals, especially those with a history of allergy, are easily exposed to undue amounts of leukotrienes and these are responsible for the adverse reactions. (orig.)

  14. An experimental study on tissue damage following subcutaneous injection of water soluble contrast media

    International Nuclear Information System (INIS)

    Kim, Seung Hyup; Park, Jae Hyung; Kang, Heung Sik; Kim, Chu Wan; Han, Man Chung; Kim, Yong Il

    1989-01-01

    The water soluble contrast media cause tissue necrosis infrequently by extravasation during intravenous injection in various radiological examinations. However, it has not been well documented that what kind and what concentration of contrast media can cause tissue necrosis. And also, the mechanism of tissue necrosis by extravasated contrast media has not been well known. The purpose of this experimental study was to evaluate the frequency and severity of tissue damage following subcutaneous injection of various water soluble contrast media to investigate the characteristics of the contrast media acting on the tissue damage, and to provide the basic data for the clinical application. Meglumine ioxithalamate,sodium and meglumine ioxithalamate, iopromide, iopamidol, ioxaglate,meglumine diatrizoate and sodium diatrizoate of various iodine content and osmolality were injected into subcutaneous tissue of the dorsum of 970 feet of 485 rats. The tissue reaction of injection sites were grossly examined with period from 1 day to 8 weeks after the injection. Representative gross changes were correlated with histologic findings. The results were as follows; 1. The basic tissue damage by extravasated contrast media was acute and chronic inflammatory reaction of the soft tissue with subsequent progress into the hemorrhagic and necrotizing lesion. 2. Lager volume of contrast media caused more severe tissue damage. 3. Contrast media of higher osmolality caused more severe tissue damage. 4. At same osmolality, contrast media of higher iodine content caused more severe tissue damage

  15. Contrast-enhanced voiding urosonography phantom study: intravenous iodinated and gadolinium-based contrast agents may cause false-negative results in assessment of vesicoureteral reflux in children

    International Nuclear Information System (INIS)

    Veldhoen, Simon; Sauer, Alexander; Gassenmaier, Tobias; Petritsch, Bernhard; Herz, Stefan; Blanke, Philipp; Bley, Thorsten A.; Wirth, Clemens; Derlin, Thorsten

    2015-01-01

    Contrast-enhanced voiding urosonography (ce-VUS) is commonly requested simultaneously to other diagnostic imaging necessitating intravenous contrast agents. To date there is limited knowldedge about intravesical interactions between different types of contrast agents. To assess the effect of excreted intravenous iodinated and gadolinium-based contrast agents on the intravesical distribution of ultrasound contrast within contrast-enhanced voiding urosonography. Iodinated (iomeprol, iopamidol) and gadolinium-based (gadoterate meglumine) contrast agents were diluted to bladder concentration and injected into balloons filled with saline solution. CT scans were performed to assess the contrast distribution in these phantoms. Regions of interest were placed at the top and bottom side of each balloon and Hounsfield units (HU) were measured. Three other balloons were filled with saline solution and contrast media likewise. The ultrasound contrast agent sulphur hexafluoride was added and its distribution was assessed using sonography. MDCT scans showed a separation of two liquid layers in all bladder phantoms with the contrast layers located at the bottom and the saline solution at the top. Significant differences of the HU measurements at the top and bottom side were observed (P < 0.001-0.007). Following injection of ultrasound contrast agent, US showed its distribution exclusively among the saline solution. False-negative results of contrast-enhanced voiding urosonography may occur if it is performed shortly after imaging procedures requiring intravenous contrast. (orig.)

  16. Are the nonionic contrast media really safe

    International Nuclear Information System (INIS)

    Seyferth, W.; Zeitler, E.

    1987-01-01

    The authors used a wide variety of ionic and nonionic contrast media in 11,203 patient examinations (angiography, phlebography, CT). Data have been collected in prospective studies since 1982. The rate of mild side effects was reduced by a factor of 2 to 3 for all examinations when nonionic contrast media were used. Angiography may not be suitable for evaluating the safety of contrast media. Because of statistical requirements, the influence of nonionic media on the rate of severe side effects will not be known for some time. The side effects of nonionic contrast media were somewhat delayed, and differed from times reported in the literature: 29% of wide effects were noticed within 15 minutes and 71% between 25 minutes to 72 hours after the study. The final results of the study will have numerous consequences for patient treatment protocols

  17. Apparition of iodinated contrast agents in twin neonatal gastrointestinal tracts after maternal contrast-enhanced computed tomography

    International Nuclear Information System (INIS)

    Kato, Hiroki; Kanematsu, Masayuki; Kato, Zenichiro; Kondo, Naomi; Orii, Kenji E.; Morimoto, Masahiro

    2011-01-01

    We describe a case of the appearance of iodinated contrast agents in the same locations of twins' neonatal gastrointestinal tracts 1 day after maternal contrast-enhanced computed tomography (CT). The CT examination had been performed on the expectant mother for suspected deep venous thrombosis on the day previous to the twin delivery. At 23 h after the CT examination and after cesarean section, iodinated contrast agents appeared in the same place in the twins' neonatal gastrointestinal tracts, mainly in the ascending colon, on plain abdominal radiographs. Radiologists, obstetricians, and pediatricians should understand the mechanism of appearance of iodinated contrast agents in fetal gastrointestinal tracts when the expectant mother had been given iodinated contrast agents intravenously shortly before delivery. (author)

  18. Contrast media osmolality and plasma volume changes

    International Nuclear Information System (INIS)

    Hine, A.L.; Lui, D.; Dawson, P.; Middlesex Hospital, London

    1985-01-01

    A theoretical and experimental study of the plasma volume expansion consequent on the hyperosmolality of contrast media is presented. In the case of the ratio 1.5 media theory and experiment coincide closely but in the case of the ratio 3 media the observed changes exceed the predicted. It is proposed that this is due partly to the slower diffusion of the ratio 3 media out of the intravascular space and partly due to the fact that the osmotic load presented by these media is greater than would be expected from a study of their commercial solutions in which osmolality is reduced by molecular aggregation. The implications for the relative haemodynamic effects of different contrast media are discussed. The osmotic effects of contrast media also play a part in determining the image quality achievable in intravenous digital subtraction angiography (IV-DSA). It is predicted that ratio 3 contrast media will give better quality images in IV-DSA than ratio 1.5 media. (orig.)

  19. Contrast media on abdominal computed tomography

    International Nuclear Information System (INIS)

    Skalpe, I.O.; Oestensen, H.M.

    1984-01-01

    Abdominal computed tomography was performed in 55 patients before and after intravenous injection of 60 ml of a non-ionic (iohexol) or an ionic (metrizoate) contrast medium. The adverse effects were recorded and a series of measurements of attenuation values before and after the contrast medium injection was performed in the aorta and in hepatic and renal parenchyma. Only minor adverse effects were seen with both contrast media, but iohexol was clearly better tolerated than metrizoate. No difference in the enhancement properties was found between the two contrast media. (orig.)

  20. Manganese(II) chelate contrast media

    International Nuclear Information System (INIS)

    Rocklage, S.M.; Quay, S.C.

    1994-01-01

    New chelate forming compounds for use as contrast media in NMR imaging are described. Especially mentioned are manganese(II) ion chelates of N,N' dipyridoxaldiamine, N,N' diacetic acid, and salts and esters thereof. 1 fig

  1. Death following intravascular administration of contrast media

    International Nuclear Information System (INIS)

    Shehadi, W.H.

    1985-01-01

    Adverse reactions to intravascularly administered contrast media preceding death and the autopsy findings in 44 patients are presented. There is a wide scatter of the age distribution of fatal reactions. The highest incidence is in the 50-70 year age group. Similar observations were obtained from the 405 deaths due to contrast media reported to the Food and Drug Administration of the United States. In the same age group the number of reactions is highest, likewise the autopsy findings. The predominant autopsy findings are pulmonary edema, congestion and hemorrhage; arteriosclerosis, both general and coronary. In the younger age group the autopsy findings are limited mostly to the respiratory tract. Fatal reactions to contrast media occur often without warning and most deaths occur within 15 min to 6 hours. Reactions to contrast media occur without relation to sex or age. (orig.)

  2. Contrast timing in computed tomography: Effect of different contrast media concentrations on bolus geometry

    International Nuclear Information System (INIS)

    Mahnken, Andreas H.; Jost, Gregor; Seidensticker, Peter; Kuhl, Christiane; Pietsch, Hubertus

    2012-01-01

    Objective: To assess the effect of low-osmolar, monomeric contrast media with different iodine concentrations on bolus shape in aortic CT angiography. Materials and methods: Repeated sequential computed tomography scanning of the descending aorta of eight beagle dogs (5 male, 12.7 ± 3.1 kg) was performed without table movement with a standardized CT scan protocol. Iopromide 300 (300 mg I/mL), iopromide 370 (370 mg I/mL) and iomeprol 400 (400 mg I/mL) were administered via a foreleg vein with an identical iodine delivery rate of 1.2 g I/s and a total iodine dose of 300 mg I/kg body weight. Time-enhancement curves were computed and analyzed. Results: Iopromide 300 showed the highest peak enhancement (445.2 ± 89.1 HU), steepest up-slope (104.2 ± 17.5 HU/s) and smallest full width at half maximum (FWHM; 5.8 ± 1.0 s). Peak enhancement, duration of FWHM, enhancement at FWHM and up-slope differed significantly between iopromide 300 and iomeprol 400 (p 0.05). Conclusions: Low viscous iopromide 300 results in a better defined bolus with a significantly higher peak enhancement, steeper up-slope and smaller FWHM when compared to iomeprol 400. These characteristics potentially affect contrast timing.

  3. Role of hemolysis in potassium release by iodinated contrast medium

    Energy Technology Data Exchange (ETDEWEB)

    Hayakawa, K.; Nakamura, T.; Shimizu, Y. [Department of Radiology, Kyoto City Hospital (Japan)

    1999-09-01

    It has been demonstrated that an iodinated contrast medium (CM) causes release of potassium into blood vessel lumina, resulting in an increase in serum potassium. The purpose of the present study was to assess whether this potassium release is due to hemolysis. Fresh human blood was mixed in vitro with CM at a ratio of 10:2. Potassium release rates were determined, and serum haptoglobin and free hemoglobin were measured after 30 min of exposure to CM. To compare the potassium release curve between CM exposure and true hemolysis induced by distilled water, fresh human blood was also mixed with distilled water. The level of serum haptoglobin decreased due to hemodilution. Changes in haptoglobin were not correlated with potassium release rates. The serum free hemoglobin level did not increase significantly, and there was no correlation between changes in the free hemoglobin level and the rate of potassium release. Hemolysis caused by water occurred instantaneously, whereas potassium release caused by CM was a slow response, which was linearly correlated with exposure time. Potassium release from blood cannot be explained by hemolysis. (orig.) With 4 figs., 4 tabs., 3 refs.

  4. Are ionic CAT contrast media still justifiable

    International Nuclear Information System (INIS)

    Witt, H.; Trempenau, B.; Dietz, G.

    1984-01-01

    The authors' clinical results revealed no statistically significant differences of tolerance between the two X-ray contrast media 'Ioxitalamat' and 'Ioglicinat'. Side-effects were found in 4.3% of the cases for both contrast media, a rate which is slightly below the one for urography. However, it must not be overlooked that patients exposed to certain risk faktors such as e.g. relative contraindications were as far as possible excluded from the study. (orig./WU) [de

  5. A Complete Resolution of Sialadenitis Induced by Iodine Containing Contrast with Intravenous Dexamethasone Infusion

    OpenAIRE

    Homam Alkaied; Kassem Harris; Basem Azab; Marcel Odaimi

    2012-01-01

    Salivary gland enlargement following the administration of iodine is an extremely rare event, and the pathophysiology of iodine-induced sialadenitis is not yet fully known. The onset of symptoms can start within a few minutes to five days after contrast administration. The course of iodine-induced sialadenitis is extremely benign, and rapid resolution of symptoms is expected without treatment. We report the case of a 59-year-old white female who noted mildly painful swelling involving the rig...

  6. Changes in Renal Function in Elderly Patients Following Intravenous Iodinated Contrast Administration: A Retrospective Study

    International Nuclear Information System (INIS)

    Alsafi, A.; Alsafi, Z.; Lakhani, A.; Strickland, N.H.

    2014-01-01

    Contrast-induced nephropathy (CIN) is a recognised complication of intravascular administration of iodinated contrast media (ICM). Previous studies suggest a higher incidence in the elderly, but no large study has assessed this to date. We set out to assess changes in creatinine in elderly inpatients following computed tomography (CT) examination and compare those who received intravenous contrast to those who did not. Methods. Using the Radiology Information System in two teaching hospitals, inpatients over the age of seventy who had a CT examination and a baseline creatinine were identified and their follow-up creatinine levels were analysed. Elderly inpatients who underwent a non contrast CT over the same period were used as controls. Results. 677 elderly inpatients who received ICM were compared with 487 controls. 9.2% of patients who received ICM developed acute kidney injury (AKI) compared to 3.5% of inpatient controls (Ρ<0.0001). Patients with higher baseline eGFR had a higher incidence of post-CT AKI. Conclusions. The incidence of post-CT AKI is higher in patients who received IV ICM compared to those who did not; the difference may be partly attributable to contrast-induced nephropathy. This suggests that the incidence of CIN in the elderly may not be as high as previously thought.

  7. MDCT angiography of the pulmonary arteries: intravascular contrast enhancement does not depend on iodine concentration when injecting equal amounts of iodine at standardized iodine delivery rates

    International Nuclear Information System (INIS)

    Keil, S.; Plumhans, C.; Behrendt, F.F.; Das, M.; Muehlenbruch, G.; Mahnken, A.H.; Guenther, R.W.; Stanzel, S.; Seidensticker, P.; Knackstedt, C.; Wildberger, J.E.

    2008-01-01

    To compare the impact of iodine concentration using two different contrast materials (CM) at standardized iodine delivery rate (IDR) and overall iodine load in 16-multidetector-row-CT-angiography (MDCTA) of the pulmonary arteries of 192 patients with known or suspected pulmonary embolism. One hundred three patients (group A) received 148 ml of a CM containing 300 mg iodine/ml (Ultravist 300 trademark, BayerScheringPharma) at a flow rate of 4.9 ml/s. Eighty-nine patients (group B) received 120 ml of a CM with a concentration of 370 mg iodine/ml (Ultravist370 trademark) at a flow rate of 4.0 ml/s, resulting in a standardized IDR (∝1.5 gI/s) and the same overall amount of iodine (44.4 g). Both CM injections were followed by a saline chaser. Mean density values were determined in the pulmonary trunk, the ascending and the descending aorta, respectively. Applying repeated-measures ANOVA, no statistically significant differences between both MDCTA protocols were found (p=0.5790): the mean density in the pulmonary trunk was 355±116 Hounsfield Units (group A) and 358±115 (group B). The corresponding values for the ascending and descending aorta were 295±79 (group A) and 284±65 (group B) as well as 272±71 and 262±70. In conclusion, the use of standardized IDR and overall iodine load provides comparable intravascular CM density in pulmonary 16-MDCTA for delivering contrast materials with different iodine concentrations. (orig.)

  8. Comparison of the image quality of intravenous urograms using low-osmolar contrast media

    International Nuclear Information System (INIS)

    Kaye, B.; Howard, J.; Foord, K.D.; Cumberland, D.C.

    1988-01-01

    Almost equivalent, intravenous iodine doses of the three new low-osmolar contrast media, ioxaglate (Hexabrix), iopamidol (Niopam) and iohexol (Omnipaque) have been compared for image quality on the intravenous urogram. Generally good radiographic images were obtained. Iohexol gave better results for the nephrogram and pelvicalyceal distension compared with the other contrast media, but only the nephrogram results were statistically significant. Pyelographic density and ureteric distension and density were similar with all three contrast media. In patients where low-osmolality contrast media need to be used for intravenous urography, we suggest that iohexol gives the best radiographic images. Other factors, such as cost and the relative incidence of side-effects of the low-osmolar contrast media also need to be taken into consideration. (author)

  9. Criteria for choice and use of contrast media in intra-arterial D.S.A

    International Nuclear Information System (INIS)

    Dalla-Palma, L.; Stacul, F.; Pozzi-Mucelli, R.

    1985-01-01

    The authors investigated the optimal characteristics of contrast media for use in intra-arterial DSA. 209 injections in 108 patients were evaluated, most of them in the abdominal and peripheral regions. In order to decrease contrast media osmolarity and obtain an adequate mixing with blood, contrast media with low iodine concentration were injected using the same volumes and flow rates of conventional arteriography. Good results were obtained with ionic contrast media, 100 and 150 mgI/ml. depending on the area investigated. The low concentrations allowed the use of ionic agents with an osmolarity very close to that of the non ionic contrast media: the pain has been eliminated and the heat sensation reduced. Furthermore the comparison with the cost of nonionic agents shows a great saving. (orig.)

  10. A Complete Resolution of Sialadenitis Induced by Iodine Containing Contrast with Intravenous Dexamethasone Infusion

    Directory of Open Access Journals (Sweden)

    Homam Alkaied

    2012-01-01

    Full Text Available Salivary gland enlargement following the administration of iodine is an extremely rare event, and the pathophysiology of iodine-induced sialadenitis is not yet fully known. The onset of symptoms can start within a few minutes to five days after contrast administration. The course of iodine-induced sialadenitis is extremely benign, and rapid resolution of symptoms is expected without treatment. We report the case of a 59-year-old white female who noted mildly painful swelling involving the right side of her face within five days of receiving intravenous iodine-containing contrast. A diagnosis of iodine-related sialadenitis was made. She was given 20 mg of decadron intravenously, with prompt resolution of the swelling within a few hours.

  11. Release of iodine radionuclides from gas media in a system of selective block sorbents

    International Nuclear Information System (INIS)

    Moskvin, L.N.; Miroshnikov, V.S.; Mel'nikov, V.A.; Chetverikov, V.V.

    1979-01-01

    A scheme of extracting iodine radionuclides from gas flows in a system of selective sorbents has been developed. The method provides separation of three forms of iodine: the aerosol component, the elementary iodine and organic-iodine compounds. Aerosols are trapped by a mechanical filter made of porous polytetrafluoroethylene with pores of no more than 1 μm. Silver-based sorbents for the elementary iodine are made by sintering the granular polytetrafluoroethylene (the size of granules is 0.1-0.5 mm) with of finely dispersed solver (5% mass). Organic iodine compounds are extracted by a silica sorbent impregnated with silver nitrate. The efficiency of sorbents was tested in gas flows with a known content of 131 I in the form of elementary iodine and methyl iodide. The results of experiments show that the efficiency of sorption of elementary iodine by a metallic-silver sorbent and of methyl iodide by a SiO 2 /AgNO 3 sorbent constitutes no less than 99% at a flow rate of up to 200 l/h. The iodine has been extracted at a flow rate of 100 l/h during 100 hours and for that time the efficiency of the iodine sorbtion has not changed. The suggested variant of extracting iodine radionuclides from gaseous media can be used both for fast control of iodine content in gas blowoffs and for researches aimed at studying the distribution of iodine forms in steam-and-gas media depending on nuclear plant operating conditions

  12. Comparison of soft tissue effects of conventional ionic, low osmolar ionic and nonionic iodine containing contrast material in experimental animals

    International Nuclear Information System (INIS)

    McAlister, W.H.; Kissane, J.M.

    1990-01-01

    Conventional, low osmolar, and non-ionic iodine containing contrast media and saline controls were placed in the paws, muscles, and subcutaneous tissues of Sprague-Dawley rat thighs. The paw injections were observed and photographed, while the thighs were examined histologically. Results showed that although the low osmolar and non-ionic agents did produce inflammatory reactions and focal necrosis in the soft tissues, they were much better tolerated than were the conventional ionic agents. A non-ionic or low osmolar ionic contrast agent should be strongly considered when a possibility for extravasation exists. (orig.)

  13. Carbon dioxide as a substitute for iodine contrast in arteriography during embolectomy

    Energy Technology Data Exchange (ETDEWEB)

    Wolosker, Nelson; Teivelis, Marcelo Passos; Mendes, Cynthia de Almeida; Nishinari, Kenji; Ribeiro, Mariângela de Freitas; Kuzniec, Sergio [Hospital Israelita Albert Einstein, São Paulo, SP (Brazil)

    2015-07-01

    Acute limb ischemia can be potentially harmful to the limb and life threatening. Renal failure is a possible outcome associated with release of products of ischemic limb reperfusion. Some authors reported the benefit of performing angiography after embolectomy, even though iodine contrast is also nephrotoxic. We report a case of embolectomy on a patient with renal insufficiency in whom carbon dioxide was used as a substitute for iodine contrast.

  14. Stratified premedication strategy for the prevention of contrast media hypersensitivity in high-risk patients.

    Science.gov (United States)

    Lee, Suh-Young; Yang, Min Suk; Choi, Young-Hoon; Park, Chang Min; Park, Heung-Woo; Cho, Sang Heon; Kang, Hye-Ryun

    2017-03-01

    Although the severity of hypersensitivity reactions to iodinated contrast media varies, it is well correlated with the severity of recurrent reactions; however, prophylaxis protocols are not severity-stratified. To assess the outcomes of tailored prophylaxis according to the severity of hypersensitivity reactions to iodinated contrast media. Our premedication protocols were stratified based on the severity of previous reactions: (1) 4 mg of chlorpheniramine for mild reactions, (2) adding 40 mg of methylprednisolone for moderate reactions, and (3) adding multiple doses of 40 mg of methylprednisolone for severe index reactions. Cases of reexposure in patients with a history of hypersensitivity reactions were routinely monitored and mandatorily recorded. Among a total of 850 patients who underwent enhanced computed tomography after severity-tailored prophylaxis, breakthrough reactions occurred in 17.1%, but most breakthrough reactions (89.0%) were mild and did not require medical treatment. Additional corticosteroid use did not reduce the breakthrough reaction rate in cases with a mild index reaction (16.8% vs 17.2%, P = .70). However, underpremedication with a single dose of corticosteroid revealed significantly higher rates of breakthrough reaction than did double doses of corticosteroid in cases with a severe index reaction (55.6% vs 17.4%, P = .02). Changing the iodinated contrast media resulted in an additional reduction of the breakthrough reaction rate overall (14.9% vs 32.1%, P = .001). In a total severity-based stratified prophylaxis regimens and changing iodinated contrast media can be considered in patients with a history of previous hypersensitivity reaction to iodinated contrast media to reduce the risk of breakthrough reactions. Copyright © 2016 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  15. In which patients should serum creatinine be measured before iodinated contrast medium administration?

    International Nuclear Information System (INIS)

    Thomsen, Henrik S.

    2005-01-01

    Routine measurement of serum creatinine before injection of intravascular iodinated contrast material in all patients would be cumbersome and have an associated cost. There is doubt about whether serum creatinine should be measured routinely in all patients or selectively. The Contrast Media Safety Committee of the European Society of Urogenital Radiology decided to review the literature and draw up guidelines on this important practical issue. A literature search was carried out and summarized in a report. Based on the available information and discussions amongst the members of the Committee, guidelines were produced. The report and guidelines were discussed at the 11th European Symposium on Urogenital Radiology in Santiago de Compostela, Spain. The practice for identifying patients at risk of contrast medium induced nephropathy varies considerably from one institution to another. Patients at risk constitute only a small percentage of all cases referred for contrast enhanced imaging examination. However, it is important to identify them and take the necessary precautions. Recent serum creatinine level should be available in patients with an increased probability of a raised serum creatinine level (renal disease, renal surgery, proteinuria, diabetes mellitus, hypertension, gout, current intake of nephrotoxic drugs). A simple guideline has been produced. (orig.)

  16. In which patients should serum creatinine be measured before iodinated contrast medium administration?

    Energy Technology Data Exchange (ETDEWEB)

    Thomsen, Henrik S. [Copenhagen University Hospital, Herlev (Denmark). Department of Diagnostic Radiology; Morcos, Sameh K. [Northern General Hospital, Department of Diagnostic Imaging, Sheffield Teaching Hospitals NHS Trust, Sheffield (United Kingdom)

    2005-04-01

    Routine measurement of serum creatinine before injection of intravascular iodinated contrast material in all patients would be cumbersome and have an associated cost. There is doubt about whether serum creatinine should be measured routinely in all patients or selectively. The Contrast Media Safety Committee of the European Society of Urogenital Radiology decided to review the literature and draw up guidelines on this important practical issue. A literature search was carried out and summarized in a report. Based on the available information and discussions amongst the members of the Committee, guidelines were produced. The report and guidelines were discussed at the 11th European Symposium on Urogenital Radiology in Santiago de Compostela, Spain. The practice for identifying patients at risk of contrast medium induced nephropathy varies considerably from one institution to another. Patients at risk constitute only a small percentage of all cases referred for contrast enhanced imaging examination. However, it is important to identify them and take the necessary precautions. Recent serum creatinine level should be available in patients with an increased probability of a raised serum creatinine level (renal disease, renal surgery, proteinuria, diabetes mellitus, hypertension, gout, current intake of nephrotoxic drugs). A simple guideline has been produced. (orig.)

  17. The effect of newer water-soluble contrast media on I-131 uptake by the thyroid gland

    International Nuclear Information System (INIS)

    Starinsky, R.; Horne, T.; Barr, J.; Ramot, Y.

    2006-01-01

    The aim of this study was to evaluate the effect of two water-soluble contrast media (nonionic and Dimer) on iodine uptake by the thyroid gland. Twenty-eight euthyroid patients (16 females and 12 males) were subjected to 24hrs radioiodine uptake (RAIU) studies following brain CT examinations using the above cited two water-soluble contrast media. Radioiodine uptake studies were done at one (Group-1), two (Group-2) and four (Group-3) weeks following performance of contrast enhanced CT scans. The effect of both contrast media on the thyroid uptake was found to be identical. The radio active iodine uptake (RAIU) was observed to be suppressed in 30% of patients in Group-1, 33% of patients in Group-2 and in none of the patients belonging to Group-3. On the basis of this pilot study on a limited number of patients it was concluded that dimer and non-ionic water soluble contrast media cause suppression of radio iodine uptake by the thyroid gland in a significant proportion of patients. It has also been observed that both contrast media have similar suppressive effects on radio iodine uptake by the thyroid gland. This effect is transient and does not persist beyond a period of four weeks following the administration of the contrast media. (author)

  18. Two new contrast media in coronary angiography

    International Nuclear Information System (INIS)

    Selin, K.; Bjoerk, L.

    1983-01-01

    Amipaque, ioxaglic acid and Isopaque Coronar 300 were compared in a double blind investigation of coronary angiography in patients with ischemic heart disease. Amipaque affected systolic blood pressure and ECG less than the other contrast media. Ioxaglic acid appeared to give more ST and T changes than Isopaque Coronar. (Auth.)

  19. Safety of MR liver specific contrast media

    Energy Technology Data Exchange (ETDEWEB)

    Bellin, Marie-France [Hopital Paul Brousse, Universite Paris 11, Villejuif Cedex (France); Webb, Judith A.W. [St. Bartholomew' s Hospital, Department of Diagnostic Imaging, London (United Kingdom); Molen, Aart J. van der [Leiden University Medical Centre, Department of Radiology, Leiden (Netherlands); Thomsen, Henrik S. [Copenhagen University Hospital at Herlev, Department of Diagnostic Radiology 54E2, Herlev (Denmark); Morcos, Sameh K. [Northern General Hospital, Sheffield Teaching Hospitals NHS Trust, Department of Diagnostic Imaging, Sheffield (United Kingdom)

    2005-08-01

    Over the past few years a number of magnetic resonance (MR) liver specific contrast agents have been introduced. In this report the safety issues of these agents are addressed. A literature search was carried out. Based on the available information, simple guidelines on the safety issue of liver specific contrast agents have been produced by the Contrast Media Safety Committee of the European Society of Urogenital Radiology. The report and guidelines were discussed at the 11th European Symposium on Urogenital Radiology in Santiago de Compostela. Liver specific contrast agents appear in general to be safe and well tolerated. However, the incidence of adverse reactions with iron oxides and the intravenous manganese based agent seems to be slightly higher than with gadolinium based agents. However, no safety information from comparative clinical trials has been published. Guidelines on the safety aspects are presented. (orig.)

  20. Safety of MR liver specific contrast media

    International Nuclear Information System (INIS)

    Bellin, Marie-France; Webb, Judith A.W.; Molen, Aart J. van der; Thomsen, Henrik S.; Morcos, Sameh K.

    2005-01-01

    Over the past few years a number of magnetic resonance (MR) liver specific contrast agents have been introduced. In this report the safety issues of these agents are addressed. A literature search was carried out. Based on the available information, simple guidelines on the safety issue of liver specific contrast agents have been produced by the Contrast Media Safety Committee of the European Society of Urogenital Radiology. The report and guidelines were discussed at the 11th European Symposium on Urogenital Radiology in Santiago de Compostela. Liver specific contrast agents appear in general to be safe and well tolerated. However, the incidence of adverse reactions with iron oxides and the intravenous manganese based agent seems to be slightly higher than with gadolinium based agents. However, no safety information from comparative clinical trials has been published. Guidelines on the safety aspects are presented. (orig.)

  1. Efficacy of high iodine concentration contrast medium with saline pushing in hepatic CT in patients with chronic liver disease. Comparison of high doses-standard contrast medium concentration

    International Nuclear Information System (INIS)

    Matoba, Munetaka; Kondo, Tamaki; Nishikawa, Takahiro; Kuginuki, Yasuaki; Yokota, Hajime; Higashi, Kotaro; Tonami, Hisao

    2006-01-01

    The aim of this study was to compare the enhancement of liver parenchyama with high iodine concentration contrast medium with saline pushing to that with high doses standard iodine concentration in hepatic CT in patients with chronic liver disease. There was no statistically significant difference regarding to the enhancement of liver parenchyama between the 370 mgI/ml of contrast medium with saline pushing and high doses standard iodine concentration contrast medium. (author)

  2. Accuracy of contrast-enhanced dual-energy MDCT for the assessment of iodine uptake in renal lesions.

    Science.gov (United States)

    Mileto, Achille; Marin, Daniele; Ramirez-Giraldo, Juan Carlos; Scribano, Emanuele; Krauss, Bernhard; Mazziotti, Silvio; Ascenti, Giorgio

    2014-05-01

    The objective of our study was to assess the accuracy of iodine-related attenuation and iodine quantification as imaging biomarkers of iodine uptake in renal lesions on a single-phase nephrographic image with dual-energy MDCT. Fifty-nine patients (41 men, 18 women; age range, 28-84 years) with 80 renal lesions underwent contrast-enhanced dual-energy CT during the nephrographic phase of enhancement. Renal lesions were characterized as enhancing or nonenhancing on color-coded iodine overlay maps using iodine-related attenuation (in Hounsfield units) and iodine quantification (in milligrams per milliliter). For iodine-related attenuation the iodine uptake thresholds of 15 and 20 HU were tested; a threshold of 0.5 mg/mL was used for iodine quantification. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of iodine-related attenuation and iodine quantification were calculated from chi-square tests of contingency with histopathology or imaging follow-up as the reference standard. The 95% CIs were calculated from binomial expression. Differences in sensitivity and specificity were assessed by means of McNemar analysis. A significant difference in sensitivity and specificity was found between iodine-related attenuation with the thresholds of 15 HU (sensitivity, 91.4%; specificity, 93.3%; PPV, 91.4%; NPV, 93.3%) and 20 HU (sensitivity, 77.1%; specificity, 100%; PPV, 100%; NPV, 84.9%) (p = 0.008) and between iodine quantification (sensitivity, 100%; specificity, 97.7%; PPV, 97.2%; NPV, 100%) and iodine-related attenuation with a threshold of 20 HU (p = 0.004). No significant difference in sensitivity and specificity was found between iodine quantification and iodine-related attenuation with a threshold of 15 HU. Contrast-enhanced dual-energy MDCT with iodine-related attenuation and iodine quantification allows accurate evaluation of iodine uptake in renal lesions on a single-phase nephrographic image.

  3. Contrast media properties in interventional radiology

    International Nuclear Information System (INIS)

    Laerum, F.; Enge, I.

    1989-01-01

    Potential hazards of the use of contrast media (CM) in interventional radiology are analyzed by looking into each procedure regarding interactions of CM with pharmaceutical additives, with technical equipment possibly affecting CM stability, and special local or systemic demands related to the procedure. Also the impact of these factors upon the physiological mechanisms are taken into account. (H.W.). 32 refs.; 4 figs.; 2 tabs

  4. Nephrotoxicity of cyclosporin A and contrast media

    International Nuclear Information System (INIS)

    Thomsen, H.S.; Larsen, S.; Skaarup, P.; Hemmingsen, L.; Dieperink, H.; Golman, K.; Herlev Hospital; Herlev Hospital; Centralsygehuset, Nykoebing Falster; Odense Sygehus; Malmoe Allmaenna Sjukhus

    1989-01-01

    Urine profiles (albumin, glucose, NAG, LDH, GGT and sodium) were followed for 22 h or 8 days after intravenous injection of diatrizoate, iohexol or saline in 30 adult Wistar rats in which nephrotoxicity was induced by daily peroral administration of 25 mg/kg body weight cyclosporin A over a 14-day period. Another 10 rats which had the vehicle of the cyclosporin A solution (placebo) and saline injected intravenously served as controls. The effect of iohexol and saline on the albumin excretion was similar, whereas diatrizoate increased it significantly. Both contrast media caused significantly increased excretion of all three enzymes. The contrast media had no effect on the excretion of glucose and sodium. Except for the fact that the excretion of NAG was significantly higher following iohexol than following diatrizoate 24 to 46 h after injection no significant differences between the two media were found from 24 h after injection among the rats given cyclosporin A. No contrast medium related changes were found by light microscopy of the kidneys. Neither iohexol nor diatrizoate potentiate acute cyclosporin A nephrotoxicity. (orig.)

  5. Safe Use of Contrast Media: What the Radiologist Needs to Know.

    Science.gov (United States)

    Beckett, Katrina R; Moriarity, Andrew K; Langer, Jessica M

    2015-10-01

    Iodinated and gadolinium-based contrast media are used on a daily basis in most radiology practices. These agents often are essential to providing accurate diagnoses, and are nearly always safe and effective when administered correctly. However, reactions to contrast media do occur and can be life threatening. Therefore, it is critical for faculty and staff to know how reactions to contrast agents manifest and how to treat them promptly. The decline in renal function seen occasionally after intravenous administration of iodinated contrast agents is poorly understood and likely multifactorial, and its association with the contrast medium may be overemphasized. However, it is important that radiologists be aware of current understanding and strategies to decrease the incidence of renal dysfunction. Nephrogenic systemic fibrosis, a skin disease, is an adverse reaction related to use of some gadolinium-based contrast agents in patients with chronic renal failure. The types of gadolinium most often associated with this condition and the indications for withholding gadolinium are important and are discussed in this article. The use of enteric contrast agents and contrast agents during pregnancy and nursing are reviewed briefly. Current knowledge for safe use of contrast media and key concepts that all radiologists should know are summarized in this review. © RSNA, 2015.

  6. Iodine

    Science.gov (United States)

    ... Health Information Supplement Fact Sheets Frequently Asked Questions Making Decisions What you Need To Know About Supplements Dietary ... mild iodine deficiency and of iodine supplements on cognitive ... breasts. It mainly affects women of reproductive age but can also occur ...

  7. Potentials and limitations of low-concentration contrast medium (150 mg iodine/ml) in CT pulmonary angiography

    International Nuclear Information System (INIS)

    Radon, M.R.; Kaduthodil, M.J.; Jagdish, J.; Matthews, S.; Hill, C.; Bull, M.J.; Morcos, S.K.

    2011-01-01

    Aim: To assess the feasibility of producing diagnostic multidetector computed tomography (MDCT) pulmonary angiography with low iodine concentration contrast media (150 mg iodine/ml) in patients with suspected acute pulmonary embolism. Materials and methods: Ninety-five randomized patients underwent MDCT (64 row) pulmonary angiography with 100 ml iopromide either at low concentration (LC) of 150 mg iodine/ml (n = 45) or high concentration (HC) of 300 mg iodine/ml (n = 50), delivered at the rate of 5 ml/s via a power injector. Two experienced radiologists, blinded to the concentration used, subjectively assessed the diagnostic quality and confidence using a four-point scale [1 = poor (not diagnostic), 2 = satisfactory, 3 = good, 4 = excellent]. Attenuation values (in HU) were measured in the main proximal branches of the pulmonary arteries. Results: The median diagnostic quality score for both observers was 3.5 (interquartile range 3-4) in the HC group and 2.5 (interquartile range 1.5-3) in the LC group (p < 0.01). The median diagnostic confidence score for both observers was 4 (interquartile range 3-4) in the HC group and 3 (interquartile range 1.5-4) in the LC group (p < 0.01). Both observers rated examinations as diagnostic in 69% of cases in the LC group, compared with 96% of cases in the HC group. Good interobserver agreement was found in both groups (K value 0.72 in the LC group and 0.73 in the HC). Obesity, poor scan timing, and dilution by venous return of non-opacified blood were the main reasons for a reduction in diagnostic quality of examinations in the LC group. Conclusion: Despite a 50% reduction of contrast medium dose in comparison to the standard technique, 150 mg iodine/ml can produce diagnostic MDCT pulmonary angiogram studies in the absence of obesity or high cardiac output and hyper-dynamic pulmonary circulation. Reducing the dose of contrast media would minimize the risk of contrast nephropathy in patients at risk of this complication

  8. Spectroscopic (multi-energy) CT distinguishes iodine and barium contrast material in MICE

    Energy Technology Data Exchange (ETDEWEB)

    Anderson, N.G. [University of Otago, Department of Radiology, Christchurch (New Zealand); Butler, A.P. [University of Otago, Department of Radiology, Christchurch (New Zealand); University of Canterbury, Physics and Astronomy, Christchurch (New Zealand); Scott, N.J.A. [University of Otago, Department of Medicine, Christchurch (New Zealand); Cook, N.J. [Christchurch Hospital, Medical Physics and Bioengineering, Christchurch (New Zealand); Butzer, J.S. [Karlsruhe Institute of Technology, Physics Department, Karlsruhe (Germany); Schleich, N. [University of Canterbury, Physics and Astronomy, Christchurch (New Zealand); Christchurch Hospital, Medical Physics and Bioengineering, Christchurch (New Zealand); Firsching, M. [Friedrich Alexander University, Physics Department, Erlangen (Germany); Grasset, R.; Ruiter, N. de [University of Canterbury, Hitlab NZ, Christchurch (New Zealand); Campbell, M. [European Organisation for Nuclear Research, Physics Section, Geneva (Switzerland); Butler, P.H. [University of Canterbury, Physics and Astronomy, Christchurch (New Zealand)

    2010-09-15

    Spectral CT differs from dual-energy CT by using a conventional X-ray tube and a photon-counting detector. We wished to produce 3D spectroscopic images of mice that distinguished calcium, iodine and barium. We developed a desktop spectral CT, dubbed MARS, based around the Medipix2 photon-counting energy-discriminating detector. The single conventional X-ray tube operated at constant voltage (75 kVp) and constant current (150 {mu}A). We anaesthetised with ketamine six black mice (C57BL/6). We introduced iodinated contrast material and barium sulphate into the vascular system, alimentary tract and respiratory tract as we euthanised them. The mice were preserved in resin and imaged at four detector energy levels from 12 keV to 42 keV to include the K-edges of iodine (33.0 keV) and barium (37.4 keV). Principal component analysis was applied to reconstructed images to identify components with independent energy response, then displayed in 2D and 3D. Iodinated and barium contrast material was spectrally distinct from soft tissue and bone in all six mice. Calcium, iodine and barium were displayed as separate channels on 3D colour images at <55 {mu}m isotropic voxels. Spectral CT distinguishes contrast agents with K-edges only 4 keV apart. Multi-contrast imaging and molecular CT are potential future applications. (orig.)

  9. Spectroscopic (multi-energy) CT distinguishes iodine and barium contrast material in MICE.

    Science.gov (United States)

    Anderson, N G; Butler, A P; Scott, N J A; Cook, N J; Butzer, J S; Schleich, N; Firsching, M; Grasset, R; de Ruiter, N; Campbell, M; Butler, P H

    2010-09-01

    Spectral CT differs from dual-energy CT by using a conventional X-ray tube and a photon-counting detector. We wished to produce 3D spectroscopic images of mice that distinguished calcium, iodine and barium. We developed a desktop spectral CT, dubbed MARS, based around the Medipix2 photon-counting energy-discriminating detector. The single conventional X-ray tube operated at constant voltage (75 kVp) and constant current (150 microA). We anaesthetised with ketamine six black mice (C57BL/6). We introduced iodinated contrast material and barium sulphate into the vascular system, alimentary tract and respiratory tract as we euthanised them. The mice were preserved in resin and imaged at four detector energy levels from 12 keV to 42 keV to include the K-edges of iodine (33.0 keV) and barium (37.4 keV). Principal component analysis was applied to reconstructed images to identify components with independent energy response, then displayed in 2D and 3D. Iodinated and barium contrast material was spectrally distinct from soft tissue and bone in all six mice. Calcium, iodine and barium were displayed as separate channels on 3D colour images at contrast agents with K-edges only 4 keV apart. Multi-contrast imaging and molecular CT are potential future applications.

  10. [Radiographic, MR or ultrasound contrast media in pregnant or breast-feeding women: what are the key issues?].

    Science.gov (United States)

    Fröhlich, J M; Kubik-Huch, R A

    2013-01-01

    The use and the safety of radiographic, MR- or ultrasound contrast media in the diagnostic work-up of pregnant or lactating patients is a frequently discussed question. As only sparse clinical data is available, a careful benefit-risk assessment must contain physico-chemical properties, preclinical data including teratogeneity and embryotoxicity, as well as maternal and foetal exposure. With consideration to the individual risks, iodinated contrast media, macrocyclic MR contrast media with increased stability or sulphur hexafluoride ultrasound contrast media may, if clinically justified, be administered in the smallest possible doses throughout pregnancy. After parental administration of an iodinated contrast medium after the 12th week of pregnancy, the neonate's thyroidal function should be checked during the first week after birth. After parental administration of iodinated, stable macrocyclic, gadolinium or ultrasound contrast media, lactation can be continued normally. In any case, contrast media should be used with caution and only if the benefits outweigh the risk. © Georg Thieme Verlag KG Stuttgart · New York.

  11. The study of cardiovascular changes by intravascular injection of contrast media

    International Nuclear Information System (INIS)

    Kim, Yang Sook; Park, Chang Yoon

    1986-01-01

    This investigation was aimed to study the effect of contrast media on the cardiovascular system. So in this study, pithed rats were used whether alteration in cardiovascular system by contrast media were controlled centrally. Furthermore, several hypertonic solutions were also used to clarify the effect of contrast media. The results are as follows: 1. Intravenous injection of contrast media in rats (2.5 ml/kg) caused hypotension and bradycardia. The effects were neither blocked by pretreatment of atropine nor pyribenzamine+atropine. 2. NaCI 4.7%, dextrose 24.8%, urea 9.0% and glycerol 10.1% (v/v) which were equiosmolar with contrast media, caused hypotension, but did not affect the heart rate. 3. In pithed rats, intravenous injection of Angiografin increased blood pressure in a dose-dependant manner, and caused decrease in heart rate compared with those of control rats. 4. In pithed rats, bradycardia by intravascular injection with Angiografin was partially blocked by atropine. 5. Metrizamide of which iodine content was adjusted to 280 mg/ml caused increased in blood pressure when was injected intravenously in pithed rats with little effect on heart rate. 6. When perfused with contrast media in rat hindlimb at 15 ml/min./kg speed both perfusion pressure and flow effluent increased, simultaneously. These results suggest that hypotension might be caused by the central effect due to hyperosmolarity of contrast media and bradycardia caused by both parasympathetic stimulation and direct inhibitory action on the cardiac conductive system.

  12. Comparison of iodine, krypton, and xenon retention efficiencies for various silver loaded adsorption media

    International Nuclear Information System (INIS)

    Huchton, R.L.; Tkachyk, J.W.; Taylor, J.T.; Motes, B.G.

    1985-03-01

    A comparison was made among various silver impregnated adsorption media to determine their iodine, krypton, and xenon retention efficiencies. The program consisted of three components. First, laboratory measurements of the noble gas retention efficiencies of commercially available adsorption media were determined as a function of relative humidity, sample duration, test cartridge geometry, and ambient air purge. Second, a literature survey was performed to evaluate the iodine species retention efficiencies of the selected media. Third, data associated with a media previously proposed for an emergency response air sampler were incorporated to enlarge the data base. 41 refs., 6 figs., 14 tabs

  13. Rôle of contrast media viscosity in altering vessel wall shear stress and relation to the risk of contrast extravasations.

    Science.gov (United States)

    Sakellariou, Sophia; Li, Wenguang; Paul, Manosh C; Roditi, Giles

    2016-12-01

    Iodinated contrast media (CM) are the most commonly used injectables in radiology today. A range of different media are commercially available, combining various physical and chemical characteristics (ionic state, osmolality, viscosity) and thus exhibiting distinct in vivo behaviour and safety profiles. In this paper, numerical simulations of blood flow with contrast media were conducted to investigate the effects of contrast viscosity on generated vessel wall shear stress and vessel wall pressure to elucidate any possible relation to extravasations. Five different types of contrast for Iodine fluxes ranging at 1.5-2.2gI/s were modelled through 18G and 20G cannulae placed in an ideal vein at two different orientation angles. Results demonstrate that the least viscous contrast media generate the least maximum wall shear stress as well as the lowest total pressure for the same flow rate. This supports the empirical clinical observations and hypothesis that more viscous contrast media are responsible for a higher percentage of contrast extravasations. In addition, results support the clinical hypothesis that a catheter tip directed obliquely to the vein wall always produces the highest maximum wall shear stress and total pressure due to impingement of the contrast jet on the vessel wall. Copyright © 2016 IPEM. Published by Elsevier Ltd. All rights reserved.

  14. Better and safer diagnostic possibilities with non-ionic contrast media

    International Nuclear Information System (INIS)

    Dalmstrom, K.; Svinn, K.

    1991-01-01

    The synthesis of contrast media for medical radiography is followed out since their introduction in late 50's. A discussion is presented on the genesis of undesirable side effects of ionic contrast media due to the sodium and meglumine cations, the hypertonicity of the media and the iodinated molecule itself. The advantages of the new non-ionic non-dissociating low osmolar contrast media is stressed and its low chemotoxicity is explained in the light of their chemical structure. The qualities of the specific representatives of new three generations of non-ionic contrast media are analysed and compared: 1) metrizamide (Amipaque, Nycomed) - a soluble monomer; 2) iopamidol (Iopamiro, Bracco), iohexol (Omnipaque, Nycomed), iopromid (Ultravist, Schering), iopentol (Imagopaque, Nycomed), ioversol (Optiray Mallincrodt) - monomers, more tolerable and with lower toxicity; 3) ioxaglat, iotrolan and iodixanol -monoacidic dimers with lower osmolarity. Results from clinical trial and monitoring programs in large patients' groups are presented. The severity and incidence of the observed side effects in different organs and systems including the risk's groups are given. Compared to the conventional ionic media, the occurence of undesired effects has been reduced to about 1/6 with the use of the new products. The review unabiguously show the advantages of the non-ionic contrast media. 6 tabs., 2 figs., 26 refs

  15. The determination of iodine in biological media using radioactivation analysis (1962)

    International Nuclear Information System (INIS)

    Comar, D.

    1962-06-01

    The object of this study is to show that the application of radioactivation analysis to the determination of iodine in biological media makes it possible to measure iodine concentrations of the order of 0.0001 μg. After a review of the chemical methods with a mention of the difficulties they present, the optimum conditions for the determination of iodine in biological liquids are given. Three methods are described: - the first consists of a chemical treatment which liberates the protein bound iodine in an inorganic form. After distillation this iodine is irradiated in a flux of thermal neutrons. The induced radioactivity is compared to that of a standard sample irradiated in the same conditions by γ spectrometry. - the second method which is of more general application consists in irradiating the sample and then extracting the iodine; its induced radio-activity is then measured by β-counting. - the third method measures the iodine directly in the thyroid tissue by anti-compton spectrometry. The sensitivity, the reproducibility and the accuracy are discussed. Some applications are described: determination of iodine in its various organic forms in serum, determination of iodine in urines, in food-stuffs, etc., in the thyroid tissue, etc. (author) [fr

  16. A method to evaluate the dose increase in CT with iodinated contrast medium

    International Nuclear Information System (INIS)

    Amato, Ernesto; Lizio, Domenico; Settineri, Nicola; Di Pasquale, Andrea; Salamone, Ignazio; Pandolfo, Ignazio

    2010-01-01

    Purpose: The objective of this study is to develop a method to calculate the relative dose increase when a computerized tomography scan (CT) is carried out after administration of iodinated contrast medium, with respect to the same CT scan in absence of contrast medium. Methods: A Monte Carlo simulation in GEANT4 of anthropomorphic neck and abdomen phantoms exposed to a simplified model of CT scanner was set up in order to calculate the increase of dose to thyroid, liver, spleen, kidneys, and pancreas as a function of the quantity of iodine accumulated; a series of experimental measurements of Hounsfield unit (HU) increment for known concentrations of iodinated contrast medium was carried out on a Siemens Sensation 16 CT scanner in order to obtain a relationship between the increment in HU and the relative dose increase in the organs studied. The authors applied such a method to calculate the average dose increase in three patients who underwent standard CT protocols consisting of one native scan in absence of contrast, followed by a contrast-enhanced scan in venous phase. Results: The authors validated their GEANT4 Monte Carlo simulation by comparing the resulting dose increases for iodine solutions in water with the ones presented in literature and with their experimental data obtained through a Roentgen therapy unit. The relative dose increases as a function of the iodine mass fraction accumulated and as a function of the Hounsfield unit increment between the contrast-enhanced scan and the native scan are presented. The data shown for the three patients exhibit an average relative dose increase between 22% for liver and 74% for kidneys; also, spleen (34%), pancreas (28%), and thyroid (48%) show a remarkable average increase. Conclusions: The method developed allows a simple evaluation of the dose increase when iodinated contrast medium is used in CT scans, basing on the increment in Hounsfield units observed on the patients' organs. Since many clinical protocols

  17. A method to evaluate the dose increase in CT with iodinated contrast medium

    Energy Technology Data Exchange (ETDEWEB)

    Amato, Ernesto; Lizio, Domenico; Settineri, Nicola; Di Pasquale, Andrea; Salamone, Ignazio; Pandolfo, Ignazio [Department of Radiological Sciences, University of Messina, Messina 98125 (Italy); Department of Physics, University of Messina, Messina 98166 (Italy); University Hospital ' ' G. Martino' ' , Messina 98125 (Italy); Department of Radiological Sciences, University of Messina, Messina 98125 (Italy) and University Hospital ' ' G. Martino' ' , Messina 98125 (Italy)

    2010-08-15

    Purpose: The objective of this study is to develop a method to calculate the relative dose increase when a computerized tomography scan (CT) is carried out after administration of iodinated contrast medium, with respect to the same CT scan in absence of contrast medium. Methods: A Monte Carlo simulation in GEANT4 of anthropomorphic neck and abdomen phantoms exposed to a simplified model of CT scanner was set up in order to calculate the increase of dose to thyroid, liver, spleen, kidneys, and pancreas as a function of the quantity of iodine accumulated; a series of experimental measurements of Hounsfield unit (HU) increment for known concentrations of iodinated contrast medium was carried out on a Siemens Sensation 16 CT scanner in order to obtain a relationship between the increment in HU and the relative dose increase in the organs studied. The authors applied such a method to calculate the average dose increase in three patients who underwent standard CT protocols consisting of one native scan in absence of contrast, followed by a contrast-enhanced scan in venous phase. Results: The authors validated their GEANT4 Monte Carlo simulation by comparing the resulting dose increases for iodine solutions in water with the ones presented in literature and with their experimental data obtained through a Roentgen therapy unit. The relative dose increases as a function of the iodine mass fraction accumulated and as a function of the Hounsfield unit increment between the contrast-enhanced scan and the native scan are presented. The data shown for the three patients exhibit an average relative dose increase between 22% for liver and 74% for kidneys; also, spleen (34%), pancreas (28%), and thyroid (48%) show a remarkable average increase. Conclusions: The method developed allows a simple evaluation of the dose increase when iodinated contrast medium is used in CT scans, basing on the increment in Hounsfield units observed on the patients' organs. Since many clinical

  18. Contrast media and pain during peripheral arteriography

    International Nuclear Information System (INIS)

    Hagen, B.; Clauss, W.

    1982-01-01

    Some contrast media (CM) were for inducing pain and heat by an intraindividual comparison in 60 patients with occlusive peripheral arterial disease. A dolorimeter and calorimeter (graduated scales) were employed to register and differentiate the subjective sensations experienced by the patient, while objective reactions (peripheral motoric reactions, circulatory parameters) were recorded by the trialist at the same time. Ioxaglate, an ionic dimer, was distinctly superior to Ioglicinate, an ionic CM. However, the differences were less marked in the comparison with a Ioglicinate-Lidocaine-mixture. Emphasis is given to the fact osmolality is the most important parameter in the development of pain. Potential points at which the intraarterially administered local anaesthetic could attack are discussed. The clinical conclusions include consideration of the cost-effectivity ratios of the tested CM's and a discussion of whether or not modern stanards still justify general anaesthesia for peripheral angiography. (orig.)

  19. Magnetic resonance perfusion imaging without contrast media

    International Nuclear Information System (INIS)

    Martirosian, Petros; Graf, Hansjoerg; Schick, Fritz; Boss, Andreas; Schraml, Christina; Schwenzer, Nina F.; Claussen, Claus D.

    2010-01-01

    Principles of magnetic resonance imaging techniques providing perfusion-related contrast weighting without administration of contrast media are reported and analysed systematically. Especially common approaches to arterial spin labelling (ASL) perfusion imaging allowing quantitative assessment of specific perfusion rates are described in detail. The potential of ASL for perfusion imaging was tested in several types of tissue. After a systematic comparison of technical aspects of continuous and pulsed ASL techniques the standard kinetic model and tissue properties of influence to quantitative measurements of perfusion are reported. For the applications demonstrated in this paper a flow-sensitive alternating inversion recovery (FAIR) ASL perfusion preparation approach followed by true fast imaging with steady precession (true FISP) data recording was developed and implemented on whole-body scanners operating at 0.2, 1.5 and 3 T for quantitative perfusion measurement in various types of tissue. ASL imaging provides a non-invasive tool for assessment of tissue perfusion rates in vivo. Images recorded from kidney, lung, brain, salivary gland and thyroid gland provide a spatial resolution of a few millimetres and sufficient signal to noise ratio in perfusion maps after 2-5 min of examination time. Newly developed ASL techniques provide especially high image quality and quantitative perfusion maps in tissues with relatively high perfusion rates (as also present in many tumours). Averaging of acquisitions and image subtraction procedures are mandatory, leading to the necessity of synchronization of data recording to breathing in abdominal and thoracic organs. (orig.)

  20. Spectroscopic (multi-energy) CT distinguishes iodine and barium contrast material in MICE

    CERN Document Server

    Anderson, NG; Firsching, M; de Ruiter, N; Schleich, N; Butzer, J S; Cook, N J; Grasset, R; Campbell, M; Scott, N J A; Anderson, N G

    2010-01-01

    Spectral CT differs from dual-energy CT by using a conventional X-ray tube and a photon-counting detector. We wished to produce 3D spectroscopic images of mice that distinguished calcium, iodine and barium. We developed a desktop spectral CT, dubbed MARS, based around the Medipix2 photon-counting energy-discriminating detector. The single conventional X-ray tube operated at constant voltage (75 kVp) and constant current (150 A mu A). We anaesthetised with ketamine six black mice (C57BL/6). We introduced iodinated contrast material and barium sulphate into the vascular system, alimentary tract and respiratory tract as we euthanised them. The mice were preserved in resin and imaged at four detector energy levels from 12 keV to 42 keV to include the K-edges of iodine (33.0 keV) and barium (37.4 keV). Principal component analysis was applied to reconstructed images to identify components with independent energy response, then displayed in 2D and 3D. Iodinated and barium contrast material was spectrally distinct f...

  1. The evidence-based evaluation of the safety of contrast media in patients with diabetes mellitus

    International Nuclear Information System (INIS)

    Li Jixia; Huang Baosheng

    2009-01-01

    Contrast-induced nephropathy (CIN) has now been the third most common cause of acquired renal failure. Diabetes mellitus (DM), the type of contrast agent used and the intra-arterial route of administration are three important risk factors inducing CIN. The incidence rate of CIN is very high in patients with DM or renal insufficiency after iodinated contrast was administered. Unfortunately, it has not yet attracted physicians'and radiologists'sufficient attention. This paper aims to make an evidence-based evaluation of the safety and rephrotoxicity of various contrast agents when they are used in patients with DM. Usually, intravenous administration of contrast media will not cause permanent damage to the kidney in highrisk patients. Low-osmolarity contrast media is relatively safe for patients with DM only, while it takes much risk of CIN when low-osmolarity contrast media is used in patients with diabetic nephropathy or in patients of DM accompanied with renal insufficiency, for such patients, the iso-osmolarity contrast media, iodixanol, can be used. (authors)

  2. Iodine

    Science.gov (United States)

    ... leg ulcers and reduce the chance of a future infection. Conjunctivitis (pinkeye). Research suggests that using eye ... National Institute of Medicine has set Adequate Intake (AI) of iodine for infants: 0 to 6 months, ...

  3. Myths and misconceptions concerning contrast media-induced anaphylaxis: a narrative review.

    Science.gov (United States)

    Böhm, Ingrid; Morelli, John; Nairz, Knud; Silva Hasembank Keller, Patricia; Heverhagen, Johannes T

    2017-03-01

    Contrast-enhanced radiological examinations are an increasingly important diagnostic tool in modern medicine. All approved and available contrast media (iodinated and gadolinium-based) are safe compounds that are well-tolerated by most patients. However, a small percentage of patients exhibit contrast medium-induced adverse drug reactions that are dose-dependent and predictable (type A) or an even smaller cohort experience so-called type B (dose-independent, non-predictable). To increase patients' safety, recommendations/guidelines have been put forth in the literature and advice passed down informally by radiologists in practice to ensure contrast media safety. Through these, both reasonable suggestions as well as misinterpretations and myths (such as the misleading terms "allergy-like" reactions, and "iodine-allergy", the wrong assumption that the initial contact to a contrast medium could not induce an allergy, the estimation that an anti-allergy premedication could suppress all possible adverse reactions, and interleukin-2 as a risk/trigger for contrast medium adverse events) have arisen. Since the latter are not only unhelpful but also potentially reduce patients' safety, such myths and misconceptions are the focus of this review.

  4. A simple method to estimate the optimum iodine concentration of contrast material through microcatheters: hydrodynamic calculation with spreadsheet software

    International Nuclear Information System (INIS)

    Yamauchi, Teiyu; Hayashi, Toshihiko; Yamada, Takeshi; Futami, Choichiro; Tsukiyama, Yumiko; Harada, Motoko; Furui, Shigeru; Suzuki, Shigeru; Mimura, Kohshiro

    2008-01-01

    It is important to increase the iodine delivery rate (I), that is the iodine concentration of the contrast material (C) x the flow rate of the contrast material (Q), through microcatheters to obtain arteriograms of the highest contrast. It is known that C is an important factor that influences I. The purpose of this study is to establish a method of hydrodynamic calculation of the optimum iodine concentration (i.e., the iodine concentration at which I becomes maximum) of the contrast material and its flow rate through commercially available microcatheters. Iopamidol, ioversol and iohexol of ten iodine concentrations were used. Iodine delivery rates (I meas) of each contrast material through ten microcatheters were measured. The calculated iodine delivery rate (I cal) and calculated optimum iodine concentration (calculated C opt) were obtained with spreadsheet software. The agreement between I cal and I meas was studied by correlation and logarithmic Bland-Altman analyses. The value of the calculated C opt was within the optimum range of iodine concentrations (i.e. the range of iodine concentrations at which I meas becomes 90% or more of the maximum) in all cases. A good correlation between I cal and I meas (I cal = 1.08 I meas, r = 0.99) was observed. Logarithmic Bland-Altman analysis showed that the 95% confidence interval of I cal/I meas was between 0.82 and 1.29. In conclusion, hydrodynamic calculation with spreadsheet software is an accurate, generally applicable and cost-saving method to estimate the value of the optimum iodine concentration and its flow rate through microcatheters

  5. Acute Respiratory Distress Syndrome after the Use of Gadolinium Contrast Media.

    Science.gov (United States)

    Park, Jihye; Byun, Il Hwan; Park, Kyung Hee; Lee, Jae-Hyun; Nam, Eun Ji; Park, Jung-Won

    2015-07-01

    Acute respiratory distress syndrome (ARDS) is a medical emergency that threatens life. To this day, ARDS is very rarely reported by iodine contrast media, and there is no reported case of ARDS induced by gadolinium contrast media. Here, we present a case with ARDS after the use of gadobutrol (Gadovist) as a magnetic resonance imaging (MRI) contrast medium. A 26 years old female without any medical history, including allergic diseases and without current use of drugs, visited the emergency room for abdominal pain. Her abdominopelvic computed tomography with iodine contrast media showed a right ovarian cyst and possible infective colitis. Eighty-three hours later, she underwent pelvis MRI after injection of 7.5 mL (0.1 mL/kg body weight) of gadobutrol (Gadovist) to evaluate the ovarian cyst. She soon presented respiratory difficulty, edema of the lips, nausea, and vomiting, and we could hear wheezing upon auscultation. She was treated with dexamethasone, epinephrine, and norepinephrine. Her chest X-ray showed bilateral central bat-wing consolidative appearance. Managed with mechanical ventilation, she was extubated 3 days later and discharged without complications.

  6. Non-ionic contrast media: are they obligatory?

    International Nuclear Information System (INIS)

    Halva, S.R.

    1993-01-01

    Author presents recommendations for nonionic contrast media application. They are more expensive but less toxic than ionic ones. In order to avoid side effects in many radiological examinations (phlebography, arteriography, coronarography, ventriculography) one should use nonionic contrast media. Another reason for application of nonionic contrast agents is young age of patient or his state of health

  7. Correlation of contrast agent kinetics between iodinated contrast-enhanced spectral tomosynthesis and gadolinium-enhanced MRI of breast lesions

    International Nuclear Information System (INIS)

    Froeling, Vera; Diekmann, Felix; Renz, Diane M.; Fallenberg, Eva M.; Steffen, Ingo G.; Diekmann, Susanne; Schmitzberger, Florian F.; Lawaczeck, Ruediger

    2013-01-01

    Assessment of contrast agent kinetics in contrast-enhanced MRI (CE-MRI) with gadolinium-containing contrast agents offers the opportunity to predict breast lesion malignancy. The goal of our study was to determine if similar patterns exist for spectral contrast-enhanced digital breast tomosynthesis (CE-DBT) using an iodinated contrast agent. The protocol of our prospective study was approved by the relevant institutional review board and the German Federal Office for Radiation Protection. All patients provided written informed consent. We included 21 women with a mean age of 62.4 years. All underwent ultrasound-guided biopsy of a suspect breast lesion, spectral CE-DBT and CE-MRI. For every breast lesion, contrast agent kinetics was assessed by signal intensity-time curves for spectral CE-DBT and CE-MRI. Statistical comparison used Cohen's kappa and Spearman's rho test. Spearman's rho of 0.49 showed significant (P = 0.036) correlation regarding the contrast agent kinetics in signal intensity-time curves for spectral CE-DBT and CE-MRI. Cohen's kappa indicated moderate agreement (kappa = 0.438). There is a statistically significant correlation between contrast agent kinetics in the signal intensity-time curves for spectral CE-DBT and CE-MRI. Observing intralesional contrast agent kinetics in spectral CE-DBT may aid evaluation of malignant breast lesions. (orig.)

  8. Contrast media in diagnostic radiology. 3. rev. and enlarged ed.

    International Nuclear Information System (INIS)

    Elke, M.; Gueckel, C.; Schmitt, H.E.; Felder, E.; Froehlich, J.M.; Radue, E.W.; Scheidegger, D.; Speck, U.

    1992-01-01

    With the 3rd edition of this book a comprehensive description is provided of all the properties and side-effects of contrast media as well as of the available remedies in mishaps caused by these agents. The individual chapters are headed as follows: (s. table of contents). 1. Introduction. 2. Contrast media for X-ray radiography, MRT, and ultrasonic scanning. 3. Kinetics of X-ray contrast media. 4. Pharamcodynamics of X-ray contrast media. 5. Side-effects of X-ray contrast media and complications encountered in practical radiology. 6. The mobile reanimation unit and the emergency kit. 7. Treatment of reactions to contrast media. 8. Appendix. 9. Bibliography, subject index. (orig./MG) With 25 figs., 5 text tabs., 39 tabs [de

  9. A survey of contrast media used in coronary angiograph

    International Nuclear Information System (INIS)

    Weikl, A.; Hubmann, M.

    1982-01-01

    In recent years, various contrast media have been developed for use in coronary angiography. These contrast media may be divided into ionic contrast media of high osmolality, those of low osmolality, and nonionic contrast materials. We conducted our own clinical studies with 40 patients. In random succession a standard contrast medium (ionic, of high osmolality) and a new-generation contrast medium (either nonionic or ionic with low osmolality) were injected into the right and left coronary arteries. After each injection we measured the systolic and diastolic blood pressure using a liquid-filled coronary catheter. In addition, the change in the length of the cardiac cycle was registered in terms of the R-R interval (in ms) and at the same time, leads I, II, and III of the ECG were recorded. We studied the influence of the various contrast media on the activity of ATPase in in vitro experiments, using Lasser and Lang's. When ionic contrast media of low osmolality and nonionic contrast media were utilized the heart rate showed no change. Disturbances of rhythm such as ventricular tachycardia or fibrillation were not observed. All of the contrast media used produced the same ECG changes. These changes can be ascribed to the inhibition of ATPase. The arterial blood pressure was lowered significantly only by ionic contrast media of high osmolality only. (orig.)

  10. Complementary contrast media for metal artifact reduction in dual-energy computed tomography.

    Science.gov (United States)

    Lambert, Jack W; Edic, Peter M; FitzGerald, Paul F; Torres, Andrew S; Yeh, Benjamin M

    2015-07-01

    Metal artifacts have been a problem associated with computed tomography (CT) since its introduction. Recent techniques to mitigate this problem have included utilization of high-energy (keV) virtual monochromatic spectral (VMS) images, produced via dual-energy CT (DECT). A problem with these high-keV images is that contrast enhancement provided by all commercially available contrast media is severely reduced. Contrast agents based on higher atomic number elements can maintain contrast at the higher energy levels where artifacts are reduced. This study evaluated three such candidate elements: bismuth, tantalum, and tungsten, as well as two conventional contrast elements: iodine and barium. A water-based phantom with vials containing these five elements in solution, as well as different artifact-producing metal structures, was scanned with a DECT scanner capable of rapid operating voltage switching. In the VMS datasets, substantial reductions in the contrast were observed for iodine and barium, which suffered from contrast reductions of 97% and 91%, respectively, at 140 versus 40 keV. In comparison under the same conditions, the candidate agents demonstrated contrast enhancement reductions of only 20%, 29%, and 32% for tungsten, tantalum, and bismuth, respectively. At 140 versus 40 keV, metal artifact severity was reduced by 57% to 85% depending on the phantom configuration.

  11. Contrast media-associated nephrotoxicity - pathogenenesis and prevention

    International Nuclear Information System (INIS)

    Erley, C.M.; Duda, S.H.

    1997-01-01

    Contrast media-associated nephrotoxicity continues to be a relevant cause of acute renal failure, especially in patients with pre-existing renal insufficiency. Alterations in renal hemodynamics and direct tubular toxicity by contrast media are the primary factors believed to be responsible for contrast media-associated nephrotoxicity. We review recent insights into the pathogenesis of this complication and summarize prophylactic strategies focussing on hydration, vasoactive pharmacological agents, and prophylactic hemodialysis'. (orig.) [de

  12. Feasibility of low contrast media volume in CT angiography of the aorta

    International Nuclear Information System (INIS)

    Seehofnerová, Anna; Kok, Madeleine; Mihl, Casper; Douwes, Dave; Sailer, Anni; Nijssen, Estelle; Haan, Michiel J.W. de; Wildberger, Joachim E.; Das, Marco

    2015-01-01

    Using smaller volumes of contrast media (CM) in CT angiography (CTA) is desirable in terms of cost reduction and prevention of contrast-induced nephropathy (CIN). The purpose was to evaluate the feasibility of low CM volume in CTA of the aorta. 77 patients referred for CTA of the aorta were scanned using a standard MDCT protocol at 100 kV. A bolus of 50 ml CM (Iopromide 300 mg Iodine/ml) at a flow rate of 6 ml/s was applied (Iodine delivery rate IDR = 1.8 g/s; Iodine load 15 g) followed by a saline bolus of 40 ml at the same flow rate. Scan delay was determined by the test bolus method. Subjective image quality was assessed and contrast enhancement was measured at 10 anatomical levels of the aorta. Diagnostic quality images were obtained for all patients, reaching a mean overall contrast enhancement of 324 ± 28 HU. Mean attenuation was 350 ± 60 HU at the thoracic aorta and 315 ± 83 HU at the abdominal aorta. A straightforward low volume CM protocol proved to be technically feasible and led to CTA examinations reaching diagnostic image quality of the aorta at 100 kV. Based on these findings, the use of a relatively small CM bolus can be incorporated into routine clinical imaging

  13. Influence of MRI contrast media on histamine release from mast cells.

    Science.gov (United States)

    Kun, Tomasz; Jakubowski, Lucjusz

    2012-07-01

    Mast cells, owing to diversity of secreted mediators, play a crucial role in the regulation of inflammatory response. Together with basophils, mast cells constitute a central pathogenetic element of anaphylactic (IgE-dependent) and anaphylactoid (IgE-independent) reactions. In severe cases, generalized degranulation of mast cells may cause symptoms of anaphylactic shock. The influence of the classical, iodine-based contrast media on mastocyte degranulation has been fully described. Our objective was to determine the influence of the gadolinium-based MRI contrast media on histamine release from mast cells and to compare the activity of ionic and non-ionic preparations of contrast media. To determine the intensity of mast cell degranulation, we used an experimental model based on mastocytes isolated from rat peritoneal fluid. Purified suspensions of mast cells were incubated with various concentrations of Gd-DTPA and Gd-DTPA-BMA, and solutions of PEG 600 which served as a non-toxic osmotic stimulus. The intensity of mast cell activation was presented as mean percentage of histamine released from cells after incubation. The obtained results demonstrate that both ionic and non-ionic preparations of the MRI contrast media are able to induce mast cell degranulation in vitro. It was also proved that the non-ionic MRI contrast media stimulate mast cells markedly more weakly than ionic contrast media at identical concentration. The aforementioned results may suggest a more profitable safety profile of the non-ionic contrast preparations. We may also conclude that triggering of mast cell degranulation after incubation with the solutions of MRI contrast media results from non-specific osmotic stimulation and direct toxicity of free ionic residues.

  14. Influence of MRI contrast media on histamine release from mast cells

    International Nuclear Information System (INIS)

    Kun, Tomasz; Jakubowski, Lucjusz

    2012-01-01

    Mast cells, owing to diversity of secreted mediators, play a crucial role in the regulation of inflammatory response. Together with basophils, mast cells constitute a central pathogenetic element of anaphylactic (IgE-dependent) and anaphylactoid (IgE-independent) reactions. In severe cases, generalized degranulation of mast cells may cause symptoms of anaphylactic shock. The influence of the classical, iodine-based contrast media on mastocyte degranulation has been fully described. Our objective was to determine the influence of the gadolinium-based MRI contrast media on histamine release from mast cells and to compare the activity of ionic and non-ionic preparations of contrast media. To determine the intensity of mast cell degranulation, we used an experimental model based on mastocytes isolated from rat peritoneal fluid. Purified suspensions of mast cells were incubated with various concentrations of Gd-DTPA and Gd-DTPA-BMA, and solutions of PEG 600 which served as a non-toxic osmotic stimulus. The intensity of mast cell activation was presented as mean percentage of histamine released from cells after incubation. The obtained results demonstrate that both ionic and non-ionic preparations of the MRI contrast media are able to induce mast cell degranulation in vitro. It was also proved that the non-ionic MRI contrast media stimulate mast cells markedly more weakly than ionic contrast media at identical concentration. The aforementioned results may suggest a more profitable safety profile of the non-ionic contrast preparations. We may also conclude that triggering of mast cell degranulation after incubation with the solutions of MRI contrast media results from non-specific osmotic stimulation and direct toxicity of free ionic residues

  15. An experimental study on MRI signal intensity vs concentration of water-soluble contrast media

    International Nuclear Information System (INIS)

    Lee, Ghi Jai; Han, Chang Yul; Chang, Kee Hyun; Han, Moon Hee; Han, Man Chung

    1991-01-01

    There has been only one report that water-soluble contrast media containing iodine and used in conventional X -ray radiography reduce T1-and T2-relaxation times. We evaluated the relationship between signal intensity (relative signal intensity to normal saline) and T2-relaxation time of MRI and the concentration of 3 water-soluble contrast media [meglumine ioxithalamate (Telebrix 30), iopromide (Ultravist 300), iotrolan (Isovist 300)] through the phantom study, using both 2.0T and 0.5T MR units. We found that the signal intensity increased significantly on the T1-weighted images as the concentration of contrast media increased. The degree of the increase was larger on 0.5T MR than on 2.0T MR. The signal intensity on proton density image showed no significant difference at various concentrations. However, there were significant decreases of both signal intensity on the T2-weighted images and T2-relaxation time as the concentration of contrast media increased, which was more prominent on 2.0T MR than 0.5T MR. Between the contrast media of the same concentration, there was no significant difference in signal intensity and T2-relaxation time

  16. Prolonged retainment of contrast media in renal tumours by oily X-ray contrast media

    International Nuclear Information System (INIS)

    Ryzkov, V.K.; Anisimov, V.N.

    1990-01-01

    In 194 patients with renal tumours an angiographic investigation with the oily X-ray contrast medium Iodolipol was carried out. A selective tropism of oily X-ray contrast media was found in the malignant zones only. The application of the preparation caused no complications. The oily X-ray contrast medium persisted in the tumours over several weeks or months. After embolization of the renal arteria a moderate size reduction of malign tumours in the first 10-14 d was seen. The ability of Iodolipol for a lasting retainment in malign tumour tissue allows a follow-up of the involution of the pathologic focus after arterial embolization of the tumour vessels. (author)

  17. Quantitative dosimetric assessment for effect of gold nanoparticles as contrast media on radiotherapy planning

    Science.gov (United States)

    Tu, Shu-Ju; Yang, Pei-Ying; Hong, Ji-Hong; Lo, Ching-Jung

    2013-07-01

    In CT planning for radiation therapy, patients may be asked to have a medical procedure of contrast agent (CA) administration as required by their physicians. CA media improve quality of CT images and assist radiation oncologists in delineation of the target or organs with accuracy. However, dosimetric discrepancy may occur between scenarios in which CA media are present in CT planning and absent in treatment delivery. In recent preclinical experiments of small animals, gold nanoparticles (AuNPs) have been identified as an excellent contrast material of x-ray imaging. In this work, we quantitatively evaluate the effect of AuNPs to be used as a potential material of contrast enhancement in radiotherapy planning with an analytical phantom and clinical case. Conray 60, an iodine-based product for contrast enhancement in clinical uses, is included as a comparison. Other additional variables such as different concentrations of CA media, radiation delivery techniques and dose calculation algorithms are included. We consider 1-field AP, 4-field box, 7-field intensity modulated radiation therapy (IMRT) and a recent technique of volumetric modulated arc therapy (VMAT). CA media of AuNPs (Conray 60) with concentrations of 10%, 20%, 30%, 40% and 50% containing 28.2, 56.4, 84.6, 112.8 and 141.0 mg of gold (iodine) per mL were prepared prior to CT scanning. A virtual phantom with a target where nanoparticle media are loaded and clinical case of gastric lymphoma in which the Conray 60 media were given to the patient prior to the CT planning are included for the study. Compared to Conray 60 media with concentration of 10%/50%, Hounsfield units for AuNP media of 10%/50% are 322/1608 higher due to the fact that atomic number of Au (Z=79) is larger than I (Z=53). In consequence, dosimetric discrepancy of AuNPs is magnified between presence and absence of contrast media. It was found in the phantom study that percent dose differences between presence and absence of CA media may be

  18. Transient angioedema of small bowel secondary to intravenous iodinated contrast medium

    Directory of Open Access Journals (Sweden)

    Kirankumar N Kulkarni

    2014-01-01

    Full Text Available We report the clinical details and imaging findings of a case of transient angioedema of the small bowel following intravenous administration of non-ionic iodinated contrast material in a 17 year old female with no predisposing risk factors. Findings included long segment, symmetric, circumferential, low-density, bowel wall thickening involving the duodenum, jejunum, and most of the ileum on computed tomography scan obtained at 7 min following intravenous contrast material injection. This entity is self-limiting with a favourable clinical outcome and requires no specific treatment but only aggressive clinical monitoring.

  19. Contrast media for fluoroscopic examinations of the GI and GU tracts: current challenges and recommendations.

    Science.gov (United States)

    Federle, Michael P; Jaffe, Tracy A; Davis, Peter L; Al-Hawary, Mahmoud M; Levine, Marc S

    2017-01-01

    One of the significant challenges facing radiologists who perform and interpret studies of the gastrointestinal and genitourinary systems have been periodic interruptions in the availability of barium and iodinated contrast media specially formulated for gastrointestinal (GI) and genitourinary (GU) studies. These interruptions are due to the US Food and Drug Administration's recent requirement for more stringent documentation of the safety and efficacy of contrast media and the consolidation among contrast manufacturers. Therefore, radiologists may be required to recommend an alternative means of evaluation, such as computed tomography, magnetic resonance, or endoscopy, or they may need to substitute a different formulation of a contrast agent not specifically developed for GI or GU use, for example the utilization of an agent designed and marketed for vascular use. This article reviews the current status of fluoroscopic contrast media, and provides suggestions and recommendations for the optimal and alternative use of contrast media formulations.

  20. The use of contrast media in computer tomography

    International Nuclear Information System (INIS)

    Galanski, M.; Cramer, B.M.; Drewes, G.

    1980-01-01

    There are a variety of applications for contrast media in CT. They can be used for better anatomic demonstration or for showing pathological processes. Nearly all available contrast media may be found useful. Intravenously injected renographic contrast media are most commonly employed. In addition to their inherent contrast, specific pharmaco-kinetic changes may be of diagnostic value. This adds some knowledge of function to the purely morphological information obtained by computer tomography. For this purpose, contrast has to be injected rapidly and a fast scanner must be used (so-called angio-CT). (orig.) [de

  1. Pharmacodynamics and tolerance of X-ray contrast media

    International Nuclear Information System (INIS)

    Schmiedel, E.

    1987-01-01

    The improved tolerance of nonionic contrast media compared with conventional contrast media is mainly due to their lower osmolality and reduced allergoid potential. Tolerance advantages that have been definitely proven are, for example, low-pain contrast medium injection and superior systemic tolerance; side effects of an allergic pattern occur less often. Animals experiments have established that nonionic contrast media exercise a comparatively lower influence on the cardiovascular system. The haemodynamics of pulmonary circulation are less adversely affected on intravenous bolus injection. Reduced potential risk is to be expected especially in cardiac and bronchopulmonary high-risk patients. The reduced nephrotoxicity of nonionic contrast media was definitely established by clinical studies. Further systematic studies will however be required to provide an answer to the question whether this also entails a reduction in the incidence of renal failures induced by contrast media. (orig.) [de

  2. Nephrogenic systemic fibrosis and gadolinium-based contrast media

    DEFF Research Database (Denmark)

    Thomsen, Henrik S; Morcos, Sameh K; Almén, Torsten

    2012-01-01

    PURPOSE: To update the guidelines of the Contrast Media Safety Committee (CMSC) of the European Society of Urogenital Radiology (ESUR) on nephrogenic systemic fibrosis and gadolinium-based contrast media. AREAS COVERED: Topics reviewed include the history, clinical features and prevalence of neph...... guidelines regarding gadolinium contrast agents minimises the risk of NSF • Potential long-term harm from gadolinium accumulation in the body is discussed.......PURPOSE: To update the guidelines of the Contrast Media Safety Committee (CMSC) of the European Society of Urogenital Radiology (ESUR) on nephrogenic systemic fibrosis and gadolinium-based contrast media. AREAS COVERED: Topics reviewed include the history, clinical features and prevalence...... of nephrogenic systemic fibrosis and the current understanding of its pathophysiology. The risk factors for NSF are discussed and prophylactic measures are recommended. The stability of the different gadolinium-based contrast media and the potential long-term effects of gadolinium in the body have also been...

  3. Addition of lacal anesthetics to contrast media. Pt. 2

    International Nuclear Information System (INIS)

    Nilsson, P.; Almen, T.; Golman, K.; Jonsson, K.; Nyman, U.; Malmoe Allmaenna Sjukhus

    1988-01-01

    The acute intravenous toxicity (i.v. LD 50 ) of solutions of the ratio 1.5 contrast media metrizoate or diatrizoate and the ratio 3.0 contrast medium metrizamide was determined in mice with and without the addition of local anesthetics to the solutions. The two local anesthetics mepivacaine or lidocaine were added to final concentrations up to 2.0 mg/ml of the contrast medium solutions. This corresponds to clinically used concentrations. All additions of local anesthetics to the solutions increased the mortalities caused by the contrast medium solutions. Addition of local anesthetics to a final concentration of 2 mg/ml approximately doubled the acute intravenous toxicity of the contrast media. The ratio 3 contrast media produce less hypertonic solutions than the ratio 1.5 contrast media and should be preferred for angiography because they cause less pain and do not require the addition of local anesthetics which increase the acute toxicity of the solutions. (orig.)

  4. Hemodynamic and tubular changes induced by contrast media.

    Science.gov (United States)

    Caiazza, Antonella; Russo, Luigi; Sabbatini, Massimo; Russo, Domenico

    2014-01-01

    The incidence of acute kidney injury induced by contrast media (CI-AKI) is the third cause of AKI in hospitalized patients. Contrast media cause relevant alterations both in renal hemodynamics and in renal tubular cell function that lead to CI-AKI. The vasoconstriction of intrarenal vasculature is the main hemodynamic change induced by contrast media; the vasoconstriction is accompanied by a cascade of events leading to ischemia and reduction of glomerular filtration rate. Cytotoxicity of contrast media causes apoptosis of tubular cells with consequent formation of casts and worsening of ischemia. There is an interplay between the negative effects of contrast media on renal hemodynamics and on tubular cell function that leads to activation of renin-angiotensin system and increased production of reactive oxygen species (ROS) within the kidney. Production of ROS intensifies cellular hypoxia through endothelial dysfunction and alteration of mechanisms regulating tubular cells transport. The physiochemical characteristics of contrast media play a critical role in the incidence of CI-AKI. Guidelines suggest the use of either isoosmolar or low-osmolar contrast media rather than high-osmolar contrast media particularly in patients at increased risk of CI-AKI. Older age, presence of atherosclerosis, congestive heart failure, chronic renal disease, nephrotoxic drugs, and diuretics may multiply the risk of CI-AKI.

  5. Effect of organic contrast Media on the haematology and Serum ...

    African Journals Online (AJOL)

    Key Words: Contrast media, haematology, serum electrolytes, dogs, xylazine. The effect of contrast media on the hematology and serum electrolyte was determined in five dogs sedated with 2mg/kg of xylazine intramuscular (i.m). A total of 800mg/kg bolus of 76% urograffin was then administered by intravenous injection ...

  6. Use of gadolinium chelate to confirm epidural needle placement in patients with an iodinated contrast reaction

    International Nuclear Information System (INIS)

    Shetty, Sanjay K.; Nelson, Erik N.; Lawrimore, Tara M.; Palmer, William E.

    2007-01-01

    When performing epidural steroid injections for the management of chronic back pain, imaging guidance and a limited epidurogram improve accuracy of needle placement and ensure appropriate delivery of the injectate into the epidural space. We describe our experience using a gadolinium chelate as an alternative contrast agent for limited epidurography in patients with a history of an iodinated contrast reaction. Thirty-eight of 2,067 (1.8%) epidural steroid injections performed in our department over a 25-month period (December 2003-January 2006) employed gadolinium. All injections were performed in the lumbar spine employing a paramedian interlaminar approach. Procedural notes and patient charts were reviewed to evaluate for immediate or delayed complications related to incorrect intrathecal or intravascular needle placement. A retrospective analysis of selected fluoroscopic spot images was performed to evaluate confidence of epidural needle placement; this analysis compared these spot images against those obtained from age- and gender-matched control patients in whom iodinated contrast was used to confirm needle placement. Real-time fluoroscopic guidance permitted confident visualization of an epidurogram at the time of procedure in all 38 cases as documented in the procedural report, and no procedure resulted in a complication due to incorrect needle placement. Retrospective review of fluoroscopic spot images revealed at least moderate confidence of epidural needle placement by both readers in 29/38 cases (76.3%). Fluoroscopic spot images obtained using gadolinium yielded significantly less confidence than images obtained in control patients whose procedures were performed using iodinated contrast (P < 0.01). However, operators were sufficiently confident in needle placement based on real-time fluoroscopic images (not available in our subsequent review) to inject anesthestic in all 38 cases, despite the immediate consequences that could result from intrathecal

  7. Use of gadolinium chelate to confirm epidural needle placement in patients with an iodinated contrast reaction

    Energy Technology Data Exchange (ETDEWEB)

    Shetty, Sanjay K. [Massachusetts General Hospital, Harvard Medical School, Division of Musculoskeletal Radiology, Department of Radiology, Boston, MA (United States); Beth Israel Deaconess Medical Center, Harvard Medical School, Department of Radiology, Boston, MA (United States); Nelson, Erik N.; Lawrimore, Tara M.; Palmer, William E. [Massachusetts General Hospital, Harvard Medical School, Division of Musculoskeletal Radiology, Department of Radiology, Boston, MA (United States)

    2007-04-15

    When performing epidural steroid injections for the management of chronic back pain, imaging guidance and a limited epidurogram improve accuracy of needle placement and ensure appropriate delivery of the injectate into the epidural space. We describe our experience using a gadolinium chelate as an alternative contrast agent for limited epidurography in patients with a history of an iodinated contrast reaction. Thirty-eight of 2,067 (1.8%) epidural steroid injections performed in our department over a 25-month period (December 2003-January 2006) employed gadolinium. All injections were performed in the lumbar spine employing a paramedian interlaminar approach. Procedural notes and patient charts were reviewed to evaluate for immediate or delayed complications related to incorrect intrathecal or intravascular needle placement. A retrospective analysis of selected fluoroscopic spot images was performed to evaluate confidence of epidural needle placement; this analysis compared these spot images against those obtained from age- and gender-matched control patients in whom iodinated contrast was used to confirm needle placement. Real-time fluoroscopic guidance permitted confident visualization of an epidurogram at the time of procedure in all 38 cases as documented in the procedural report, and no procedure resulted in a complication due to incorrect needle placement. Retrospective review of fluoroscopic spot images revealed at least moderate confidence of epidural needle placement by both readers in 29/38 cases (76.3%). Fluoroscopic spot images obtained using gadolinium yielded significantly less confidence than images obtained in control patients whose procedures were performed using iodinated contrast (P < 0.01). However, operators were sufficiently confident in needle placement based on real-time fluoroscopic images (not available in our subsequent review) to inject anesthestic in all 38 cases, despite the immediate consequences that could result from intrathecal

  8. Iodinated Contrast Does Not Alter Clotting Dynamics in Acute Ischemic Stroke as Measured by Thromboelastography

    Science.gov (United States)

    McDonald, Mark M; Archeval-Lao, Joancy M; Cai, Chunyan; Peng, Hui; Sangha, Navdeep; Parker, Stephanie A; Wetzel, Jeremy; Riney, Stephen A; Cherches, Matt F; Guthrie, Greer J; Roper, Tiffany C; Kawano-Castillo, Jorge F; Pandurengan, Renga; Rahbar, Mohammad H; Grotta, James C

    2014-01-01

    Background and Purpose Iodinated contrast agents used for computed tomography angiography (CTA) may alter fibrin fiber characteristics and decrease fibrinolysis by tissue plasminogen activator (tPA). Thromboelastography (TEG™) measures the dynamics of coagulation and correlates with thrombolysis in acute ischemic stroke (AIS) patients. We hypothesized that receiving CTA prior to tPA will not impair thrombolysis as measured by TEG™. Methods AIS patients receiving 0.9 mg/kg tPA within 4.5 hours of symptom onset were prospectively enrolled. For CTA, 350 mg/dL of iohexol or 320 mg/dL of iodixanol at a dose of 2.2 ml/kg was administered. TEG™ was measured prior to tPA and 10-minutes after tPA bolus. CTA timing was left to the discretion of the treating physician. Results Of 136 AIS patients who received tPA, 47 had CTA prior to tPA bolus, and 42 had either CTA following tPA and post-tPA TEG™ draw or no CTA (non-contrast group). The median change in clot lysis (LY30) following tPA was 95.3% in the contrast group vs. 95.0% in the non-contrast group (p = 0.74). Thus, tPA-induced thrombolysis did not differ between contrast and non-contrast groups. Additionally, there was no effect of contrast on any pre-tPA TEG™ value. Conclusions Our data do not support an effect of iodinated contrast agents on clot formation or tPA activity. PMID:24370757

  9. Safety of contrast media. Focus on contrast-induced nephropathy (CIN)

    International Nuclear Information System (INIS)

    Kuwatsuru, Ryohei

    2011-01-01

    Despite advances in imaging diagnosis, contrast media still play an important role in diagnosing the existence of the disease, demonstrating the extent of disease, and determining the perfusion of the disease, which is important to make a differential diagnosis. However, the administration of contrast media may cause contrast-induced nephropathy (CIN), especially in patients with renal impairment. It is estimated that 20-30% of patients with renal impairment who received contrast media develop CIN. Though the precise cause of CIN currently remains unknown, almost all injected contrast media are excreted through the kidney and the effects of contrast media on the kidney are easily understood. As CIN is the most common cause of death due to complications after receiving contrast media, prevention of CIN is important. There are several known risk factors for CIN. Patients with renal impairment, diabetes mellitus, and dehydration are at high risk for CIN. Furthermore, a high osmolar contrast media, excessive amount of contrast media, and ionic contrast media are also risk factors for CIN. CIN can be prevented in several ways. Certain drugs seem to be useful to prevent CIN, while others are harmful. Hydration is useful to prevent CIN, although there is no widely acceptable hydration method to prevent CIN. Both sodium bicarbonate and N-acetylcysteine are promising candidates for prevention of CIN. There are few reports to study CIN after intravenous administration, although reports of CIN after percutaneous cardiac intervention (PCI) and angiography are well recognized. In clinical situations, intravenous administration of contrast media is common. Therefore, a study of CIN after intravenous administration of contrast media should be performed. (author)

  10. Role of informed consent for intravascular contrast media

    International Nuclear Information System (INIS)

    Hopper, K.D.; Tyler, H.N. Jr.

    1988-01-01

    To evaluate the usefulness of different degrees of informed consent for intravascular contrast media, the authors divided 100 patients into four groups: (1) informed consent with no information on intravascular contrast media, (2) simple written informed consent that detailed common risks, (3) detailed written informed consent that detailed all known risks, and (4) MD informed consent, during which a radiologist discussed all known risks of intravascular contrast media. Physician counseling time for group 4 averaged 11.4 minutes. On a postprocedure test about the common complications and risk factors of intravascular contrast media, the average scores were: group 1, 38.4%; group 2, 68.2%; group 3, 63.2%; and group 4, 69.8%. There was no statistical difference between groups 2-4 on the postprocedure test. If informed consent is to be used prior to intravascular contrast media administration, a simple written consent detailing the common risks and risk factors appears to be the best method

  11. Adverse drug reactions to CT contrast media in south Korea: Incidence and risk factors

    International Nuclear Information System (INIS)

    Bae, Kyung Soo; Jeon, Kyung Nyeo; Moon, Jin Il; Choi, Bo Hwa; Baek, Hye Jin; Cho, Soo Buem; Lee, Sang Min; Ha, Ji Young; Choi, Dae Seob; Cho, Jae Min; Na, Jae Beom

    2016-01-01

    To evaluate the incidence, severity, and risk factors of adverse drug reactions (ADR) to intravenous administration of nonionic iodinated contrast media in computed tomography (CT), and to determine the recurrence rate after premedication in patients with a previous history of ADR. We prospectively recorded all ADR to intravenous CT contrast media in 32313 consecutive outpatients (54572 cases) who underwent contrast enhanced CT examinations. Clinical report forms and electronic medical records were reviewed to search for the incidence of ADR, treatment, and clinical outcome of patients. The risk factors of ADR to CT contrast media (age, sex, history of previous ADR, season) were evaluated using statistical analysis. Of the 54572 cases, a total of 191 (0.35%) had adverse reactions. Of the 191 cases, 157 (82%) were categorized as mild reactions, 29 (15%) were moderate, and 5 (3%) were severe. A total of 165 (86.4%) cases had acute adverse reactions (which occurred within 1 hour after administration), while 26 (13.6%) had delayed adverse reactions (occurred 1 hour after the administration). The rate of ADR was significantly higher in females [relative risk (RR) = 2.05, 95% confidence interval (CI) 1.53-2.75], patients under the age of 60 years (RR = 1.45, 95% CI 1.07-1.98), patients with a history of previous ADR (RR = 6.51, 95% CI 3.13-13.57), and in the spring season (RR = 1.44, 95% CI 1.07-1.95). The recurrence rate after premedication in patients with previous ADR to CT contrast media was 3.2% (8/247). No deaths occurred that were attributed to the contrast media. The incidence of ADR to nonionic CT contrast media was 0.35%; most of which were mild reactions. Risk factors for ADR included female gender, an age of under 60 years, a history of previous ADR, and spring season

  12. Adverse drug reactions to CT contrast media in south Korea: Incidence and risk factors

    Energy Technology Data Exchange (ETDEWEB)

    Bae, Kyung Soo; Jeon, Kyung Nyeo; Moon, Jin Il; Choi, Bo Hwa; Baek, Hye Jin; Cho, Soo Buem [Dept. of Radiology, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Changwon (Korea, Republic of); Lee, Sang Min; Ha, Ji Young; Choi, Dae Seob; Cho, Jae Min; Na, Jae Beom [Dept. of Radiology, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju (Korea, Republic of)

    2016-07-15

    To evaluate the incidence, severity, and risk factors of adverse drug reactions (ADR) to intravenous administration of nonionic iodinated contrast media in computed tomography (CT), and to determine the recurrence rate after premedication in patients with a previous history of ADR. We prospectively recorded all ADR to intravenous CT contrast media in 32313 consecutive outpatients (54572 cases) who underwent contrast enhanced CT examinations. Clinical report forms and electronic medical records were reviewed to search for the incidence of ADR, treatment, and clinical outcome of patients. The risk factors of ADR to CT contrast media (age, sex, history of previous ADR, season) were evaluated using statistical analysis. Of the 54572 cases, a total of 191 (0.35%) had adverse reactions. Of the 191 cases, 157 (82%) were categorized as mild reactions, 29 (15%) were moderate, and 5 (3%) were severe. A total of 165 (86.4%) cases had acute adverse reactions (which occurred within 1 hour after administration), while 26 (13.6%) had delayed adverse reactions (occurred 1 hour after the administration). The rate of ADR was significantly higher in females [relative risk (RR) = 2.05, 95% confidence interval (CI) 1.53-2.75], patients under the age of 60 years (RR = 1.45, 95% CI 1.07-1.98), patients with a history of previous ADR (RR = 6.51, 95% CI 3.13-13.57), and in the spring season (RR = 1.44, 95% CI 1.07-1.95). The recurrence rate after premedication in patients with previous ADR to CT contrast media was 3.2% (8/247). No deaths occurred that were attributed to the contrast media. The incidence of ADR to nonionic CT contrast media was 0.35%; most of which were mild reactions. Risk factors for ADR included female gender, an age of under 60 years, a history of previous ADR, and spring season.

  13. Computed tomography lung iodine contrast mapping by image registration and subtraction

    Science.gov (United States)

    Goatman, Keith; Plakas, Costas; Schuijf, Joanne; Beveridge, Erin; Prokop, Mathias

    2014-03-01

    Pulmonary embolism (PE) is a relatively common and potentially life threatening disease, affecting around 600,000 people annually in the United States alone. Prompt treatment using anticoagulants is effective and saves lives, but unnecessary treatment risks life threatening haemorrhage. The specificity of any diagnostic test for PE is therefore as important as its sensitivity. Computed tomography (CT) angiography is routinely used to diagnose PE. However, there are concerns it may over-report the condition. Additional information about the severity of an occlusion can be obtained from an iodine contrast map that represents tissue perfusion. Such maps tend to be derived from dual-energy CT acquisitions. However, they may also be calculated by subtracting pre- and post-contrast CT scans. Indeed, there are technical advantages to such a subtraction approach, including better contrast-to-noise ratio for the same radiation dose, and bone suppression. However, subtraction relies on accurate image registration. This paper presents a framework for the automatic alignment of pre- and post-contrast lung volumes prior to subtraction. The registration accuracy is evaluated for seven subjects for whom pre- and post-contrast helical CT scans were acquired using a Toshiba Aquilion ONE scanner. One hundred corresponding points were annotated on the pre- and post-contrast scans, distributed throughout the lung volume. Surface-to-surface error distances were also calculated from lung segmentations. Prior to registration the mean Euclidean landmark alignment error was 2.57mm (range 1.43-4.34 mm), and following registration the mean error was 0.54mm (range 0.44-0.64 mm). The mean surface error distance was 1.89mm before registration and 0.47mm after registration. There was a commensurate reduction in visual artefacts following registration. In conclusion, a framework for pre- and post-contrast lung registration has been developed that is sufficiently accurate for lung subtraction

  14. Contrast media in urography, angiography and computerized tomography

    International Nuclear Information System (INIS)

    Taenzer, V.; Zeitler, E.

    1983-01-01

    The fact that new contrast media have been introduced in Germany or are currently undergoing clinical trials prompted the authors to assemble available experiences in a special edition of ''Roentgen-Fortschritte''. Particular prominence is given in the publication to preclinical and clinical experiences with another new non-ionic contrast medium, Iopromide. Experimental and clinical studies both indicate changes in certain clinically pertinent properties of the new contrast media. (orig./MG) [de

  15. A case of pulmonary edema developed after intraarterial injection of iodinated contrast medium

    International Nuclear Information System (INIS)

    Min, Byoung Chol; Chun, Kang Woo; Koh, Jae Hyu; Yoon, Jong Sup

    1982-01-01

    Pulmonary edema is a rare adverse reaction to the iodinated contrast medium. Complaining of huge abdominal mass, a 52 years old female was admitted to the Hangang Sungsim Hospital. On physical examination, the patient appeared to be healthy. She had stable vital signs, i.e. BP: 120/80 mmHg, pulse rate: 80/min.etc. An adult head sized mass was palpated in the left mid and lower abdomen. Otherwise nonspecific. On laboratory studies the positive findings were 8-10 WBC/HPF in urine, 25.6 mg/dl for BUN and PVC in EKG. It was negative for urine protein, serum creatinline and liver function test. We injected 100 ml and 30 ml of Urografin 60 through the abdominal aorta dividing 3 times and major branches of the abdominal aorta, respectively. Immediately after complicating angiography, interstitial pulmonary edema was found, showing blurring of the vascular margins, perivascular haziness and thickening of the interlobular septal lines in the both lower lung fields. The blood pressure was dropped to 80/60 mmHg, but pulse rate was normal. She did not complain of dyspnea, and cyanosis was not developed. The urine volume was normally maintained. She was treated for pulmonary edema, which was completely absorbed after 20 hours. And the blood pressure was also normalized. We have experienced a case of pulmonary edema developed after intraarterial injection of the iodinated contrast medium without underlying cardiac, renal and hepatic problems, and reviewed the literatures on mechanisms of pulmonary edema caused by intravascular injection of the iodinated contrast materials

  16. Synthesis of results of randomized controlled trials of contrast media

    International Nuclear Information System (INIS)

    Kinnison, M.L.; Powe, N.R.; Steinberg, E.P.

    1988-01-01

    The authors review 100 randomized controlled trials (RCTs) that examine the safety or efficacy of new low-osmolality contrast media (LOM) and focus on the 43 RCTs judged to be of the highest quality. These RCTs showed no consistent differences in nephrotoxicity between high- and low-osmolality contrast media. Certain cardiovascular parameters were altered less with low-osmolality agents during intracardiac injection, but the clinical significance of these differences in unclear. Heat and pain sensations occurred less often with low-osmolality contrast media. No differences were noted in the incidence of nausea, vomiting, urticaria, or bronchospasm. Even with numerous RCTs comparing these media, physicians still must make economically significant choices about contrast media without sufficient data about their relative safety

  17. Advice on the management of reactions to intravenous contrast media

    International Nuclear Information System (INIS)

    1996-01-01

    The College has previously issued guidelines for the management of adverse reactions to intravenous ionic and non-ionic contrast media. The following updated guidelines are applicable to both children and adults. The reported adverse reaction rate to conventional ionic contrast media is about 5%, the vast majority of reactions being of a minor nature, and to the newer non-ionic contrast media, approximately 1%. The rare serious reaction, with an estimated incidence of 0.05% with ionic contrast media and substantially less with non-ionic media, must be treated quickly and appropriately. Identification and symptomatic characterisation of the reaction are the key first steps and should be followed by ad hoc management based on general principles. (author)

  18. Streak artifacts on Kidney CT: Ionic vs nonionic contrast media

    International Nuclear Information System (INIS)

    Cho, Eun Ok; Kim, Won Hong; Jung, Myung Suk; Kim, Yong Hoon; Hur, Gham

    1993-01-01

    The authors reviewed findings of enhanced abdominal computed tomography (CT) scans to know the difference between a higher dose of conventional ionic contrast media(iothalamate meglumine) and a lower dose of a new, nonionic contrast material(ioversol). One hundred adult patients were divided into two groups. Each group consisted of 50 patients. Iothalamate meglumine and ioversol were intravenously administered in each group. The radio of the male to female in the former was 28:22, and the latter 29:21. We examine the degree of renal streak artifact and measure the Hounsfield number of urine in renal collecting system. There were significant differences of the degree of the streak artifact depending upon the osmolality of contrast media used and that was related with urine CT number(P value<0.005). We authors conclude that nonionic low osmolar contrast media is prone to cause streak artifacts and distortions of renal image than conventional ionic high osmolar contrast media

  19. Use of high concentration contrast media (HCCM): principles and rationale--body CT

    International Nuclear Information System (INIS)

    Brink, James A.

    2003-01-01

    Numerous complex pharmacokinetic interrelationships affect the use of contrast media for computed tomography (CT) imaging. The volume, concentration, and rate of injection, all affect the degree of enhancement that is achieved with an injection of contrast material. In addition, the injection technique, whether the contrast is infused with a constant injection rate (uniphasic injection) or whether the rate is altered during the injection (multiphasic injection) also affect the magnitude and duration of contrast enhancement. In body CT imaging, the liver poses unique challenges in managing the use of intravenous contrast material because of its dual blood supply and the need to complete imaging before equilibrium occurs between the intravascular and extravascular compartments. The magnitude of hepatic enhancement that is ultimately achieved is related primarily to the amount of iodinated contrast material that accumulates in the extravascular space within the target organ, independent of the speed of the CT scanner. The key determinant of the onset of the equilibrium phase is the injection duration. Given that a high injection flow rate (4-5 ml/s) is desirable for arterial phase imaging, the injection duration is maintained with use of an appropriate contrast volume. Thus, modifications of total iodine dose are best done with alterations in contrast concentration. The magnitude of arterial enhancement that is achieved is related to both the concentration and rate of contrast administration. The speed of the scanner determines its ability to record image data during the most advantageous time period, the peak of arterial enhancement. Thus, rapid imaging is particularly advantageous for optimal contrast use in CT angiography as well as in multiphasic imaging of the parenchymal organs

  20. The effect of iodine uptake on radiation dose absorbed by patient tissues in contrast enhanced CT imaging. Implications for CT dosimetry

    Energy Technology Data Exchange (ETDEWEB)

    Perisinakis, Kostas; Damilakis, John [University of Crete, Department of Medical Physics, Medical School, Heraklion, Crete (Greece); University Hospital of Heraklion, Department of Medical Physics, Heraklion, Crete (Greece); Tzedakis, Antonis; Papadakis, Antonios E. [University Hospital of Heraklion, Department of Medical Physics, Heraklion, Crete (Greece); Spanakis, Kostas [University Hospital of Heraklion, Department of Radiology, Heraklion, Crete (Greece); Hatzidakis, Adam [University Hospital of Heraklion, Department of Radiology, Heraklion, Crete (Greece); University of Crete, Department of Radiology, Medical School, Heraklion, Crete (Greece)

    2018-01-15

    To investigate the effect of iodine uptake on tissue/organ absorbed doses from CT exposure and its implications in CT dosimetry. The contrast-induced CT number increase of several radiosensitive tissues was retrospectively determined in 120 CT examinations involving both non-enhanced and contrast-enhanced CT imaging. CT images of a phantom containing aqueous solutions of varying iodine concentration were obtained. Plots of the CT number increase against iodine concentration were produced. The clinically occurring iodine tissue uptake was quantified by attributing recorded CT number increase to a certain concentration of aqueous iodine solution. Clinically occurring iodine uptake was represented in mathematical anthropomorphic phantoms. Standard 120 kV CT exposures were simulated using Monte Carlo methods and resulting organ doses were derived for non-enhanced and iodine contrast-enhanced CT imaging. The mean iodine uptake range during contrast-enhanced CT imaging was found to be 0.02-0.46% w/w for the investigated tissues, while the maximum value recorded was 0.82% w/w. For the same CT exposure, iodinated tissues were found to receive higher radiation dose than non-iodinated tissues, with dose increase exceeding 100% for tissues with high iodine uptake. Administration of iodinated contrast medium considerably increases radiation dose to tissues from CT exposure. (orig.)

  1. Influence of tri-iodinated water soluble X-ray contrast medium for uro, angio and cholangiography on the plasmic coagulation system

    International Nuclear Information System (INIS)

    Kaps, H.P.

    1982-01-01

    In-vitro coagulation studies comprising overall and individual factor determinations were carried out with the aim of clarifying the nature of unforeseen incidents arising from the use of contrast media in X-ray diagnosis. In all tests a reproducible, dose-dependent, exponential coagulation inhibition was obtained, and resulted in complete inhibition at higher dose levels. This effect occurred by a factor of ten earlier, on average, with iodine ipamide, representative of liver passage bile CM, compared to uro, and angiographic CM diatrozoate and iodine thalamate used for kidney passage. Hepatotrophic CM act initially hypercoagulative at low dises through activation of the thrombin coagulase complex; later inhibition of coagulation sets in through direct fixation on functional proteins and their subsequent denaturation. A discussion is given of the importance of direct physico-chemical toxicity, histamine liberation reactions and cellular reactions, and the controversial role of the complement system is presented. (orig./MG) [de

  2. Characterisation of urinary stones in the presence of iodinated contrast medium using dual-energy CT: a phantom study

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Jia; Qu, Mingliang; Duan, Xinhui; Takahashi, Naoki; Kawashima, Akira; Leng, Shuai; McCollough, Cynthia H. [Mayo Clinic, Department of Radiology, Rochester, MN (United States)

    2012-12-15

    To develop a dual-energy CT (DECT) method for differentiating uric acid (UA) from non-UA stones in the presence of iodinated contrast medium. Thirty UA and 45 non-UA stones were selected after infra-red spectroscopic analysis and independently placed in a 1.5-ml vial, which was filled first with saline and then with increasing concentrations of iodine. For each condition, tubes were put in a 35-cm water phantom and examined using a dual-source CT system at 100 and 140 kV. Virtual unenhanced images created from CT data sets of the stones in iodine-containing solutions provided position and volume information. This map was used to calculate a CT number ratio to differentiate stone type. A region-growing method was developed to improve the ability to differentiate between UA and non-UA stones with iodinated contrast medium. The sensitivity for detecting UA stones was 100 % for unenhanced images but fell to 18 % with 20 mgI/ml iodine solution and 0 % for higher concentrations. With region growing, the sensitivity for detecting UA stones was increased to 100 %, 82 %, 57 %, 50 % and 21 % for iodine solutions of 20, 40, 60, 80 and 100 mgI/ml. The region-growing method improves differentiation of UA from non-UA stones on contrast-enhanced DECT urograms. (orig.)

  3. Contrast media safety-an update

    DEFF Research Database (Denmark)

    Thomsen, Henrik S

    2011-01-01

    The value of contrast agents has for long been documented by their common daily use in imaging departments worldwide. In principle, they should be injected and leave the body immediately after use in the same condition or undergo natural metabolism without making any harm to the patient. However......, this is not the case. It is of utmost importance to reduce the prevalence to as close as possible to zero. This can be done by identifying the patients at risk before administration of contrast agents. For acute non-renal adverse reactions, it is also important to be prepared for treating them instantly. The current...... review is a short state of the art regarding adverse reactions to contrast agents....

  4. Acute anterior myocardial infarction seen on conventional iodine-contrast CT

    Directory of Open Access Journals (Sweden)

    Christian Hagdrup, MD

    2017-09-01

    Full Text Available Diagnosis of acute myocardial infarction (AMI is based on clinical symptoms of chest pain and dyspnea in combination with electrocardiographic changes and a raise in myocardial-specific biomarkers. Imaging is by echocardiography and magnetic resonance. The preferred technique for identification of previous myocardial infarction (MI is magnetic resonance imaging with late gadolinium technique, but in the acute patient echocardiography is applied. In selected cases, important information can be obtained from other imaging modalities. We describe a case of a patient first suspected of an abdominal catastrophe in whom acute MI was diagnosed from a computerized tomography (CT scan with iodine contrast. Our case together with a few other cases reported in the literature demonstrate that contrast enhancement of the myocardium can be important to follow in the acute patient because the CT scans sometimes give a unique opportunity to recognize findings consistent with MI even though the CT scan was performed for another reason.

  5. Prevention of adverse reactions to intravascular contrast media

    International Nuclear Information System (INIS)

    Soyer, P.; Levesque, M.

    1990-01-01

    The exact mechanisms of adverse reactions to contrast media are still imperfectly known. However, these reactions may be classified as idiosyncratic. Non-idiosyncratic reactions can be prevented by using new, non-ionic contrast agents. Idiosyncratic reactions can be prevented by specific premedication. Patients with a history of idiosyncratic reaction may benefit from corticosteroids and antihistamines administered prophylactically. Patients who seem to be more likely than others to react to contrast media must be premedicated, the risk of reaction being identified and evaluated by questioning. It has recently been suggested that all patients about to receive an intravascular injection of contrast medium should also be premedicated [fr

  6. Contrast media: interactions with other drugs and clinical tests

    International Nuclear Information System (INIS)

    Morcos, Sameh K.; Exley, C.M.; Thomsen, Henrik S.

    2005-01-01

    Many patients with multiple medical problems who are receiving a variety of drugs are investigated with imaging techniques which require intravascular contrast media. The Contrast Media Safety Committee of the European Society of Urogenital Radiology therefore decided to review the literature and to draw up simple guidelines on interactions between contrast media and other drugs. An extensive literature search was carried out and summarized in a report. Based on the available information, simple guidelines have been drawn up. The report and guidelines were discussed at the 11th European Symposium on Urogenital Radiology in Santiago de Compostela. Contrast media may interact with other drugs, and may interfere with isotope studies and biochemical measurements. Awareness of the patient drug history is important to avoid potential hazards. Simple guidelines are presented. (orig.)

  7. Application of iodic contrast media in roentgen examinations

    International Nuclear Information System (INIS)

    Mielecki, T.; Januszkiewicz-Mielecka, K.; Kukula, A.; Szechinski, J.

    1993-01-01

    An analysis of adverse reactions after administration of iodic contrast media in 1780 patients in 1952 various X-ray examinations is presented. Various preparations by different producers were used. As a rule, domestic contrast media were administered in non high-risk patients, whereas imported contrast media were applied in patients with documented high-risk factors (20%) and nonionic compounds were intended for patients of severe clinical condition (10%). Adverse reactions occurred in 6.9% of non high-risk patients and in 10.9% of high-risk patients. Nonionic preparations caused adverse reactions in 5.6%. Considering the significant differences in prices of domestic, imported and nonionic contrast media, authors advice to use safer but clearly more expensive preparations in patients with documented factors of increased risk. (author)

  8. Contrast media safety-an update

    DEFF Research Database (Denmark)

    Thomsen, Henrik S

    2011-01-01

    The value of contrast agents has for long been documented by their common daily use in imaging departments worldwide. In principle, they should be injected and leave the body immediately after use in the same condition or undergo natural metabolism without making any harm to the patient. However...

  9. Advances in equine computed tomography and use of contrast media.

    Science.gov (United States)

    Puchalski, Sarah M

    2012-12-01

    Advances in equine computed tomography have been made as a result of improvements in software and hardware and an increasing body of knowledge. Contrast media can be administered intravascularly or intrathecally. Contrast media is useful to differentiate between tissues of similar density. Equine computed tomography can be used for many different clinical conditions, including lameness diagnosis, fracture identification and characterization, preoperative planning, and characterization of skull diseases. Copyright © 2012 Elsevier Inc. All rights reserved.

  10. Contrast media and the brain - the basis of computed tomography and magnetic resonance imaging enhancement: a review

    International Nuclear Information System (INIS)

    Sage, M.R.; Wilson, A.J.; Scroop, R.

    2000-01-01

    The blood, cerebrospinal fluid (CSF), and extracellular fluid of the parenchyma form the fluid compartments of the brain with three interfaces between, namely the blood-brain interface (BBB), the CSF-brain interface, and the blood-CSF interface. When either water-soluble iodinated contrast media (CM) or water-soluble paramagnetic CM are injected intravenously, they are rapidly brought into contact with both the BBB and the blood-CSF interface. It is the behaviour of the water-soluble CM at these two interfaces that determines the normal and abnormal enhancement patterns demonstrated by either CT or MRI. Unlike lipophilic solutes, current iodinated and MRI contrast media all have high affinities for plasma water, low affinities for plasma proteins and, in particular, extremely low partition coefficients. Therefore they do not penetrate the normal BBB. On the other hand, radiopharmaceuticals used in positron emission tomography (PET) and single photon emission computed tomography (SPECT) to demonstrate regional cerebral blood flow are highly lipophilic and readily cross the intact BBB completely during the first pass through the cerebral vasculature. It is the inability of the current iodinated and MRI contrast media to cross the normal intact BBB that is the basis of their use in CT and MRI studies of the brain. Copyright (1999) Blackwell Science Pty Ltd

  11. Correlating intravenous radiographic contrast media reactions with the allergic profile

    International Nuclear Information System (INIS)

    Chua-Lim, A.; Enright, T.; Duda, E.; Lim, D.T.

    1987-01-01

    To determine the relevance of allergy as a predisposing factor in reactions to radiographic contrast media, the authors investigated the incidence of allergy among 100 randomly selected patients undergoing intravenous excretory urography and CT. The study population consisted of 50 reactors and 50 nonreactos to radiographic contrast media. All 100 subjects completed an allergy history, percutaneous allergy tests, and an in vitro specific IgE assay to common allergens. Thirty-four of 50 reactors had a positive allergy history, in contrast to 15 of 50 nonreactors (P < .001). Twenty-seven reactors had positive skin tests, in contrast to 12 of 50 nonreactors (P < .005). In vitro IgE assay results are pending. The results indicate that patients with positive histories or positive skin tests or both are at an increased risk for reactions to radiographic contrast media

  12. Evaluation of contrast media for bronchography

    International Nuclear Information System (INIS)

    Thompson, I.M.; Whittlesey, G.C.; Slovis, T.L.; Chang, C.H.; Cullen, M.L.; Philippart, A.I.; Stockmann, P.S.; Adkins, E.S.; Klein, M.D.

    1997-01-01

    Background. Bronchography is occasionally needed for the evaluation and management of some congenital pulmonary anomalies as well as some acquired diseases, usually of the tracheo- bronchial tree. There is currently no effective, approved contrast agent for this imaging tech- nique. Objective. We evaluated five agents (barium sulfate, iohexol, propyliodone oily, propyliodone aqueous, and perflubron) in terms of image quality, histologic changes, and effects on hemodynamics, blood gases, and standard laboratory tests in New Zealand White rabbits. Materials and methods. Animals were anesthetized and intubated. Each contrast agent (0.25 ml/kg) was administered intratracheally. Three animals in each group had intravenous lines placed for blood sampling and blood pressure monitoring and were sacrificed at 1 h. An additional three animals for each agent were sacrificed at 24 h and 1 week after imaging. Blood samples were taken immediately before contrast instillation and at 1 h postbronchography. Fluoroscopic images were recorded on standard VHS video tape and evaluated in blind fashion. Segments of lung tissue and bronchi were obtained for histologic examination. Results. Necrosis and/or inflammatory infiltrates were noted in 78 % of the bronchograms performed with propyliodone aqueous, 67 % with propyliodone oily, 55 % with perflubron, and 33 % with iohexol 120, 240 and 350. No histologic damage was observed with barium. The propyliodones gave the best-quality imaging results and the most histologic changes. Iohexol, in any concentration, gave the least acceptable images and a moderate number of histologic changes. Barium sulfate demonstrated acceptable images with virtually no histologic changes. Conclusion. From the histologic and imaging results, barium is the best available contrast material for bronchography. (orig.). With 6 figs., 4 tabs

  13. Impact of Contrast Media Concentration on Low-Kilovolt Computed Tomography Angiography: A Systematic Preclinical Approach.

    Science.gov (United States)

    Fleischmann, Ulrike; Pietsch, Hubertus; Korporaal, Johannes G; Flohr, Thomas G; Uder, Michael; Jost, Gregor; Lell, Michael M

    2018-05-01

    Low peak kilovoltage (kVp) protocols in computed tomography angiography (CTA) demand a review of contrast media (CM) administration practices. The aim of this study was to systematically evaluate different iodine concentrations of CM in a porcine model. Dynamic 70 kVp CTA was performed on 7 pigs using a third-generation dual-source CT system. Three CM injection protocols (A-C) with an identical total iodine dose and iodine delivery rate (150 mg I/kg, 12 s, 0.75 g I/s) differed in iodine concentration and flow rate (protocol A: 400 mg I/mL, 1.9 mL/s; B: 300 mg I/mL, 2.5 mL/s; C: 150 mg I/mL, 5 mL/s). All protocols were applied in a randomized order and compared intraindividually. Arterial enhancement at different locations in the pulmonary artery, the aorta, and aortic branches was measured over time. Time attenuation curves, peak enhancement, time to peak, and bolus tracking delay times needed for static CTA were calculated. The reproducibility of optimal parameters was tested in single-phase CTA. The heart rates of the pigs were comparable for all protocols (P > 0.7). The injection pressure was significantly higher for protocol A (64 ± 5 psi) and protocol C (55 ± 3 psi) compared with protocol B (39 ± 2 psi) (P < 0.001). Average arterial peak enhancement in the dynamic scans was 359 ± 51 HU (protocol A), 382 ± 36 HU (B), and 382 ± 60 HU (C) (A compared with B and C: P < 0.01; B compared with C: P = 0.995). Time to peak enhancement decreased with increasing injection rate. The delay time for bolus tracking depended on the injection rate as well and was highest for protocol A (4.7 seconds) and lowest for protocol C (3.9 seconds) (P = 0.038). The peak enhancement values of the dynamic scans highly correlated with those of the single-phase CTA scans. In 70 kVp CTA, 300 mg I/mL iodine concentrations showed to be superior to high-concentration CM when keeping the iodine delivery rate constant. Besides, iodine concentrations as low as 150 mg I/mL can be administered

  14. Evaluation of efficacy of metal artefact reduction technique using contrast media in Computed Tomography

    Science.gov (United States)

    Yusob, Diana; Zukhi, Jihan; Aziz Tajuddin, Abd; Zainon, Rafidah

    2017-05-01

    The aim of this study was to evaluate the efficacy of metal artefact reduction using contrasts media in Computed Tomography (CT) imaging. A water-based abdomen phantom of diameter 32 cm (adult body size) was fabricated using polymethyl methacrylate (PMMA) material. Three different contrast agents (iodine, barium and gadolinium) were filled in small PMMA tubes and placed inside a water-based PMMA adult abdomen phantom. The orthopedic metal screw was placed in each small PMMA tube separately. These two types of orthopedic metal screw (stainless steel and titanium alloy) were scanned separately. The orthopedic metal crews were scanned with single-energy CT at 120 kV and dual-energy CT at fast kV-switching between 80 kV and 140 kV. The scan modes were set automatically using the current modulation care4Dose setting and the scans were set at different pitch and slice thickness. The use of the contrast media technique on orthopedic metal screws were optimised by using pitch = 0.60 mm, and slice thickness = 5.0 mm. The use contrast media can reduce the metal streaking artefacts on CT image, enhance the CT images surrounding the implants, and it has potential use in improving diagnostic performance in patients with severe metallic artefacts. These results are valuable for imaging protocol optimisation in clinical applications.

  15. A prospective evaluation of contrast and radiation dose and image quality in cardiac CT in children with complex congenital heart disease using low-concentration iodinated contrast agent and low tube voltage and current.

    Science.gov (United States)

    Hou, Qiao-Ru; Gao, Wei; Sun, Ai-Min; Wang, Qian; Qiu, Hai-Sheng; Wang, Fang; Hu, Li-Wei; Li, Jian-Ying; Zhong, Yu-Min

    2017-02-01

    To the assess image quality, contrast dose and radiation dose in cardiac CT in children with congenital heart disease (CHD) using low-concentration iodinated contrast agent and low tube voltage and current in comparison with standard dose protocol. 110 patients with CHD were randomized to 1 of the 2 scan protocols: Group A (n = 45) with 120 mA tube current and contrast agent of 270 mgI/ml in concentration (Visipaque ™ ; GE Healthcare Ireland, Co., Cork, UK); and Group B (n = 65) with the conventional 160 mA and 370 mgI/ml concentration contrast (Iopamiro ® ; Shanghai Bracco Sine Pharmaceutical Corp Ltd, Shanghai, China). Both groups used 80 kVp tube voltage and were reconstructed with 70% adaptive statistical iterative reconstruction algorithm. The CT value and noise in aortic arch were measured and the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated. A five-point scale was used to subjectively evaluate image quality. Contrast and radiation dose were recorded. There was no difference in age and weight between the two groups (all p > 0.05). The iodine load and radiation dose in Group A were statistically lower (3976 ± 747 mgI vs 5763 ± 1018 mgI in iodine load and 0.60 ± 0.08 mSv vs 0.77 ± 0.10 mSv in effective dose; p  0.05), and with good agreement between the two observers. Comparing the surgery results, the diagnostic accuracy for extracardiac and intracardiac defects for Group A was 96% and 92%, respectively, while the corresponding numbers for Group B were 95% and 93%. Compared with the standard dose protocol, the use of low tube voltage (80 kVp), low tube current (120 mA) and low-concentration iodinated contrast agent (270 mgI/ml) enables a reduction of 30% in iodine load and 22% in radiation dose while maintaining compatible image quality and diagnostic accuracy. Advances in knowledge: The new cardiac CT scanning protocol can largely reduce the adverse effects of

  16. Should nonionic radiographic contrast media be given to all patients?

    International Nuclear Information System (INIS)

    Parfrey, P.S.; Cramer, B.C.; McManamon, P.J.

    1988-01-01

    In the 1970s about one patient of every 40,000 who underwent intravenous urography died. It has been suggested that lives can be saved by using only nonionic or low-osmolarity contrast agents. The authors suggest a multicentre double-blind randomized controlled trial of nonionic versus ionic contrast media

  17. Contrast media in gall bladder diagnostics

    International Nuclear Information System (INIS)

    Schindler, G.; Frommhold, W.

    1982-01-01

    The justification of conventional X-ray diagnostic of bile ducts is repeatedly questioned by newer examination techniques like sonography and ERC. The indication for oral cholesgraphy is derived from its high-specifity of its statements for gall bladder diagnostic, that is as high as with sonography and does not depend on the experience of the investigator. The importance of the the void exposure is undoubted with correspondence of medicamentary litholysis for calcite identification. Furthermore, Choleocystic kineticals like Ceruletid let recognize better hyper plastic choleocysts like adenomyomatoses. The intravenous choleocyst-cholangiography posesses a clearly limited indication scheme even after introduction of sonography and ERC. The infusion method yields a better compatibility of the contrast medium with a simultaneous increased representation quality of the bile duct, that can be increased by a consequent application of the layer exposure technique. (orig.) [de

  18. Experience of slowly infused high-iodine-dose contrast computed tomography (SHD) of intracranial tumors

    International Nuclear Information System (INIS)

    Muraoka, Kiyoaki; Numata, Hideharu; Hokama, Yasuo

    1983-01-01

    A study was done on 20 patients with intracranial tumors by means of the slowly infused high-iodine-dose (SHD) contrast-enhancement technique. An intravenous drip infusion of 300 ml of Angiografin was given for three hours. Computerized tomograms were taken 1 hour, (2 hours), and 3 hours after the beginning of the drip infusion. The authors divided the lesions into four groups by analyzing the sequential changes in CT numbers using a histograms or profile of the region of interest. In group I, additional lesions were visible on the SHD scan (one case of metastatic brain tumors from lung cancer). In group 2, lesions were better displayed on the SHD scan due to increased enhancement (17 cases). In group 3, SHD scans showed no change (2 cases of fibrous astrocytoma). In group 4, the enhancement was diminished, but the lesion per se was still clealy identifiable (no case). Finally, in 18 cases out of 20 (90%), an additional or better display of the lesion was detected on SHD enhanced CT. The rational for doing the SHD enhancement is to detect a lesion with a minimally impaired blood-brain barrier by exposing a prolonged high blood-iodine level, and so the scanning is delayed until detectable levels of the contrast medium have accumulated within the vascular-channel pool or extravascular space of the lesion. SHD enhancement is useful: I) for revealing any additional lesion in a metastatic brain tumor; 2) for better displaying an obscure lesion on a usual scan; 3) for differentiating the quality of the lesion (for example, malignancy or cyst formation), and 4) for predicting the prognosis of the lesion. (J.P.N.)

  19. Nephropathy after administration of iso-osmolar and low-osmolar contrast media: evidence from a network meta-analysis.

    Science.gov (United States)

    Biondi-Zoccai, Giuseppe; Lotrionte, Marzia; Thomsen, Henrik S; Romagnoli, Enrico; D'Ascenzo, Fabrizio; Giordano, Arturo; Frati, Giacomo

    2014-03-15

    Contrast-induced nephropathy (CIN) may be a severe complication to the administration of iodine-based contrast media for diagnostic or interventional procedure using radiation exposure. Whether there is a difference in nephrotoxic potential between the various agents is uncertain. We aimed to perform a systematic review and network meta-analysis of randomized trials on iodine-based contrast agents. Randomized trials of low-osmolar or iso-osmolar contrast media were searched in CENTRAL, Google Scholar, MEDLINE/PubMed, and Scopus. Risk of CIN was appraised within a hierarchical Bayesian model computing absolute rates (AR) and odds ratios (OR) with 95% credibility intervals, and probability of being best (Pbest) for each agent. A total of 42 trials (10048 patients) were included focusing on 7 different iodine-based contrast media. Risk of CIN was similarly low with iodixanol (AR=5.7% [2.2%-13.9%], Pbest=18.8%), iomeprol (AR=6.0% [2.2%-15.4%], Pbest=24.8%), iopamidol (AR=6.1% [2.2%-15.5%], Pbest=21.5%), and ioversol (AR=6.0% [2.1%-16.4%], Pbest=31.3%). Conversely, CIN was twice as common with iohexol (AR=11.2% [4.1%-29.5%], Pbest=0.1%) and ioxaglate (AR=11.0% [4.0%-26.9%], Pbestcontrast media with a similar renal safety profile. Iohexol and ioxaglate have a poorer renal safety profile, whereas further data may be required on iopromide. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  20. Comparison of neutral and positive enteral contrast media for MDCT enteroclysis

    International Nuclear Information System (INIS)

    Aiyappan, Senthil Kumar; Kalra, Naveen; Sandhu, Manavjit Singh; Kochhar, Rakesh; Wig, Jai Dev; Khandelwal, Niranjan

    2012-01-01

    Objective: To compare neutral and positive enteral contrast media for MDCT enteroclysis (MDCTE) in various small bowel diseases. Materials and methods: 40 patients with suspicion of small bowel diseases were divided randomly into two equal groups. In one group, water was used as neutral enteral contrast and in other group, 2% water soluble iodinated contrast was used as positive enteral contrast. All MDCTE were done on a 16-slice multidetector row CT unit. The findings of MDCTE were compared with the standards of reference. Results: There were 12 cases of abdominal tuberculosis (30%), 5 cases of bowel masses (12%), 4 cases of Crohn's disease (10%), 3 cases of small bowel adhesions (7%), 2 cases of midgut volvulus (5%), 2 cases of segmental enteritis (5%) and 12 of all cases (30%) were normal. There was no statistically significant difference between neutral and positive enteral contrast with regards to bowel distention, contrast reflux and evaluation of duodenum. Abnormal bowel wall enhancement was appreciated only with use of neutral enteral contrast (n = 12). Evaluation of ileocaecal junction was possible in all 20 patients (100%) with positive enteral contrast but in only 17 patients (85%) with neutral enteral contrast. Overall sensitivity and specificity of MDCTE with use of neutral contrast medium (100 and 88% respectively) was greater for evaluation of small bowel diseases, when compared to MDCTE using positive enteral contrast medium (92.8 and 83.3% respectively). Conclusions: Water is a good enteral contrast medium for MDCT enteroclysis examination and allows better evaluation of abnormal bowel wall enhancement. Ileocaecal junction evaluation is better with positive enteral contrast medium.

  1. Impact of Iodinated Contrast on Renal Function and Hemodynamics in Rats with Chronic Hyperglycemia and Chronic Kidney Disease

    Science.gov (United States)

    Fernandes, Sheila Marques; Martins, Daniel Malisani; da Fonseca, Cassiane Dezoti; Watanabe, Mirian; Vattimo, Maria de Fátima Fernandes

    2016-01-01

    Iodinated contrast (IC) is clinically used in diagnostic and interventional procedures, but its use can result in contrast-induced acute kidney injury (CI-AKI). Chronic kidney disease (CKD) and chronic hyperglycemia (CH) are important predisposing factors to CI-AKI. The aim of this study was to investigate the impact of iodinated contrast on the renal function and hemodynamics in rats with chronic hyperglycemia and chronic kidney disease. A total of 30 rats were divided into six groups; Sham: control of chronic renal disease; Citrate: control of chronic hyperglycemia (CH); Nx5/6: rats with 5/6 nephrectomy; Chronic Hyperglycemia: rats receiving Streptozotocin 65 mg/kg; Nx5/6 + IC: rats Nx5/6 received 6 mL/kg of IC; CH + IC: Chronic hyperglycemia rats receiving 6 mL/kg of IC. Renal function (inulin clearance; urinary neutrophil gelatinase-associated lipocalin, NGAL) and hemodynamics (arterial blood pressure; renal blood flow; renal vascular resistance) were evaluated. Iodinated contrast significantly increased urinary NGAL and reduced inulin clearance, while the hemodynamics parameters showed changes in arterial blood pressure, renal blood flow, and renal vascular resistance in both CKD and CH groups. The results suggest that the iodinated contrast in risk factors models has important impact on renal function and hemodynamics. NGAL was confirmed to play a role of highlight in diagnosis of CI-AKI. PMID:27034930

  2. Impact of Iodinated Contrast on Renal Function and Hemodynamics in Rats with Chronic Hyperglycemia and Chronic Kidney Disease

    Directory of Open Access Journals (Sweden)

    Sheila Marques Fernandes

    2016-01-01

    Full Text Available Iodinated contrast (IC is clinically used in diagnostic and interventional procedures, but its use can result in contrast-induced acute kidney injury (CI-AKI. Chronic kidney disease (CKD and chronic hyperglycemia (CH are important predisposing factors to CI-AKI. The aim of this study was to investigate the impact of iodinated contrast on the renal function and hemodynamics in rats with chronic hyperglycemia and chronic kidney disease. A total of 30 rats were divided into six groups; Sham: control of chronic renal disease; Citrate: control of chronic hyperglycemia (CH; Nx5/6: rats with 5/6 nephrectomy; Chronic Hyperglycemia: rats receiving Streptozotocin 65 mg/kg; Nx5/6 + IC: rats Nx5/6 received 6 mL/kg of IC; CH + IC: Chronic hyperglycemia rats receiving 6 mL/kg of IC. Renal function (inulin clearance; urinary neutrophil gelatinase-associated lipocalin, NGAL and hemodynamics (arterial blood pressure; renal blood flow; renal vascular resistance were evaluated. Iodinated contrast significantly increased urinary NGAL and reduced inulin clearance, while the hemodynamics parameters showed changes in arterial blood pressure, renal blood flow, and renal vascular resistance in both CKD and CH groups. The results suggest that the iodinated contrast in risk factors models has important impact on renal function and hemodynamics. NGAL was confirmed to play a role of highlight in diagnosis of CI-AKI.

  3. Contrast media. Safety issues and ESUR guidelines. 3. ed.

    International Nuclear Information System (INIS)

    Thomsen, Henrik S.; Webb, Judith A.W.

    2014-01-01

    Fully updates the previous edition and includes new chapters on various complex topics. Represents a unique and unparalleled source of information on the many safety issues relating to different contrast media. Includes chapters on acute and delayed non-renal adverse reactions and on renal adverse reactions. Presented in a handy, easy-to-use format. In 1994 the European Society of Urogenital Radiology (ESUR) set up a committee to consider the safety of contrast media used for diagnostic imaging. Subsequently the committee questioned ESUR members, reviewed the literature, proposed guidelines, and discussed these proposals with participants at the annual symposia of the society. The end result of this work was the successful first edition of this book, published in 2006, which was followed by an equally successful second edition in 2009. This third edition not only fully updates the previous edition, but also includes new chapters on complex topics such as use of contrast media in children and practical aspects of off-label contrast media use. The authorship includes members, past members, and non-members of the Contrast Media Safety Committee.

  4. Quantitative dosimetric assessment for effect of gold nanoparticles as contrast media on radiotherapy planning

    International Nuclear Information System (INIS)

    Tu, Shu-Ju; Yang, Pei-Ying; Hong, Ji-Hong; Lo, Ching-Jung

    2013-01-01

    In CT planning for radiation therapy, patients may be asked to have a medical procedure of contrast agent (CA) administration as required by their physicians. CA media improve quality of CT images and assist radiation oncologists in delineation of the target or organs with accuracy. However, dosimetric discrepancy may occur between scenarios in which CA media are present in CT planning and absent in treatment delivery. In recent preclinical experiments of small animals, gold nanoparticles (AuNPs) have been identified as an excellent contrast material of x-ray imaging. In this work, we quantitatively evaluate the effect of AuNPs to be used as a potential material of contrast enhancement in radiotherapy planning with an analytical phantom and clinical case. Conray 60, an iodine-based product for contrast enhancement in clinical uses, is included as a comparison. Other additional variables such as different concentrations of CA media, radiation delivery techniques and dose calculation algorithms are included. We consider 1-field AP, 4-field box, 7-field intensity modulated radiation therapy (IMRT) and a recent technique of volumetric modulated arc therapy (VMAT). CA media of AuNPs (Conray 60) with concentrations of 10%, 20%, 30%, 40% and 50% containing 28.2, 56.4, 84.6, 112.8 and 141.0 mg of gold (iodine) per mL were prepared prior to CT scanning. A virtual phantom with a target where nanoparticle media are loaded and clinical case of gastric lymphoma in which the Conray 60 media were given to the patient prior to the CT planning are included for the study. Compared to Conray 60 media with concentration of 10%/50%, Hounsfield units for AuNP media of 10%/50% are 322/1608 higher due to the fact that atomic number of Au (Z=79) is larger than I (Z=53). In consequence, dosimetric discrepancy of AuNPs is magnified between presence and absence of contrast media. It was found in the phantom study that percent dose differences between presence and absence of CA media may be

  5. Immunologic basis for adverse reactions to radiographic contrast media

    Energy Technology Data Exchange (ETDEWEB)

    Stejskal, V; Nilsson, R; Grepe, A [Astra Pharmaceuticals AB, Soedertaelje (Sweden). Lab. of Safety Assessment Stockholm Univ. (Sweden). Dept. of Genetic and Cellular Toxicology Stockholm Univ. (Sweden). Wallenberglaboratoriet Danderyds Sjukhus, Danderyd (Sweden). Radiologic Clinic

    1990-11-01

    The lymphocyte transformation test (LTT) was used to elucidate whether certain side effects induced by radiographic contrast media have an immunologic etiology. Groups studied were: 8 patients who had previously experienced adverse reactions in association with urography, 6 patients who underwent urography without notable side reactions, 17 occupationally exposed nurses, and 9 unexposed controls. The lymphocytes from 2 hypersensitive patients and from 11 nurses exhibited a positive proliferative response to amidotrizoate. Five nurses who had shown a positive response, had a previous history of hypersensitivity reactions when handling contrast media, whereas the remaining 6 were free of symptoms. Amidotrizoatespecific memory cells were absent in patients who underwent urography without signs of hypersensitivity and in 7/9 of unexposed control subjects. Lymphocytes from patients sensitive to amidotrizoate cross-reacted to structurally related ionic contrast media while nonionic contrast agents did not induce proliferation of the lymphocytes. Thus, ionic radiographic contrast agents have antigenic properties in man. Irradiated mixtures of radiographic contrast media and serum proteins were, in general, not effective in inducing an LTT response. (orig.).

  6. Immunologic basis for adverse reactions to radiographic contrast media

    International Nuclear Information System (INIS)

    Stejskal, V.; Nilsson, R.; Grepe, A.; Stockholm Univ.; Stockholm Univ.; Danderyds Sjukhus, Danderyd

    1990-01-01

    The lymphocyte transformation test (LTT) was used to elucidate whether certain side effects induced by radiographic contrast media have an immunologic etiology. Groups studied were: 8 patients who had previously experienced adverse reactions in association with urography, 6 patients who underwent urography without notable side reactions, 17 occupationally exposed nurses, and 9 unexposed controls. The lymphocytes from 2 hypersensitive patients and from 11 nurses exhibited a positive proliferative response to amidotrizoate. Five nurses who had shown a positive response, had a previous history of hypersensitivity reactions when handling contrast media, whereas the remaining 6 were free of symptoms. Amidotrizoatespecific memory cells were absent in patients who underwent urography without signs of hypersensitivity and in 7/9 of unexposed control subjects. Lymphocytes from patients sensitive to amidotrizoate cross-reacted to structurally related ionic contrast media while nonionic contrast agents did not induce proliferation of the lymphocytes. Thus, ionic radiographic contrast agents have antigenic properties in man. Irradiated mixtures of radiographic contrast media and serum proteins were, in general, not effective in inducing an LTT response. (orig.)

  7. Analyzing three-dimensional position of region of interest using an image of contrast media using unilateral X-ray exposure

    International Nuclear Information System (INIS)

    Harauchi, Hajime; Gotou, Hiroshi; Tanooka, Masao

    1994-01-01

    Analyzing three-dimensional internal structure of object in an X-ray study is usually performed by using two or more of the incidents of an X-ray direction. In this report, we analyzed the three-dimensional position of tubes with a phantom by using both contrast media and imaging of one direction in the X-ray study. The concentration of the iodine in contrast media can be known by using the log-subtraction image of only the one-directional incident X-ray. Also the diameter of tube filled with contrast media is calculated by the concentration of iodine. So we can show the three-dimensional position of tubes geometrically, by the diameter of tube and the measured value of the film. We verified this method by an experiment according to the theory. (author)

  8. The effects of X-ray energy and an iodine-based contrast agent on chromosome aberrations

    International Nuclear Information System (INIS)

    Matsubara, Sho; Kubota, Nobuo; Katoh, Tsuguhisa; Yoshino, Norio; Sasaki, Takehito; Sasaki, Masao S.

    1994-01-01

    A study was undertaken to evaluate the effect of combining irradiation with X rays of various energies and an iodine-based contrast agent on the induction of chromosome aberrations in the peripheral lymphocytes of blood samples taken from healthy young donors. Although no enhancement of the effect of radiation was induced when blood samples with the iodine-based contrast agent were given 35 kV X irradiation, an 80 kV X-ray exposure induced an enhanced level of chromosome aberrations, and a 250 kV X irradiation, an enhancement of the frequencies of chromosome aberrations was seen in blood samples with the iodine-based contrast agent, especially when a Lucite phantom was employed in studies to increase the scattered rays. It was thus shown by microdosimetric analysis that X irradiation combined with an iodine-based contrast agent causes an enhancement of the absorbed radiation dose, which is dependent on the X-ray energies employed. This phenomenon may have clinical use in the radiotherapeutic management of tumors, although further extensive studies of tumor vascularity must be pursued before this can be applied clinically. 21 refs., 8 figs., 3 tabs

  9. Electrochemical reductive dehalogenation of iodine-containing contrast agent pharmaceuticals: Examination of reactions of diatrizoate and iopamidol using the method of rotating ring-disc electrode (RRDE).

    Science.gov (United States)

    Yan, Mingquan; Chen, Zhanghao; Li, Na; Zhou, Yuxuan; Zhang, Chenyang; Korshin, Gregory

    2018-06-01

    This study examined the electrochemical (EC) reduction of iodinated contrast media (ICM) exemplified by iopamidol and diatrizoate. The method of rotating ring-disc electrode (RRDE) was used to elucidate rates and mechanisms of the EC reactions of the selected ICMs. Experiments were carried at varying hydrodynamic conditions, concentrations of iopamidol, diatrizoate, natural organic matter (NOM) and model compounds (resorcinol, catechol, guaiacol) which were used to examine interactions between products of the EC reduction of ICMs and halogenation-active species. The data showed that iopamidol and diatrizoate were EC-reduced at potentials < -0.45 V vs. s.c.e. In the range of potentials -0.65 to -0.85 V their reduction was mass transfer-controlled. The presence of NOM and model compounds did not affect the EC reduction of iopamidol and diatrizoate but active iodine species formed as a result of the EC-induced transformations of these ICMs reacted readily with NOM and model compounds. These data provide more insight into the nature of generation of iodine-containing by-products in the case of reductive degradation of ICMs. Copyright © 2018 Elsevier Ltd. All rights reserved.

  10. Patients at high risk of adverse events from intravenous contrast media after computed tomography examination

    Energy Technology Data Exchange (ETDEWEB)

    Reddan, Donal [University College Galway Hospitals, Unit 7, Merlin Park Hospital, Galway (Ireland)]. E-mail: donal.reddan@mailn.hse.ie

    2007-05-15

    Adverse reactions to iodinated contrast media (CM) may occur and require prompt recognition and treatment. Although adverse reactions to radiocontrast agents cannot be eliminated, an important first step toward reducing their incidence is to identify patients at greatest risk. Prior to examinations using CM, patients should be adequately assessed by obtaining thorough medical histories and using simple screening tests. Studies have demonstrated that patients with a history of asthma, allergy, hyperthyroidism, and previous reaction to CM are at risk for severe reactions to iodinated CM. Renal adverse reactions reportedly occur more frequently in patients with pre-existing chronic kidney disease, especially those with diabetic nephropathy. Patients with congestive heart failure, dehydration, older age, and those who use nephrotoxic medications are also at risk for developing contrast-associated nephropathy. The occurrence of adverse events may be further increased in patients with multiple risk factors. As the number of patients undergoing computed tomography procedures continues to increase, it is essential for physicians to be able to identify patients at risk for adverse events of CM. Patient-related risk factors are discussed and simple tools for risk stratification presented.

  11. Multiphase CT scanning and different intravenous contrast media concentrations in combined F-18-FDG PET/CT: Effect on quantitative and clinical assessment

    Energy Technology Data Exchange (ETDEWEB)

    Rebiere, Marilou, E-mail: Marilou.Rebiere@rwth-aachen.de [Department of Nuclear Medicine, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52057 Aachen (Germany); Verburg, Frederik A., E-mail: fverburg@ukaachen.de [Department of Nuclear Medicine, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52057 Aachen (Germany); Department of Nuclear Medicine, Maastricht University Medical Center, P. Debeylaan 25, 6202 AZ Maastricht (Netherlands); Palmowski, Moritz, E-mail: mpalmowski@ukaachen.de [Department of Nuclear Medicine, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52057 Aachen (Germany); Department of Radiology, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52057 Aachen (Germany); Department of Experimental Molecular Imaging, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52057 Aachen (Germany); Krohn, Thomas, E-mail: tkrohn@ukaachen.de [Department of Nuclear Medicine, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52057 Aachen (Germany); Pietsch, Hubertus, E-mail: hubertus.pietsch@bayer.com [Contrast Media Research, Bayer Pharma AG, Muellerstr. 178, 13353 Berlin (Germany); Kuhl, Christiane K., E-mail: ckuhl@ukaachen.de [Department of Radiology, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52057 Aachen (Germany); Mottaghy, Felix M., E-mail: fmottaghy@ukaachen.de [Department of Nuclear Medicine, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52057 Aachen (Germany); Department of Nuclear Medicine, Maastricht University Medical Center, P. Debeylaan 25, 6202 AZ Maastricht (Netherlands); Behrendt, Florian F., E-mail: fbehrendt@ukaachen.de [Department of Nuclear Medicine, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52057 Aachen (Germany)

    2012-08-15

    Purpose: To evaluate the influence of multiphase CT scanning and different intravenous contrast media on contrast enhancement, attenuation correction and image quality in combined PET/CT. Material and methods: 140 patients were prospectively enrolled for F-18-FDG-PET/CT including a low-dose unenhanced, arterial and venous contrast enhanced CT. The first (second) 70 patients, received contrast medium with 370 (300) mg iodine/ml. The iodine delivery rate (1.3 mg/s) and total iodine load (44.4 g) were identical for both groups. Contrast enhancement and maximum and mean standardized FDG uptake values (SUVmax and SUVmean) were determined for the un-enhanced, arterial and venous PET/CT at multiple anatomic sites and PET reconstructions were visually evaluated. Results: Arterial contrast enhancement was significantly higher for the 300 mg/ml contrast medium compared to 370 mg I/ml at all anatomic sites. Venous enhancement was not different between the two contrast media. SUVmean and SUVmax were significantly higher for the contrast enhanced compared to the non-enhanced PET/CT at all anatomic sites (all P < 0.001). Tracer uptake was significantly higher in the arterial than in the venous PET/CT in the arteries using both contrast media (all P < 0.001). No differences in tracer uptake were found between the contrast media (all P > 0.05). Visual assessment revealed no relevant differences between the different PET reconstructions. Conclusions: There is no relevant qualitative influence on the PET scan from the use of different intravenous contrast media in its various phases in combined multiphase PET/CT. For quantitative analysis of tracer uptake it is required to use an identical PET/CT protocol.

  12. Radiologic and histopathologic evaluation of various contrast media for bronchography

    International Nuclear Information System (INIS)

    Kang, Eun Young; Hong, Ki Taek; Kim, Jin Hyung; Kim, Hyung Rae; Shin, Bong Kyung; Oh, Yu Whan; Kim, Han Kyeom; Park, Cheol Min; Seol, Hae Young; Cha, In Ho

    1999-01-01

    To determine which contrast media are both efficient and safe for the imaging of airways. We evaluated five contrast media (barium, gastrografin, iotrolan, ioxaglate, iopentol) in terms of image quality and their effects on the lungs of 25 white rabbits. For bronchography 0.5ml of contrast media was used. In each contrast group, HRCT scans were obtained immediately (n=5), 12 hours (n=4), 1 day (n=3), 2 days (n=2), and 1 week (n=1) after bronchography. Histopathologic specimens were obtained immediately, 12 hours, 1 day, 2 days, and 1 week later. Bronchograms were evaluated for image quality by three radiologists working independently, and were scored as 1(poor), 2(moderate), or 3(good) in terms of contrast quality and bronchial coating. HRCT was evaluated by two radiologists who reached a concensus;they determined the presence of contrast media, and then the pattern and extent of pulmonary opacity, and any related changes. Histopatholgic specimens were evaluated by two pathologists who sought consensus as to the extent of inflammation, pulmonary edema, and hemorrhage, and any changes in these aspects. Bronchography indicated that the sum of scores for contrast quality was 45 for barium, 33 for gastrografin, 28 for iotrolan, 30 for ioxaglate, and 28 for iopentol, while for each of these media, the sum of scores for bronchial coating was 39, 19, 25, 23, and 21, respectively. Barium showed the best image quality. In all rabbits, HRCT demonstrated the variable extent of ground-glass attenuation and/or consolidation. Lesions were most extensive at 1-2days and then regressed at 1 week;these HRCT findings correlated well with histologic findings. In histologic studies of all five contrast media groups, variable severe inflammatory reactions were observed, with or without necrosis, congesion, edema, and hemorrhage. It was noted that ioxaglate appeared to cause least tissue reaction. The imaging results of this experimental study indicate that for bronchography, barium is

  13. Are intravenous injections of contrast media really less nephrotoxic than intra-arterial injections?

    Energy Technology Data Exchange (ETDEWEB)

    Nyman, Ulf [University of Lund, Department of Diagnostic Radiology, Trelleborg (Sweden); Almen, Torsten [Skaane University Hospital, Department of Clinical Sciences/Medical Radiology, University of Lund, Malmoe (Sweden); Jacobsson, Bo [University of Gothenburg and the Sahlgrenska Academy, Department of Diagnostic Radiology, The Queen Silvia Children' s Hospital, Goeteborg (Sweden); Aspelin, Peter [Karolinska Institute and University Hospital, Division of Medical Imaging and Technology, Department of Clinical Science, Intervention and Technology (CLINTEC), Stockholm (Sweden)

    2012-06-15

    We oppose the opinion that the intra-arterial administration of iodine-based contrast media (CM) appears to pose a greater risk of contrast medium-induced nephropathy (CIN) than intravenous administration since (1) in intra-arterial coronary procedures and most other intra-arterial angiographic examinations, CM injections are also intravenous relative to the kidneys, (2) there is a lack of comparative trials studying the risk of CIN between intra-arterial and intravenous procedures with matched risk factors and CM doses, (3) a bias selection of patients with fewer risk factors may explain the seemingly lower rate of CIN after CT in comparison with coronary interventions, (4) the rate of CIN following intra-arterial coronary procedures may also be exaggerated owing to other causes of acute kidney failure, such as haemodynamic instability and microembolisation, (5) roughly the same gram-iodine/GFR ratio ({approx}1:1) as a limit of relatively safe CM doses has preliminarily been found for both intravenous CT and intra-arterial coronary procedures and (6) the substantially higher injected intravenous CM dose rate during CT relative to an intra-arterial coronary procedure might actually pose a higher risk of CIN following CT. Key Points circle Most intra-arterial injections of contrast media are intravenous relative to the kidneys. circle No evidence that intravenous CM injections should be less nephrotoxic than intra-arterial. circle Considerably higher dose rates of CM are used for CT relative to intra-arterial procedures. circle Higher dose rates may pose higher nephrotoxic risk for intravenous based CT studies. (orig.)

  14. Comparative assessment of image quality for coronary CT angiography with iobitridol and two contrast agents with higher iodine concentrations: iopromide and iomeprol. A multicentre randomized double-blind trial

    Energy Technology Data Exchange (ETDEWEB)

    Achenbach, Stephan [Friedrich-Alexander-Universitaet Erlangen-Nuernberg, Department of Cardiology, Erlangen (Germany); Paul, Jean-Francois [Centre Chirurgical Marie Lannelongue, Department of Radiology, Le Plessis Robinson (France); Laurent, Francois [University of Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, Bordeaux (France); CHU de Bordeaux, Service d' Imagerie Thoracique et Cardiovasculaire, Pessac (France); Becker, Hans-Christoph [University Hospital Grosshadern, Department of Clinical Radiology, Munich (Germany); Rengo, Marco [Sapienza - University of Rome, ICOT Hospital, Department of Radiological Sciences, Oncology and Pathology, Latina (Italy); Caudron, Jerome [University Hospital of Rouen, Department of Radiology, Rouen (France); Leschka, Sebastian [Saint Gallen Hospital, Department of Radiology, Saint Gallen (Switzerland); Vignaux, Olivier [Cochin Hospital, Department of Radiology, Paris (France); Knobloch, Gesine [La Charite, Department of Radiology, Berlin (Germany); Benea, Giorgio [Ospedale del Delta, Ferrara (Italy); Schlosser, Thomas [Elisabeth-Krankenhaus Hospital, Essen (Germany); Andreu, Jordi [Hospital Vall d' Hebron, Barcelona (Spain); Cabeza, Beatriz [Hospital Clinico San Carlos, Madrid (Spain); Jacquier, Alexis [La Timone Adult Hospital, Department of Radiology, Marseille (France); Souto, Miguel [Complejo Hospitalario Universitario, Santiago de Compostela (Spain); Revel, Didier [Louis Pradel Hospital, Department of Radiology, Lyon (France); Qanadli, Salah Dine [University of Lausanne, Department of Radiology, Lausanne (Switzerland); Cademartiri, Filippo [Giovanni XXIII Hospital, Department of Radiology, Monastier di Treviso (Italy); Collaboration: X-ACT Study Group

    2017-02-15

    To demonstrate non-inferiority of iobitridol 350 for coronary CT angiography (CTA) compared to higher iodine content contrast media regarding rate of patients evaluable for the presence of coronary artery stenoses. In this multicentre trial, 452 patients were randomized to receive iobitridol 350, iopromide 370 or iomeprol 400 and underwent coronary CTA using CT systems with 64-detector rows or more. Two core lab readers assessed 18 coronary segments per patient regarding image quality (score 0 = non diagnostic to 4 = excellent quality), vascular attenuation, signal and contrast to noise ratio (SNR, CNR). Patients were considered evaluable if no segment had a score of 0. Per-patient, the rate of fully evaluable CT scans was 92.1, 95.4 and 94.6 % for iobitridol, iopromide and iomeprol, respectively. Non-inferiority of iobitridol over the best comparator was demonstrated with a 95 % CI of the difference of [-8.8 to 2.1], with a pre-specified non-inferiority margin of -10 %. Although average attenuation increased with higher iodine concentrations, average SNR and CNR did not differ between groups. With current CT technology, iobitridol 350 mg iodine/ml is not inferior to contrast media with higher iodine concentrations in terms of image quality for coronary stenosis assessment. (orig.)

  15. Physicochemical properties of radiographic contrast media, potential nephrotoxicity and prophylaxis.

    Science.gov (United States)

    Hogstrom, Barry; Ikei, Nobuhiro

    2015-12-01

    Contrast induced nephropathy (CIN) remains a controversial topic. The clinical relevance of changes in laboratory parameters has been challenged; some authors have even suggested that CIN simply reflects natural fluctuations. Other areas of controversy include the pathophysiology of CIN, effectiveness of prophylactic approaches and differences in nephrotoxicity between individual contrast media (CM). The aim of this review is to summarize the current understanding of laboratory findings and explore its relationship to CM toxicity. © 2015 Wiley Publishing Asia Pty Ltd.

  16. A method for the investigation of cholegraphic contrast media

    International Nuclear Information System (INIS)

    Otto, H.

    1982-01-01

    Isolated perfused rat livers were used for investigating possible interactions between two simultaneously injected contrast media, and which technique, using parenteral application of cholegraphic media, is optimal. The results show that excretion of a parenteral contrast medium is reduced by giving an oral contrast medium at the same time. Simultaneous administration of two different contrast media therefore does not result in improved diagnostic information. The effect depends on the dose, and a sufficiently long interval should be observed between giving an oral and a parenteral contrast medium. A comparison of excretion values following injection of a bolus and prolonged infusion shows higher biliary contrast concentration and increased excretion after a single injection. Comparing only the period after the infusion, no difference was found between these two methods of administration. The single injection offers pharmacokinetic advantages, but an infusion is better tolerated and has fewer side effects. A rapid infusion of 10 to 15 minutes is therefore recommended as the optimal means of administration. (orig.) [de

  17. Life-Threatening Thrombocytopenia Following Intravenous Contrast Media Infusion.

    Science.gov (United States)

    Park, Mihwa; Kim, Minjeong; Park, Jisun; Cho, Jinhyun

    2018-01-01

    Radiocontrast media-induced acute severe thrombocytopenia is a very rare complication and potentially life-threatening. Here, we report the case of a 63-year-old male patient with severe acute thrombocytopenia following first exposure to intravenous non-ionic contrast media without immediate allergic reactions. His platelet count dropped from 107000/μL to 2000/μL after six hours of radiocontrast infusion. After administration of corticosteroid and transfusion of platelet concentrates, the platelet count returned gradually to normal within 5 days. To the best of our knowledge, non-ionic contrast media-induced isolated acute severe thrombocytopenia following no signs or symptoms of immediate allergic reaction has never been described. © Copyright: Yonsei University College of Medicine 2018.

  18. Effects of ionic and nonionic contrast media on cardiohemodynamics and quality of radiographic image during canine angiography

    International Nuclear Information System (INIS)

    Nakamura, H.; Kurata, M.; Haruta, K.; Takeda, K.

    1994-01-01

    Cardiovascular responses and radiographic image quality during cerebral angiography, aortofemoral angiography and left ventriculography with nonionic ioxilan, iohexol or iopamidol were compared with those of ionic sodium meglumine diatrizoate in pentobarbital anesthetized dogs. Injection of all contrast media caused cardiovascular changes to a greater or lesser degree, e.g., hypotension, bradycardia, tachycardia, a decrease in left ventricular pressure (LVP) and its first derivative (dP/dt), and prolongation of the P-Q and Q-T intervals. Ionic diatrizoate had a greater effect on cardiovascular parameters than nonionic contrast media during angiography in all areas. Moreover, diatrizoate produced cardiac arrhythmias and prominent changes in blood rheology concerned with blood viscosity and deformability of the erythrocyte. The cause of various effects of contrast media seemed to lie mainly in osmolality, viscosity and partially ionic additives. The radiographic image quality of all of the contrast media used was similar, but nonionic ioxilan and iohexol with lower iodine content and low osmolality gave better radio opacity than ionic diatrizoate in cerebral angiography. These results suggested that nonionic contrast media should be recommended as a diagnostic tool for both animals and human patients in poor health

  19. Comparative Effect of Contrast Media Type on the Incidence of Contrast-Induced Nephropathy: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Eng, John; Wilson, Renee F; Subramaniam, Rathan M; Zhang, Allen; Suarez-Cuervo, Catalina; Turban, Sharon; Choi, Michael J; Sherrod, Cheryl; Hutfless, Susan; Iyoha, Emmanuel E; Bass, Eric B

    2016-03-15

    Iodine contrast media are essential components of many imaging procedures. An important potential side effect is contrast-induced nephropathy (CIN). To compare CIN risk for contrast media within and between osmolality classes in patients receiving diagnostic or therapeutic imaging procedures. PubMed, EMBASE, Cochrane Library, Clinical Trials.gov, and Scopus through June 2015. Randomized, controlled trials that reported CIN-related outcomes in patients receiving low-osmolar contrast media (LOCM) or iso-osmolar contrast media for imaging. Independent study selection and quality assessment by 2 reviewers and dual extraction of study characteristics and results. None of the 5 studies that compared types of LOCM reported a statistically significant or clinically important difference among study groups, but the strength of evidence was low. Twenty-five randomized, controlled trials found a slight reduction in CIN risk with the iso-osmolar contrast media agent iodixanol compared with a diverse group of LOCM that just reached statistical significance in a meta-analysis (pooled relative risk, 0.80 [95% CI, 0.65 to 0.99]; P = 0.045). This comparison's strength of evidence was moderate. In a meta regression of randomized, controlled trials of iodixanol, no relationship was found between route of administration and comparative CIN risk. Few studies compared LOCM. Procedural details about contrast administration were not uniformly reported. Few studies specified clinical indications or severity of baseline renal impairment. No differences were found in CIN risk among types of LOCM. Iodixanol had a slightly lower risk for CIN than LOCM, but the lower risk did not exceed a criterion for clinical importance. Agency for Healthcare Research and Quality.

  20. Managing the risk associated with use of contrast media for computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Stacul, Fulvio [Department of Radiology, University of Trieste, Cattinara Hospital, Strada di Fiume, 447, 34149 Trieste (Italy)]. E-mail: fulvio.stacul@aots.sanita.fvg.it

    2007-05-15

    Contrast agents are widely used in patients undergoing diagnostic and therapeutic imaging procedures. In recent years, there has been a significant increase in the use of iodinated contrast media (CM) due to the growing number of computed tomography (CT) procedures. Although contrast agents are generally well-tolerated, some patient subsets are at an increased risk of complications from CM. Patients at risk include those with a history of adverse reactions to CM, asthma or severe allergies, impaired renal function, older age, dehydration, congestive heart failure, or concurrent use of some drugs. Although the incidence of CM-associated complications cannot be eliminated, the chances of developing severe adverse reactions can be reduced by incorporating a number of management strategies into clinical practice. Patients at risk for acute adverse reactions can undergo pre-medication with corticosteroids, eventually associated with anti-histamines, although opinion is divided whether this prophylaxis should be used with non-ionic CM. Patients who have been identified as at risk for contrast-induced nephropathy (CIN) should be well-hydrated and have nephrotoxic medications withdrawn prior to CM exposure. Contrast dose should be decreased, as the risk of developing CIN is dose-dependent. For patients with pre-existing renal insufficiency, use of low-osmolar or iso-osmolar CM is preferable to use of high-osmolar CM. Simple strategies for preventing the risk of adverse reactions are reviewed.

  1. Managing the risk associated with use of contrast media for computed tomography

    International Nuclear Information System (INIS)

    Stacul, Fulvio

    2007-01-01

    Contrast agents are widely used in patients undergoing diagnostic and therapeutic imaging procedures. In recent years, there has been a significant increase in the use of iodinated contrast media (CM) due to the growing number of computed tomography (CT) procedures. Although contrast agents are generally well-tolerated, some patient subsets are at an increased risk of complications from CM. Patients at risk include those with a history of adverse reactions to CM, asthma or severe allergies, impaired renal function, older age, dehydration, congestive heart failure, or concurrent use of some drugs. Although the incidence of CM-associated complications cannot be eliminated, the chances of developing severe adverse reactions can be reduced by incorporating a number of management strategies into clinical practice. Patients at risk for acute adverse reactions can undergo pre-medication with corticosteroids, eventually associated with anti-histamines, although opinion is divided whether this prophylaxis should be used with non-ionic CM. Patients who have been identified as at risk for contrast-induced nephropathy (CIN) should be well-hydrated and have nephrotoxic medications withdrawn prior to CM exposure. Contrast dose should be decreased, as the risk of developing CIN is dose-dependent. For patients with pre-existing renal insufficiency, use of low-osmolar or iso-osmolar CM is preferable to use of high-osmolar CM. Simple strategies for preventing the risk of adverse reactions are reviewed

  2. Administration of biliary contrast media in computed tomography

    International Nuclear Information System (INIS)

    Huebener, K.-H.; Treugut, H.

    1981-01-01

    Biliary contrast media have 2 main uses in computed tomography (CT) of the liver and bile ducts: 1. Labelling of extrahepatic bile ducts in order to aid in the identification of the common bile ducts and the papilla of Vater, particularly in cases of complex, mostly postoperative situs. 2. Differentiation between normal and abnormal liver tissue in cases of focal nodular hyperplasia with proliferation of tumorous bile ducts. The applicability of biliary contrast media is rather limited as far as the improvement of spatial resolution by an increase of contrast is concerned, because the attainable enhancement today remains small. The possibility of interpretation of the liver function is likewise insufficient, because the standard deviation of the time-dependent enhancement is too great in the normal collective in order to register deviations reliably. In cases of liver cirrhosis, a rise of density of at least 40-60 Hounsfield Units (HU) would be desirable. (Auth.)

  3. Incidence of immediate adverse effects of gadolinium contrast media

    International Nuclear Information System (INIS)

    Ujita, Kouishi; Matsui, Satomi; Oikawa, Satoko; Habano, Youji; Ozaki, Daisuke; Ootake, Hidenori; Amanuma, Makoto; Endo, Keigo

    2010-01-01

    We investigated the adverse effects of intravenous injection of one of 4 types of gadolinium contrast media in 6550 patients: gadopentate dimeglumine (Gd-DTPA), 4299 patients; gadodiamide (Gd-DTPA-BMA), 1612; gadoteridol (Gd (HP-DO3A)), 565; and gadoterate meglumin (Gd-DOTA), 74. Thirty-two (0.49%) patients experienced adverse effects, which included rash (18.8%), nausea (40.6%), vomiting (34.4%), and an unpleasant sensation in the throat (6.3%). No patient required hospitalization. We compared the incidence of adverse effects from the 4 types of contrast media and found no difference in sex, age, body region examined, or method of contrast administration. Incidence was significantly higher for Gd (HP-DO3A) than Gd-DTPA and Gd-DTPA-BMA (P<0.000001). (author)

  4. Abnormal gel flotation caused by contrast media during adrenal vein sampling.

    Science.gov (United States)

    Lima-Oliveira, Gabriel; Lippi, Giuseppe; Salvagno, Gian Luca; Gelati, Matteo; Bassi, Antonella; Contro, Alberto; Pizzolo, Francesca; Guidi, Gian Cesare

    2016-10-15

    During adrenal venous sampling (AVS) procedure, radiologists administer a contrast agent via the catheter to visualize the proper catheter position. A patient with primary aldosteronism diagnostic-hypothesis was admitted for AVS. A venogram was performed to
confirm the catheter's position with 2mL of Iopamidol 300 mg/mL. Samples were collected with syringe connected to a hydrophilic coated catheter by low-pressure aspiration from each of the four collection sites: inferior vena cava in the suprarenal portion, inferior vena cava in the infrarenal portion, left adrenal vein, and right adrenal vein; then immediately transferred from syringe to tubes with gel separator. All tubes were centrifuged at 1200 x g for 10 minutes. At the end of centrifugation process, primary blood tubes containing blood from inferior vena cava and left adrenal vein exhibited the standard gel separator barrier, while tubes from right adrenal vein showed abnormal flotation of gel separator. The radiologist confirmed the usage of 2.6 mL instead of 2.0 mL of Iopamidol 300 mg/mL. This iodinated contrast media, with 1.33 g/cm 3 of density, was used close to the right adrenal vein due to some difficulty to access it. The abnormal flotation of gel separator in samples taken from right adrenal vein can be explained by the usage of the iodinated
contrast media. We suggest using plain-tubes (without gel separator) for AVS in order to avoid preanalytical nonconformities. Moreover, a blood volume equivalent to twice the catheter extension should be discarded to eliminate residual contrast media before collection of samples for laboratory assays.

  5. Cardiopulmonary resuscitation and contrast media reactions in a radiology department

    International Nuclear Information System (INIS)

    O'Neill, John M.; McBride, Kieran D.

    2001-01-01

    AIM: To assess current knowledge and training in the management of contrast media reactions and cardiopulmonary resuscitation within a radiology department. MATERIALS AND METHODS: The standard of knowledge about the management of contrast media reactions and cardiopulmonary resuscitation among radiologists, radiographers and nurses were audited using a two-section questionnaire. Our results were compared against nationally accepted standards. Repeat audits were undertaken over a 28-month period. Three full audit cycles were completed. RESULTS: The initial audit confirmed that although a voluntary training programme was in place, knowledge of cardiopulmonary resuscitation techniques were below acceptable levels (set at 70%) for all staff members. The mean score for radiologists was 50%. Immediate changes instituted included retraining courses, the distribution of standard guidelines and the composition and distribution of two separate information handouts. Initial improvements were complemented by new wallcharts, which were distributed throughout the department, a series of lectures on management of contrast reactions and regular reviews with feedback to staff. In the third and final audit all staff groups had surpassed the required standard. CONCLUSION: Knowledge of contrast media reactions and resuscitation needs constant updating. Revision of skills requires a prescriptive programme; visual display of advice is a constant reminder. It is our contention all radiology departmental staff should consider it a personal duty to maintain their resuscitation skills at appropriate standards. O'Neill, J.M., McBride, K.D.(2001). Clinical Radiology 00, 000-000

  6. Cardiopulmonary resuscitation and contrast media reactions in a radiology department

    Energy Technology Data Exchange (ETDEWEB)

    O' Neill, John M.; McBride, Kieran D

    2001-04-01

    AIM: To assess current knowledge and training in the management of contrast media reactions and cardiopulmonary resuscitation within a radiology department. MATERIALS AND METHODS: The standard of knowledge about the management of contrast media reactions and cardiopulmonary resuscitation among radiologists, radiographers and nurses were audited using a two-section questionnaire. Our results were compared against nationally accepted standards. Repeat audits were undertaken over a 28-month period. Three full audit cycles were completed. RESULTS: The initial audit confirmed that although a voluntary training programme was in place, knowledge of cardiopulmonary resuscitation techniques were below acceptable levels (set at 70%) for all staff members. The mean score for radiologists was 50%. Immediate changes instituted included retraining courses, the distribution of standard guidelines and the composition and distribution of two separate information handouts. Initial improvements were complemented by new wallcharts, which were distributed throughout the department, a series of lectures on management of contrast reactions and regular reviews with feedback to staff. In the third and final audit all staff groups had surpassed the required standard. CONCLUSION: Knowledge of contrast media reactions and resuscitation needs constant updating. Revision of skills requires a prescriptive programme; visual display of advice is a constant reminder. It is our contention all radiology departmental staff should consider it a personal duty to maintain their resuscitation skills at appropriate standards. O'Neill, J.M., McBride, K.D.(2001). Clinical Radiology 00, 000-000.

  7. Contrast Media Viscosity versus Osmolality in Kidney Injury: Lessons from Animal Studies

    Science.gov (United States)

    Seeliger, Erdmann; Lenhard, Diana C.; Persson, Pontus B.

    2014-01-01

    Iodinated contrast media (CM) can induce acute kidney injury (AKI). CM share common iodine-related cytotoxic features but differ considerably with regard to osmolality and viscosity. Meta-analyses of clinical trials generally failed to reveal renal safety differences of modern CM with regard to these physicochemical properties. While most trials' reliance on serum creatinine as outcome measure contributes to this lack of clinical evidence, it largely relies on the nature of prospective clinical trials: effective prophylaxis by ample hydration must be employed. In everyday life, patients are often not well hydrated; here we lack clinical data. However, preclinical studies that directly measured glomerular filtration rate, intrarenal perfusion and oxygenation, and various markers of AKI have shown that the viscosity of CM is of vast importance. In the renal tubules, CM become enriched, as water is reabsorbed, but CM are not. In consequence, tubular fluid viscosity increases exponentially. This hinders glomerular filtration and tubular flow and, thereby, prolongs intrarenal retention of cytotoxic CM. Renal cells become injured, which triggers hypoperfusion and hypoxia, finally leading to AKI. Comparisons between modern CM reveal that moderately elevated osmolality has a renoprotective effect, in particular, in the dehydrated state, because it prevents excessive tubular fluid viscosity. PMID:24707482

  8. Contrast media in computed tomography of the pelvic organs

    International Nuclear Information System (INIS)

    Husband, J.E.

    1981-01-01

    The use of various contrast media is essential for examination of the pelvis with computed tomography (CT) because there is little fat between the organs and structures and because bowel may be misinterpreted as mass. Routine opacification of the distal small bowel and colon is achieved using dilute oral and rectal contrast medium, and all patients are scanned with a full bladder. A tampon is used to outline the vaginal vault. Intravenous contrast medium may be required to opacify the urinary tract or to distinguish vessels from a suspected space-occupying lesion. Pelvic masses may show tissue enhancement following injection of intravenous contrast medium but further studies are required to determine the diagnostic value of the information obtained. (Auth.)

  9. The effect of palatability of oral contrast media on compliance with drinking protocols, and on bowel opacification, in abdominal CT

    International Nuclear Information System (INIS)

    Morgan, Bruno; Basu, Avi; Kithoray, Surjinder; Tyagi, Raman; Campbell, Shona; Liddicoat, Amanda

    2009-01-01

    Purpose: To assess whether palatability of oral contrast in CT has an impact on adherence to oral contrast media drinking protocols; and whether such variation has an impact on bowel opacification. Three different types of contrast media were compared; ionic and non-ionic iodinated oral contrast (Gastrografin, Diatrizoate, Schering AG), Gastromiro (Iopamidol, Bracco SpA) and the barium based contrast E-Z-Cat (E-Z-EM). Materials and methods: In the first stage of the study 101 prospective patients were randomly given 1 L of a ∼2% solution of Gastrografin or Gastromiro prior to a body CT scan. Data was recorded concerning the palatability of the oral contrast, drinking protocol compliance and bowel opacification. The second stage involved 66 prospective patients given Gastromiro or E-Z-Cat (again 1 L of ∼2% solution). Results: Gastromiro had better palatability than Gastrografin (p = 0.001) and improved protocol compliance. E-Z-Cat had similar palatability to Gastromiro . Patients who found the oral contrast more palatable had improved drinking protocol compliance (p = 0.007) and improved small bowel opacification (p = 0.03). E-Z-Cat had similar palatability and protocol compliance to Gastromiro but better overall small bowel opacification (p = 0.001). Conclusion: In conclusion we suggest that the palatability of oral contrast is not only important to the patients overall experience of body CT, but that it is also linked to adherence with oral contrast drinking protocols leading to better bowel opacification.

  10. Effects of high iodine doses given parenterally as contrast medium on parameter of the pro/antioxidative balance

    International Nuclear Information System (INIS)

    Winkler, R.; Griebenow, S.; Scheidleder, B.; Bailer, H.

    2002-01-01

    The aim of this study was to investigate effects of high iodine doses given parenterally as contrast medium on parameters of lipid status and thyroid hormone status as well as on parameters of the pro/antioxidative balance of spa patients. 29 patients with a comparable indication who had to undergo an angiography were chosen. The blood parameters of these patients were determined before and after the angiographic treatment. No provable changes of the thyroid parameters f-T 3 , f-T 4 and TSH were found after the angiography. In case of enzyme activities, the protective enzymes SOD and GSHPX showed no changes, while the concentrations of peroxides and MDA were increased significantly. Corresponding to this, the total antioxidative status and the vitamin E level decreased significantly. Altogether these results stand for a moderate deterioration of the antioxidative protective potential by the highly iodine containing contrast medium. (author)

  11. Multidetector computed tomography (MDCT) evaluation of myocardial viability: intraindividual comparison of monomeric vs. dimeric contrast media in a rabbit model

    Energy Technology Data Exchange (ETDEWEB)

    Mahnken, Andreas H. [RWTH Aachen University, Department of Diagnostic Radiology, Aachen (Germany)]|[RWTH Aachen University, Applied Medical Engineering, Helmholtz Institute, Aachen (Germany)]|[University Hospital, RWTH Aachen University, Department of Diagnostic Radiology, Aachen (Germany); Jost, Gregor; Sieber, Martin; Seidensticker, Peter R.; Pietsch, Hubertus [Bayer-Schering Pharma AG, Berlin (Germany); Bruners, Philipp [RWTH Aachen University, Department of Diagnostic Radiology, Aachen (Germany)]|[RWTH Aachen University, Applied Medical Engineering, Helmholtz Institute, Aachen (Germany); Guenther, Rolf W. [RWTH Aachen University, Department of Diagnostic Radiology, Aachen (Germany)

    2009-02-15

    To evaluate the influence of different types of iodinated contrast media on the assessment of myocardial viability, acute myocardial infarction (MI) was surgically induced in six rabbits. Over a period of 45 min, contrast-enhanced cardiac MDCT (64 x 0.6 mm, 80 kV, 680mAs{sub eff.}) was repeatedly performed using a contrast medium dose of 600 mg iodine/kg body weight. Animals received randomized iopromide 300 and iodixanol 320, respectively. Attenuation values of healthy and infarcted myocardium were measured. The size of MI was computed and compared with nitroblue tetrazolium (NBT)-stained specimen. The highest attenuation differences between infarcted and healthy myocardium occurred during the arterial phase with 140.0{+-}3.5 HU and 141.0{+-}2.2 HU for iopromide and iodixanol, respectively. For iodixanol the highest attenuation difference on delayed contrast-enhanced images was achieved 3 min post injection (73.5 HU). A slightly higher attenuation difference was observed for iopromide 6 min after contrast medium injection (82.2 HU), although not statistically significant (p=0.6437). Mean infarct volume as measured by NBT staining was 33.5%{+-}13.6%. There was an excellent agreement of infarct sizes among NBT-, iopromide- and iodixanol-enhanced MDCT with concordance-correlation coefficients ranging from {rho}{sub (c)=} 0.9928-0.9982. Iopromide and iodixanol both allow a reliable assessment of MI with delayed contrast-enhanced MDCT. (orig.)

  12. X-ray contrast media-an overview

    International Nuclear Information System (INIS)

    Christiansen, Cathrine

    2005-01-01

    X-ray contrast media are chemically inert drugs which are given intravascularly in very high amounts within a very short time period. Although they are regarded as relatively safe drugs, adverse reactions can occur: these are normally divided into immediate and delayed reactions. The latter appear hours to days after injection. Immediate reactions have been drastically reduced since the introduction of non-ionic monomers and non-ionic dimers. However, the delayed reactions still occur in a frequency of 1-3% in X-ray contrast media exposed patients. The majority of these reactions are mild and manifest as skin eruption, but severe reactions can also occur. Further improvement of the safety of these drugs is only possible with a better understanding of etiologies behind the observed adverse reactions

  13. Pathogenesis of Renal Failure in Multiple Myeloma: Any Role of Contrast Media?

    Directory of Open Access Journals (Sweden)

    Michele Mussap

    2014-01-01

    Full Text Available The spectrum of kidney disease-associated monoclonal immunoglobulin and plasma cell malignancies is remarkably broad and encompasses nearly all nephropathologic entities. Multiple myeloma with kidney impairment at presentation is a medical emergency since the recovery of kidney function is associated with survival benefits. In most cases, kidney impairment may be the first clinical manifestation of malignant plasma cell dyscrasias like multiple myeloma and light chain amyloidosis. Multiple myeloma per se cannot be considered a main risk factor for developing acute kidney injury following intravascular administration of iodinated contrast media. The risk is increased by comorbidities such as chronic kidney disease, diabetes, hypercalcemia, dehydration, and use of nephrotoxic drugs. Before the administration of contrast media, the current recommended laboratory tests for assessing kidney function are serum creatinine measurement and the estimation of glomerular filtration rate by using the CKD-EPI equation. The assessment of Bence Jones proteinuria is unnecessary for evaluating the risk of kidney failure in patients with multiple myeloma, since this test cannot be considered a surrogate biomarker of kidney function.

  14. Pathogenesis of Renal Failure in Multiple Myeloma: Any Role of Contrast Media?

    Science.gov (United States)

    Mussap, Michele; Merlini, Giampaolo

    2014-01-01

    The spectrum of kidney disease-associated monoclonal immunoglobulin and plasma cell malignancies is remarkably broad and encompasses nearly all nephropathologic entities. Multiple myeloma with kidney impairment at presentation is a medical emergency since the recovery of kidney function is associated with survival benefits. In most cases, kidney impairment may be the first clinical manifestation of malignant plasma cell dyscrasias like multiple myeloma and light chain amyloidosis. Multiple myeloma per se cannot be considered a main risk factor for developing acute kidney injury following intravascular administration of iodinated contrast media. The risk is increased by comorbidities such as chronic kidney disease, diabetes, hypercalcemia, dehydration, and use of nephrotoxic drugs. Before the administration of contrast media, the current recommended laboratory tests for assessing kidney function are serum creatinine measurement and the estimation of glomerular filtration rate by using the CKD-EPI equation. The assessment of Bence Jones proteinuria is unnecessary for evaluating the risk of kidney failure in patients with multiple myeloma, since this test cannot be considered a surrogate biomarker of kidney function. PMID:24877060

  15. Indication-related dosing for magnetic resonance contrast media

    International Nuclear Information System (INIS)

    Yuh, W.T.C.; Parker, J.R.; Carvlin, M.J.

    1997-01-01

    This presentation reviews the issue of contrast media dosing and imaging protocols for the optimal MR imaging detection and characterization of pathology. The cumulative clinical experience gained in performing contrast-enhanced MR examinations with gadolinium chelates indicates that a dose of 0.1 mmol/kg body weight provides safe and effective enhancement of most CNS pathology. Doses lower than 0.1 mmol/kg have been shown to be inadequate for delineating all but selected types of CNS pathology, such as masses with a high lesion to background ratio on post-contrast images (acoustic neuromas) or lesions located in areas in which the normal tissue very rapidly takes up contrast agent (e. g. microadenomas in the pituitary gland). Recent clinical studies have suggested a role for high dose gadolinium administration (up to 0.3 mmol/kg) for the optimal detection and delineation of cerebral metastases or other small or poorly enhancing lesions. Differences in the histopathologic characteristics (capillary permeability, vascularity, location, size) of specific diseased tissues may require varying doses or even a different contrast agent to be used for optimal imaging results. As new MR contrast agents and new scanning techniques are introduced, the specific diagnostic question posed will likely determine the choice of pulse sequence, contrast agent and dose used. (orig.)

  16. Clinical application and side effects of non-ionic, low-osmolar contrast media: Iopromide (Ultavist)

    International Nuclear Information System (INIS)

    Lee, Jong Tae; Suh, Jung Ho; Suh, Jin Suk; Lee, Yeon Hee

    1988-01-01

    Generally non-ionic, water-soluble contrast media has been known to be considerably better than the conventional ionic contrast agents, because of its physiochemical properties which are more hydrophilic, lower in osmolality than the ionic agents of equivalent iodine concentration. It means that the non-ionic agent has less side reaction and better general tolerance. Iopromide (Ultavist) is a newly developed non-ionic contrast media that is suitable for angiography. Some non-ionic contrast media such as Metrizamide and lopamidol were clinically introduced and proved tobe the most compromising agents for neuroradiographic study, but lopromide is not yet freely available in the vascular study. In order to evaluate the clinical fitness and its side effects of lopromide for angiography various type of angiography were done in 136 patients using lopromide and 51 received Diatrizoate meglumine (DTM). Similar volumes of the contrast media was administered at similar rate to both groups. The results were as the follows: 1. In celiac angiography of 31 patients with lopromide (Ultravist 370) and 18 with DTM 60, there were observed 9.7% mild pain and 25.8% mild heat sensation in lopromide. In DTM 60 mild pain was approximately 3 times more frequently observed than lopromide. Heat sensation is mild and similar in frequency of both groups. There was no clinically significant side effects related to the osmolality and its difference between two groups. 2. In peripheral angiography of 47 patients with lopromide 300 and 24 with DTM 60, there were observed 19.1% mild, 6.4 moderate in pain and 46.8% mild, 1% moderate heat sensation in lopromide. But in DTM there were 33.3% mild, 58.3% moderate and 8.3% severe pain, and also 70.8% mild and 16.7% moderate heat sensation in DTM were observed. lopromide is more advantageous and better contrast agents than the DTM for peripheral vascular study on the point of low side effect related to osmolality. 3. In renal angiography, there was no

  17. ASCI 2010 contrast media guideline for cardiac imaging: a report of the Asian Society of Cardiovascular Imaging cardiac computed tomography and cardiac magnetic resonance imaging guideline working group

    Science.gov (United States)

    Kitagawa, Kakuya; Tsai, I-Chen; Chan, Carmen; Yu, Wei; Yong, Hwan Seok; Choi, Byoung Wook

    2010-01-01

    The use of contrast media for cardiac imaging becomes increasing as the widespread of cardiac CT and cardiac MR. A radiologist needs to carefully consider the indication and the injection protocol of contrast media to be used as well as the possibility of adverse effect. There are several guidelines for contrast media in western countries. However, these are focusing the adverse effect of contrast media. The Asian Society of Cardiovascular Imaging, the only society dedicated to cardiovascular imaging in Asia, formed a Working Group and created a guideline, which summarizes the integrated knowledge of contrast media for cardiac imaging. In cardiac imaging, coronary artery evaluation is feasible by non-contrast MR angiography, which can be an alternative examination in high risk patients for the use of iodine contrast media. Furthermore, the body habitus of Asian patients is usually smaller than that of their western counterparts. This necessitates modifications in the injection protocol and in the formula for calculation of estimated glomerular filtration rate. This guideline provided fundamental information for the use of contrast media for Asian patients in cardiac imaging. PMID:20931289

  18. Synthesis of PEG-Iodine-Capped Gold Nanoparticles and Their Contrast Enhancement in In Vitro and In Vivo for X-Ray/CT

    International Nuclear Information System (INIS)

    Sun-Hee, K.; Eun-Mi, K.; Chang-Moon, L.; Dong, W.K.; Seok, T.L.; Myung-Hee, S.; Hwan-Jeong, J.

    2012-01-01

    We designed gold nanoparticles (AuNPs) capped with iodine and polyethylene glycol (PEG) to provide effective enhancement for X-ray CT imaging. The methoxy PEG-iodine-capped AuNPs were prepared through the chemisorption of iodine and substitution of methoxy PEG-SH onto the surface of gold nanoparticles, and severe aggregation in TEM was not observed. The binding energies of Au 4f 7/2 and I 3d 5/2 of the methoxy PEG-iodine-capped AuNPs were obtained as 84.1 eV and 619.3 eV, respectively. The binding energy shift of methoxy PEG-iodine-capped AuNPs would be resulted from the chemisorption between gold nanoparticles and iodine atoms. The methoxy PEG-iodine-capped AuNPs have higher enhancement compared to PEG-capped gold nanoparticles in the same amount of gold in vitro. After postinjection of methoxy PEG-iodine-capped AuNPs into the mice, dramatic contrast enhancement at the heart, aorta, liver, and kidney was observed, this was maintained up to 5 days, and there was no evidence of apparent toxicity. In conclusion, methoxy PEG-iodine-capped AuNPs might be a good candidate as a CT contrast agent for blood pool imaging, and this will also contribute to the prolongation of a blood circulation time for X-ray CT imaging.

  19. Liberation of plasma histamine after application of non-ionic contrast media

    International Nuclear Information System (INIS)

    Weiss, H.D.; Jansen, O.; Schallock, J.

    1989-01-01

    In 94 patients the levels of plasmahistamine have been measured after application of three non-ionic contrast media (Iopromid, Iopamidol, Iohexol) and after application of blood-isotonic saline solution. A significant liberation of histamine could be observed after administration of contrast media and also after administration of saline solution. Neither between the three nonionic contrast media nor between the contrast media and the saline solution significant differences could be measured. Administering contrast media after subsequently saline solution the levels of histamine were lower than in case of pure contrast media application. A psychogen induced histamine liberation is discussed. (orig.) [de

  20. Contrast media in renal insufficiency - risk and prevention; Auswirkungen einer intravasalen Roentgenkontrastmittelgabe auf die Nierenfunktion - Risiken und Praevention

    Energy Technology Data Exchange (ETDEWEB)

    Erley, C.M.; Bader, B.D. [Tuebingen Univ. (Germany). Abt. fuer Innere Medizin III

    2000-10-01

    The use of iodinated contrast media (CM) continues to be a common cause of hospital-acquired acute renal failure (ARF) and its development increases the in-hospital mortality significantly. Alterations in renal hemodynamics and direct tubular toxicity by contrast media are the primary factors believed to be responsible for contrast media-associated nephrotoxicity. We review recent insights into the pathogenesis of this complication and summarize prophylacttic strategies focussing on hydration, vasoactive pharmacological agents, alternative contrast media and 'prophylactic hemodialysis'. (orig.) [German] Das durch Roentgenkontrastmittelgabe initiierte Nierenversagen, die sogenannte Kontrastmittelnephropathie (KMN), stellt - insbesondere bei Patienten mit eingeschraekuter Nierenfunktion - nach wie vor ein erhebliches medizinisches Problem dar, dessen Auftreten mit einer deutlich erhoehten Krankenhausmortalitaet verbunden ist. Die Genese der KMN ist nach wie vor nicht eindeutig geklaert. Neben haemodynamischen Veraenderungen durch die Kontrastmittel spielen tubulotoxische Schaeden eine Rolle. Die vorliegende Uebersicht beschreibt die zur Zeit bekannten pathophysiologischen Vorgaenge bei der KMN und die moeglichen Praeventivmassnahmen mit besonderem Augenmerk auf die klinisch relevanten Themen der Hydratation, der prophylaktischen Gabe vasoaktiver Substanzen, den Einsatz alternativer Kontrastmittel und die Entfernung von Roentgenkontrastmitteln (KM) mittels Haemodialyse. (orig.)

  1. The Application of Contrast Media for In Vivo Feature Enhancement in X-Ray Computed Tomography of Soil-Grown Plant Roots.

    Science.gov (United States)

    Keyes, Samuel D; Gostling, Neil J; Cheung, Jessica H; Roose, Tiina; Sinclair, Ian; Marchant, Alan

    2017-06-01

    The use of in vivo X-ray microcomputed tomography (μCT) to study plant root systems has become routine, but is often hampered by poor contrast between roots, soil, soil water, and soil organic matter. In clinical radiology, imaging of poorly contrasting regions is frequently aided by the use of radio-opaque contrast media. In this study, we present evidence for the utility of iodinated contrast media (ICM) in the study of plant root systems using μCT. Different dilutions of an ionic and nonionic ICM (Gastrografin 370 and Niopam 300) were perfused into the aerial vasculature of juvenile pea plants via a leaf flap (Pisum sativum). The root systems were imaged via μCT, and a variety of image-processing approaches used to quantify and compare the magnitude of the contrast enhancement between different regions. Though the treatment did not appear to significantly aid extraction of full root system architectures from the surrounding soil, it did allow the xylem and phloem units of seminal roots and the vascular morphology within rhizobial nodules to be clearly visualized. The nonionic, low-osmolality contrast agent Niopam appeared to be well tolerated by the plant, whereas Gastrografin showed evidence of toxicity. In summary, the use of iodine-based contrast media allows usually poorly contrasting root structures to be visualized nondestructively using X-ray μCT. In particular, the vascular structures of roots and rhizobial nodules can be clearly visualized in situ.

  2. Effect of radiographic contrast media on renal perfusion - First results.

    Science.gov (United States)

    Lamby, P; Jung, F; Falter, J; Mrowietz, C; Graf, S; Schellenberg, L; Platz Batista da Silva, N; Prantl, L; Franke, R P; Jung, E M

    2016-01-01

    Intra-arterial administration of radiographic contrast media (CM) is discussed to impair renal perfusion. The pathogenesis of contrast-induced Nephropathy (CIN) is still not clarified. This trial was performed to prove the effects of two CM with different molecular structure on renal perfusion. A prospective, randomized study on 16 pigs was designed to compare the outcome after application of a low-osmolar iodinated CM (770 mOsm/kg H2O - Group1) and an iso-osmolar iodinated CM (290 mOsm/kg H2o - Group2).Color Coded Doppler Sonography (LOGIQ E9, GE, Milwaukee, USA) was applied for measuring the Renal Resistive Index (RRI) before and after the first, fifth, and tenth bolus of CM. Statistics was performed using analysis of variance for repeated measurements with the Factor "CM". All flow spectra were documented free of artifacts and Peak Systolic Velocity (PSV), Enddiastolic Velocity (EDV) and RRI respectively could be calculated. Mean PSV in Group 1 led to a decrease while in Group 2 PSV showed a significant increase after CM (p = 0,042). The course of the mean EDV in both groups deferred accordingly (p = 0,033). Mean RRI over time significantly deferred in both groups (p = 0,001). It showed a biphasic course in Group 2 and a decrease over time in Group 2. While iso-osmolar CM induced an increase of PSV and EDV together with a decrease of RRI, low-osmolar CM could not show this effect or rather led to the opposite.

  3. Effect of Intravenous Administration of Contrast Media on Serum Creatinine Levels in Neonates.

    Science.gov (United States)

    Bedoya, Maria A; White, Ammie M; Edgar, J Christopher; Pradhan, Madhura; Raab, Elisabeth L; Meyer, James S

    2017-08-01

    Purpose To assess the effect of intravenous contrast media on renal function in neonates. Materials and Methods Institutional review board approval was obtained with waiver of consent. Electronic health records from January 2011 to April 2013 were reviewed retrospectively. Measures of renal function were obtained in inpatient neonates who underwent magnetic resonance (MR) imaging or computed tomography (CT) and for whom serum creatinine (Cr) levels were obtained within 72 hours before imaging and at least one time after imaging (>1 day after administration of contrast material). A total of 140 neonates who received contrast material (59 who underwent CT with iohexol or iodixanol and 81 who underwent MR imaging with gadopentetate dimeglumine) were identified. These neonates were frequency matched according to sex, gestational and postnatal age, and preimaging serum Cr levels with neonates who underwent unenhanced MR imaging or CT. Cr levels and glomerular filtration rates (GFRs) were grouped according to when they were obtained (before imaging, 1-2 days after imaging, 3-5 days after imaging, 6-9 days after imaging, 10-45 days after imaging, and more than 45 days after imaging). Serum Cr levels and GFRs for each time period were compared between groups by using hierarchic regressions or χ 2 or Fisher exact tests and with repeated-measures analysis of variance to compare groups on the rate of change in serum Cr levels and GFRs from before to after imaging. Results Cr levels decreased and GFRs increased in both groups from before to after imaging (CT group, P ≤ .01; MR imaging group, P ≤ .01). The neonates who underwent contrast material-enhanced imaging and the neonates who underwent unenhanced imaging showed similar serum Cr levels at all examined time periods. Groups also did not differ in the proportion of neonates with serum Cr levels higher than the reference range (>0.4 mg/dL) at any time point (iodine- [P > .12] or gadolinium-based [P > .13] contrast

  4. Computed Tomography Imaging of Solid Tumors Using a Liposomal-Iodine Contrast Agent in Companion Dogs with Naturally Occurring Cancer.

    Science.gov (United States)

    Ghaghada, Ketan B; Sato, Amy F; Starosolski, Zbigniew A; Berg, John; Vail, David M

    2016-01-01

    Companion dogs with naturally occurring cancer serve as an important large animal model in translational research because they share strong similarities with human cancers. In this study, we investigated a long circulating liposomal-iodine contrast agent (Liposomal-I) for computed tomography (CT) imaging of solid tumors in companion dogs with naturally occurring cancer. The institutional animal ethics committees approved the study and written informed consent was obtained from all owners. Thirteen dogs (mean age 10.1 years) with a variety of masses including primary and metastatic liver tumors, sarcomas, mammary carcinoma and lung tumors, were enrolled in the study. CT imaging was performed pre-contrast and at 15 minutes and 24 hours after intravenous administration of Liposomal-I (275 mg/kg iodine dose). Conventional contrast-enhanced CT imaging was performed in a subset of dogs, 90 minutes prior to administration of Liposomal-I. Histologic or cytologic diagnosis was obtained for each dog prior to admission into the study. Liposomal-I resulted in significant (p contrast agent was demonstrated. Liposomal-I enabled visualization of primary and metastatic liver tumors. Sub-cm sized liver lesions grossly appeared as hypo-enhanced compared to the surrounding normal parenchyma with improved lesion conspicuity in the post-24 hour scan. Large liver tumors (> 1 cm) demonstrated a heterogeneous pattern of intra-tumoral signal with visibly higher signal enhancement at the post-24 hour time point. Extra-hepatic, extra-splenic tumors, including histiocytic sarcoma, anaplastic sarcoma, mammary carcinoma and lung tumors, were visualized with a heterogeneous enhancement pattern in the post-24 hour scan. The long circulating liposomal-iodine contrast agent enabled prolonged visualization of small and large tumors in companion dogs with naturally occurring cancer. The study warrants future work to assess the sensitivity and specificity of the Liposomal-I agent in various types of

  5. Update on the renal toxicity of iodinated contrast drugs used in clinical medicine

    Directory of Open Access Journals (Sweden)

    Andreucci M

    2017-05-01

    in release of NO in vasa recta; and reducing cell survival, due to decreased activation of Akt and ERK1/2, kinases involved in cell survival/proliferation. Prevention is mainly based on extracellular volume expansion, statins, and N-acetylcysteine; conflicting results have been obtained with nebivolol, furosemide, calcium-channel blockers, theophylline, and hemodialysis. Keywords: renal failure, ARF, acute kidney injury, AKI, contrast media, intracellular signaling

  6. Influence of contrast media viscosity and temperature on injection pressure in computed tomographic angiography: a phantom study.

    Science.gov (United States)

    Kok, Madeleine; Mihl, Casper; Mingels, Alma A; Kietselaer, Bas L; Mühlenbruch, Georg; Seehofnerova, Anna; Wildberger, Joachim E; Das, Marco

    2014-04-01

    Iodinated contrast media (CM) in computed tomographic angiography is characterized by its concentration and, consecutively, by its viscosity. Viscosity itself is directly influenced by temperature, which will furthermore affect injection pressure. Therefore, the purposes of this study were to systematically evaluate the viscosity of different CM at different temperatures and to assess their impact on injection pressure in a circulation phantom. Initially, viscosity of different contrast media concentrations (240, 300, 370, and 400 mgI/mL) was measured at different temperatures (20°C-40°C) with a commercially available viscosimeter. In the next step, a circulation phantom with physical conditions was used. Contrast media were prepared at different temperatures (20°C, 30°C, 37°C) and injected through a standard 18-gauge needle. All other relevant parameters were kept constant (iodine delivery rate, 1.9 g I/s; total amount of iodine, 15 g I). Peak flow rate (in milliliter per second) and injection pressure (psi) were monitored. Differences in significance were tested using the Kruskal-Wallis test (Statistical Package for the Social Sciences). Viscosities for iodinated CM of 240, 300, 370, and 400 mg I/mL at 20°C were 5.1, 9.1, 21.2, and 28.8 mPa.s, respectively, whereas, at 40°C, these were substantially lower (2.8, 4.4, 8.7, and 11.2 mPa.s). In the circulation phantom, mean (SD) peak pressures for CM of 240 mg I/mL at 20°C, 30°C, and 37°C were 107 (1.5), 95 (0.6), and 92 (2.1) psi; for CM of 300 mg I/mL, 119 (1.5), 104 (0.6), and 100 (3.6) psi; for CM of 370 mg I/mL, 150 (0.6), 133 (4.4), and 120 (3.5) psi; and for CM of 400 mg I/mL, 169 (1.0), 140 (2.1), and 135 (2.9) psi, respectively, with all P values less than 0.05. Low concentration, low viscosity, and high temperatures of CM are beneficial in terms of injection pressure. This should also be considered for individually tailored contrast protocols in daily routine scanning.

  7. Arterial double-contrast dual-energy MDCT: in-vivo rabbit atherosclerosis with iodinated nanoparticles and gadolinium agents

    Science.gov (United States)

    Carmi, Raz; Kafri, Galit; Altman, Ami; Goshen, Liran; Planer, David; Sosna, Jacob

    2010-03-01

    An in-vivo feasibility study of potentially improved atherosclerosis CT imaging is presented. By administration of two different contrast agents to rabbits with induced atherosclerotic plaques we aim at identifying both soft plaque and vessel lumen simultaneously. Initial injection of iodinated nanoparticle (INP) contrast agent (N1177 - Nanoscan Imaging), two to four hours before scan, leads to its later accumulation in macrophage-rich soft plaque, while a second gadolinium contrast agent (Magnevist) injected immediately prior to the scan blends with the aortic blood. The distinction between the two agents in a single scan is achieved with a double-layer dual-energy MDCT (Philips Healthcare) following material separation analysis using the reconstructed images of the different x-ray spectra. A single contrast agent injection scan, where only INP was injected two hours prior to the scan, was compared to a double-contrast scan taken four hours after INP injection and immediately after gadolinium injection. On the single contrast agent scan we observed along the aorta walls, localized iodine accumulation which can point on INP uptake by atherosclerotic plaque. In the double-contrast scan the gadolinium contributes a clearer depiction of the vessel lumen in addition to the lasting INP presence. The material separation shows a good correlation to the pathologies inferred from the conventional CT images of the two different scans while performing only a single scan prevents miss-registration problems and reduces radiation dose. These results suggest that a double-contrast dual-energy CT may be used for advanced clinical diagnostic applications.

  8. Effects of two types of medical contrast media on routine chemistry results by three automated chemistry analyzers.

    Science.gov (United States)

    Park, Yu Jin; Rim, John Hoon; Yim, Jisook; Lee, Sang-Guk; Kim, Jeong-Ho

    2017-08-01

    The use of iodinated contrast media has grown in popularity in the past two decades, but relatively little attention has been paid to the possible interferential effects of contrast media on laboratory test results. Herein, we investigate medical contrast media interference with routine chemistry results obtained by three automated chemistry analyzers. Ten levels of pooled serum were used in the study. Two types of medical contrast media [Iopamiro (iopamidol) and Omnipaque (iohexol)] were evaluated. To evaluate the dose-dependent effects of the contrast media, iopamidol and iohexol were spiked separately into aliquots of serum for final concentrations of 1.8%, 3.6%, 5.5%, 7.3%, and 9.1%. The 28 analytes included in the routine chemistry panel were measured by using Hitachi 7600, AU5800, and Cobas c702 analyzers. We calculated the delta percentage difference (DPD) between the samples and the control, and examined dose-dependent trends. When the mean DPD values were compared with the reference cut-off criteria, the only uniformly interferential effect observed for all analyzers was in total protein with iopamidol. Two additional analytes that showed trends toward interferential effects only in few analyzers and exceeded the limits of the allowable error were the serum iron and the total CO 2 . The other combinations of analyzer and contrast showed no consistent dose-dependent propensity for change in any analyte level. Our study suggests that many of the analytes included in routine chemistry results, except total protein and serum iron, are not significantly affected by iopamidol and iohexol. These results suggest that it would be beneficial to apply a flexible medical evaluation process for patients requiring both laboratory tests and imaging studies, minimizing the need for strict regulations for sequential tests. Copyright © 2017 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  9. Low contrast media volume in pre-TAVI CT examinations.

    Science.gov (United States)

    Kok, Madeleine; Turek, Jakub; Mihl, Casper; Reinartz, Sebastian D; Gohmann, Robin F; Nijssen, Estelle C; Kats, Suzanne; van Ommen, Vincent G; Kietselaer, Bas L J H; Wildberger, Joachim E; Das, Marco

    2016-08-01

    To evaluate image quality using reduced contrast media (CM) volume in pre-TAVI assessment. Forty-seven consecutive patients referred for pre-TAVI examination were evaluated. Patients were divided into two groups: group 1 BMI  28 kg/m(2) (n = 18). Patients received a combined scan protocol: retrospective ECG-gated helical CTA of the aortic root (80kVp) followed by a high-pitch spiral CTA (group 1: 70 kV; group 2: 80 kVp) from aortic arch to femoral arteries. All patients received one bolus of CM (300 mgI/ml): group 1: volume = 40 ml; flow rate = 3 ml/s, group 2: volume = 53 ml; flow rate = 4 ml/s. Attenuation values (HU) and contrast-to-noise ratio (CNR) were measured at the levels of the aortic root (helical) and peripheral arteries (high-pitch). Diagnostic image quality was considered sufficient at attenuation values > 250HU and CNR > 10. Diagnostic image quality for TAVI measurements was obtained in 46 patients. Mean attenuation values and CNR (HU ± SD) at the aortic root (helical) were: group 1: 381 ± 65HU and 13 ± 8; group 2: 442 ± 68HU and 10 ± 5. At the peripheral arteries (high-pitch), mean values were: group 1: 430 ± 117HU and 11 ± 6; group 2: 389 ± 102HU and 13 ± 6. CM volume can be substantially reduced using low kVp protocols, while maintaining sufficient image quality for the evaluation of aortic root and peripheral access sites. • Image quality could be maintained using low kVp scan protocols. • Low kVp protocols reduce contrast media volume by 34-67 %. • Less contrast media volume lowers the risk of contrast-induced nephropathy.

  10. Prevalence of latent and manifest hyperthyroidism in an iodine-deficient area: non-selected patient population admitted for CT studies with iodine-containing contrast agents

    International Nuclear Information System (INIS)

    Saam, T.; Hess, T.; Kasperk, C.; Kauffmann, G.W.; Duex, M.

    2005-01-01

    Purpose: to evaluate the prevalence of latent and manifest hyperthyroidism in a non-selected group of patients admitted for contrast enhanced CT studies blood samples were tested for the levels of thyroid-stimulating hormone (TSH). Material and methods: TSH blood levels were obtained in 548 consecutive patients who were scheduled for contrast-enhanced (Iopromide; 300 mg iodine/ml) CT scanning. In case of TSH levels registered (sodium perchlorate) was commenced before scanning. In case of TSH levels < 0.1 mU/l, CT scanning was not performed but further evaluation of the thyroid function was initiated. Results: TSH blood levels ranged from 0.4 to 7.5 mU/l in 512 patients, and 36 patients (6.6%) had TSH blood levels < 0.4 mU/l and 9 patients blood levels < 0.1 mU/l, with 32 of those patients (5.8%) having regular T3 and T4 blood levels consistent with latent hyperthyroidism. In 4 patients (0.8%), T3 or T4 blood levels were increased consistent with manifest hyperthyroidism. Conclusion: in South Germany, the prevalence of latent or manifest hyperthyroidism in a non-selected patient group is high. Therefore TSH blood levels should be obtained prior to contrast-enhanced CT studies. (orig.)

  11. Organizational liability for adverse reactions to the contrast media

    International Nuclear Information System (INIS)

    Lim, Chang Seon

    2007-01-01

    Contrast medium is a very useful tool for X-ray examinations. But contrast medium has some unavoidable adverse reactions. For those patients who have never received contrast medium before, it is impossible to predict whether they will suffer from certain kinds of adverse reactions. Thus, radiologists should use strategies to minimize adverse events and be prepared to promptly recognize and manage any reactions to the contrast media. If a radiologist commits medical malpractice, he will face civil responsibility. Medical malpractice means a tort or breach of contrast that occurs in a medical setting. Medical malpractices happen, despite the efforts of hospital staff. Many courts have applied the traditional doctrine of respondeat superior in actions against organizations for injuries caused by their employees. It is a legal doctrine, which states that an employer is responsible for employee actions performed within the course of the employment. A hospital is an organization for health purposes. An organization may be convicted of an offense committed by an employee of the organization acting in its behalf and within the scope of this office or employment. Organizational liability involves a wide variety of legal issues, including tort liability, wrongful employment practices, personal injury, breach of fiduciary duty, and so on. Many executive directors of organizations are aware of their personal and organizational risks of exposure to legal liabilities. The employer must have the right to control the physical conduct of the employee and must consent to receive the employee's services, while expecting some benefits from the services offered. Therefore, legal liability can be imposed for improper selection, assignment, training, and supervision of employees. In conclusion, the hospital itself has organizational liability for adverse reactions to the contrast medium

  12. The effect of contrast media on the synovial membrane

    Energy Technology Data Exchange (ETDEWEB)

    Papacharalampous, Xenophon [Department of Radiology, University of Athens, Vasilissis Sofias 76 Ave., GR-115 28 Athens (Greece)]. E-mail: medgraph@otenet.gr; Patsouris, Efstratios [Department of Pathology, University of Athens, Mikras Asias 75 str., GR-115 27 Athens (Greece); Mundinger, Alexander [Clinic of Radiology, Marienhospital Osnabrueck, Johannisfreiheit 2-4, D-49074 Osnabruek (Germany); Beck, Andreas [Clinic of Radiology, Konstanz, Luisenstrasse 7, D-78461 Konstanz (Germany); Kouloulias, Vasilios [Department of Radiotherapy, University of Athens, Vasilissis Sofias 76 Ave., GR-115 28 Athens (Greece); Primetis, Elias [Department of Radiology, University of Athens, Vasilissis Sofias 76 Ave., GR-115 28 Athens (Greece); Koureas, Andreas [Department of Radiology, University of Athens, Vasilissis Sofias 76 Ave., GR-115 28 Athens (Greece); Vlahos, Lambros [Department of Radiology, University of Athens, Vasilissis Sofias 76 Ave., GR-115 28 Athens (Greece)

    2005-09-01

    Objective: To examine the effect of intra-articular injection of contrast media, sorbitol and normal saline on the synovial membrane. Materials and methods: Sixty three rabbits (126 knees) were used in this study. We injected the knees with amidotrizoate, ioxaglate, iopamidol, iotrol and diluted gadolinium-DTPA (2 mmol/l). Normal saline and sorbitol 27.25% were used for comparison. A histological and histochemical examination of the knees was carried out 1, 2, 10, 20, 30, 40 and 60 days after the injection. Results: On histological examination, the knees injected with normal saline, ioxaglate and gadolinium-DTPA had a normal appearance. Intra-articular injection of amidotrizoate, iopamidol, iotrol and sorbitol caused early, mild and transient histological changes of the synovium (synovial hyperplasia, infiltration by leucocytes). Furthermore, the knees injected with amidotrizoate presented with late, extensive histological changes (severe synovial hyperplasia, moderate vascular dilatation, severe infiltration by leukocytes). Conclusion: The results suggest that the chemical structure and not the osmolality of the contrast media is the main cause for the histological changes of the synovium.

  13. Status survey on the adverse reactions of CT contrast media

    International Nuclear Information System (INIS)

    Moon, Il Bong; Dong, Kyung Rae; Kim, Kwang Cheol

    2016-01-01

    This study is aimed at suggesting the necessity of critical paths for the adverse reactions of contrast media, and investigating the ways to respond properly at the time of adverse reactions. The question on the size of hospitals in possession of CT equipment indicated that general hospitals accounted for 50% at the highest rate. In terms of job experience, 50% of radiological technologists had more than 10 years of experience, which accounted for the highest rate. It was shown that the average number of radiological technologists in the CT room was 3, that of nurses 0.6 and that of administrative workers and others 0.3 (87.5%) of respondents explained the treatment method of adverse reaction, and 97.5% responded that they were using the manual for the case of adverse reactions. Also, 87.5% of respondents indicated that they had the division of works at the time of adverse reaction, and the yearly average number of cases was 35. The average handling time was shown to be 51 minutes. This Emergency treatment manual and Critical Pathway program can be used as one of the patient care tools for reducing the adverse reactions to contrast media and increasing the efficiency of care process in CT examination settings

  14. Status survey on the adverse reactions of CT contrast media

    Energy Technology Data Exchange (ETDEWEB)

    Moon, Il Bong; Dong, Kyung Rae [Dept. of Radiological Technology, Gwangju Health University, Gwangju (Korea, Republic of); Kim, Kwang Cheol [Social Disaster Management Division, Jeollanamdo Provincial Government, Muan (Korea, Republic of)

    2016-11-15

    This study is aimed at suggesting the necessity of critical paths for the adverse reactions of contrast media, and investigating the ways to respond properly at the time of adverse reactions. The question on the size of hospitals in possession of CT equipment indicated that general hospitals accounted for 50% at the highest rate. In terms of job experience, 50% of radiological technologists had more than 10 years of experience, which accounted for the highest rate. It was shown that the average number of radiological technologists in the CT room was 3, that of nurses 0.6 and that of administrative workers and others 0.3 (87.5%) of respondents explained the treatment method of adverse reaction, and 97.5% responded that they were using the manual for the case of adverse reactions. Also, 87.5% of respondents indicated that they had the division of works at the time of adverse reaction, and the yearly average number of cases was 35. The average handling time was shown to be 51 minutes. This Emergency treatment manual and Critical Pathway program can be used as one of the patient care tools for reducing the adverse reactions to contrast media and increasing the efficiency of care process in CT examination settings.

  15. No detectable nephrotoxic side effect using a dimer, non-ionic contrast media in cerebral perfusion computed tomography in case of suspected brain ischemia

    International Nuclear Information System (INIS)

    Petrik, M.; Weigel, C.; Kirsch, M.; Hosten, N.

    2005-01-01

    Purpose: In suspected brain ischemia, the perfusion cerebral computed tomography (cCT) should be performed with the lowest amount of contrast media to avoid a contrast media induced nephropathy (CIN) even if the patient already is in renal failure. We were interested to find the best parameters for this examination. Material and methods: From February 2000 to March 2003, 138 patients (58 females, 80 males, mean age 66.8 years) underwent cCT-perfusion immediately after the admission to our stroke unit. Of these patients, 62% (n=86) had normal renal function and 38% (n=52) renal failure (up to 381 μmol/l basic serum creatinine). We varied volume (20-80 ml), flow (5 vs. 7.2. ml/s) and concentration (270 vs. 320 ml/mg iodine) of a dimer, non-ionic contrast media (Visipaque registered ) to establish 5 groups. So we got patients receiving 6 g, 12 g, 16 g, 19 g and 25 g of iodine. After generating the perfusion maps, two radiologists reviewed the quality of the maps and scored it (1-5). We measured the serum creatinine before contrast application and at follow up cCt (days 3 and 7). Results: The quality of the maps increases with increasing amount of iodine. However, the diagnostic result was not significantly better using more than about 16 g of iodine (e.g., 60 ml-7.2 ml/s - 270 mg/ml) in cCT-perfusion studies. Only one patient had a pathologic increase in serum creatinine (day 1: 93; day 4: 146 μmol/l) but died at day 5 because of massive co-morbidity and septic pneumonia. No CIN occurred even in the patient group with pre-existent renal failure. Conclusions: About 60 ml contrast media and a moderate flow rate of about 7 ml/s ensure good results in perfusion-cCT, even if the patients have poor blood circulation or arteriosclerosis. The use of a dimer, non-ionic contrast media (range of 6-25 g iodine) seems to minimize the risk of CIN in the daily routine. (orig.)

  16. Risk Evaluation of Endoscopic Retrograde Cholangiopancreatography-Related Contrast Media Allergic-Like Reaction: A Single Centre Experience

    Directory of Open Access Journals (Sweden)

    Félix Trottier-Tellier

    2018-01-01

    Full Text Available Background and Aims. Few cases of endoscopic retrograde cholangiopancreatography- (ERCP- related contrast media (CM adverse reactions have been reported in the current literature. There is a lack of standardisation in practice regarding premedication prophylaxis for at-risk patients undergoing ERCP and there are few data to guide the practitioners. Our goal is to evaluate the risk of CM adverse reaction in a group of patients with a past history of allergic-like reaction to iodine product undergoing ERCP. Methods. A retrospective chart review study was performed of patients who underwent ERCP at our single centre from January 2010 to December 2015. Results. 2295 ERCPs were performed among 1766 patients. No anaphylactoid or severe adverse reaction occurred. One (0.04% ERCP-related CM benign reaction was reported in a patient known for penicillin allergy. Among 127 ERCPs performed on patients with a prior adverse reaction to iodine, 121 procedures were done without and 6 with a premedication prophylaxis. In both groups, no ERCP-related CM reaction occurred. Conclusions. To our knowledge, we report the largest cohort of iodine allergic patients undergoing ERCP ever published. These results suggest that ERCP-related CM adverse reactions are very rare even among patients at risk for CM reaction.

  17. Iodinated contrast agent-induced nephropathy; Mit jodhaltigen Kontrastmitteln induzierte Nephropathie

    Energy Technology Data Exchange (ETDEWEB)

    Erley, C. [St. Joseph-Krankenhaus Berlin, Berlin (Germany)

    2007-09-15

    Contrast-induced nephropathy (CIN) is a well-known complication of therapeutic and diagnostic procedures requiring contrast administration and accounts for 10% of acute renal failure in hospitalized patients. Although the incidence of this complication is relatively low, its consequences can be catastrophic. The development of CIN is associated with increased length of hospital stay, an increased requirement for acute dialysis, and an increased risk of death. Preexisting renal dysfunction, age, diabetes, congestive heart failure, and volume of administered contrast are all associated with a risk of developing CIN. Despite a large number of clinical trials that have evaluated prophylaxis strategies for CIN, no uniform strategies have been developed so far. The use of N-acetyl-L-cysteine (NAC) or theophylline in specific subgroups of patients has been shown to reduce dialysis requirement and mortality in patients undergoing angiographic procedures. Hemofiltration has also shown positive results. In this review we will discuss the epidemiology and the risk factors for CIN and the evidence for commonly employed prophylaxis strategies, and we will provide general recommendations with respect to CIN prevention and management. A practicable strategy to prevent CIN includes: correct identification of individuals at greatest risk, thorough evaluation of whether other diagnostic maneuvers could be employed instead (i.e., sonography), application of low-osmolar contrast media at the minimum acceptable dose, stopping potential nephrotoxic drugs (NSAID), hydration with sodium chloride 0.9% 1 ml/kg per h i.v. 12 h before and after CM application, administration of acetylcysteine 600 mg twice the day before and after (in cases of emergency investigation and high-risk patients 1200 mg i.v.), and theophylline (250-350 mg) the day before and the day after CM application (in cases of emergency investigation 5 mg/kg i.v.). (orig.) [German] Die Kontrastmittelnephropathie (contrast

  18. CT angiography of intracranial arterial vessels: impact of tube voltage and contrast media concentration on image quality

    International Nuclear Information System (INIS)

    Ramgren, Birgitta; Holtaas, Stig; Siemund, Roger; Dept. of Radiology, Lund Univ., Lund

    2012-01-01

    Background Computed tomography angiography (CTA) of intracranial arteries has high demands on image quality. Important parameters influencing vessel enhancement are injection rate, concentration of contrast media and tube voltage. Purpose To evaluate the impact of an increase of contrast media concentration from 300 to 400 mg iodine/mL (mgI/mL) and the effect of a decrease of tube voltage from 120 to 90 kVp on vessel attenuation and image quality in CT angiography of intracranial arteries. Material and Methods Sixty-three patients were included into three protocol groups: Group I, 300 mgI/mL 120 kVp; Group II, 400 mgI/mL 120 kVp; Group III, 400 mgI/mL 90 kVp. Hounsfield units (HU) were measured in the internal carotid artery (ICA) and the M1 and M2 segments of the middle cerebral artery. Image quality grading was performed regarding M1 and M2 segments, volume rendering and general image impression. Results The difference in mean HU in ICA concerning the effect of contrast media concentration was statistically significant (P = 0.03) in favor of higher concentration. The difference in ICA enhancement due to the effect of tube voltage was statistically significant (P < 0.01) in favor of lower tube voltage. The increase of contrast medium concentration raised the mean enhancement in ICA with 18% and the decrease of tube voltage raised the mean enhancement with 37%. Image quality grading showed a trend towards improved grading for higher contrast concentration and lower tube voltage. Statistically significant better grading was found for the combined effect of both measures except for general impression (P 0.01-0.05). Conclusion The uses of highly concentrated contrast media and low tube voltage are easily performed measures to improve image quality in CTA of intracranial vessel

  19. Clinical Practice Guidelines for Diagnosis and Management of Hypersensitivity Reactions to Contrast Media.

    Science.gov (United States)

    Rosado Ingelmo, A; Doña Diaz, I; Cabañas Moreno, R; Moya Quesada, M C; García-Avilés, C; García Nuñez, I; Martínez Tadeo, J I; Mielgo Ballesteros, R; Ortega-Rodríguez, N; Padial Vilchez, M A; Sánchez-Morillas, L; Vila Albelda, C; Moreno Rodilla, E; Torres Jaén, M J

    2016-01-01

    The objective of these guidelines is to ensure efficient and effective clinical practice. The panel of experts who produced this consensus document developed a research protocol based on a review of the literature. The prevalence of allergic reactions to iodinated contrast media (ICM) is estimated to be 1:170 000, that is, 0.05%-0.1% of patients undergoing radiologic studies with ICM (more than 75 million examinations per year worldwide). Hypersensitivity reactions can appear within the first hour after administration (immediate reactions) or from more than 1 hour to several days after administration (nonimmediate or delayed reactions). The risk factors for immediate reactions include poorly controlled bronchial asthma, concomitant medication (eg, angiotensin-converting enzyme inhibitors, ß-blockers, and proton-pump inhibitors), rapid administration of the ICM, mastocytosis, autoimmune diseases, and viral infections. The most common symptoms of immediate reactions are erythema and urticaria with or without angioedema, which appear in more than 70% of patients. Maculopapular rash is the most common skin feature of nonimmediate reactions (30%-90%). Skin and in vitro tests should be performed for diagnosis of both immediate and nonimmediate reactions. The ICM to be administered will therefore be chosen depending on the results of these tests, the ICM that induced the reaction (when known), the severity of the reaction, the availability of alternative ICM, and the information available on potential ICM cross-reactivity. Another type of contrast media, gadolinium derivatives, is used used for magnetic resonance imaging. Although rare, IgE-mediated reactions to gadolinium derivatives have been reported.

  20. Clinical trial of non-ionic contrast media -comparison of efficacy and safety between non-ionic iopromide (Ultravist) and ionic contrast media-

    International Nuclear Information System (INIS)

    Lee, Ghi Jai; Kim, Seung Hyup; Park, Jae Hyung; Chang, Kee Hyun; Han, Man Chung; Kim, Chu Wan

    1988-01-01

    Non-ionic contrast media, iopromide (Ultravist) was compared with ioxitalamate (Telebrix) and/or ioxaglate (Hexabrix) for efficacy and safety in 203 patients undergoing cardiac angiography, neurovascular angiography, peripheral and visceral angiography and intravenous pyelography. In all patients, adverse symptoms and signs including heat sense, pain, nausea, vomiting, etc. were checked during and after the injection. In addition, EKG and LV pressure were monitored during the cardiac angiography. And also CBC, UA, BUN and creatinine were checked before and 24 hours after the cardiac angiography. Serious adverse effect did not occur in any case. Minor effects, such as nausea and abdominal pain, were less frequently caused by non-ionic contrast media than by ionic contrast media, especially in cardiac angiography and intravenous pyelography. There was no significant difference between ionic and non-ionic contrast media in regard to electrophysiologic parameters such as EKG and LV pressure. In case of intravenous pyelography, nonionic contrast media seemed to be superior to ionic contrast media in image quality. It is suggested that, in spite of higher cost, non-ionic contrast media be needed for the safety and image quality, particularly in those patients at high risk of adverse effects by ionic contrast media

  1. The use of contrast media for quality assurance in treatment planning

    International Nuclear Information System (INIS)

    Schultze, J.; Eilf, K.; Zimmermann, J.; Kimmig, B.

    1995-01-01

    In 1303 simulations between 1.1.1993 and 30.9.1993 105 times intravenous contrast media were applied, supplied by oral or endolymphatic contrast agents. It was studied if the previously intended plan had to be altered due to contrast media application. In 17 out of 105 cases (16.2%) the target volume or the preplanned technique had to be altered after contrast media application. Main reason was the existence of anatomical variations especially in kidney and small bowel detected by use of contrast agents. So standard indications for contrast media applications were defined. (orig.) [de

  2. Continuous celiac plexus block and spread of contrast media

    International Nuclear Information System (INIS)

    Itoh, Tatsushi; Kawabata, Masahiro; Suda, Takayuki; Koshimizu, Kenji

    1987-01-01

    A continuous celiac plexus block has been developed and is available for use. With this method, the drug can be repeatedly applied and the reproducibility of imaged findings is secured. It is possible to accurately judge the effect by the use of a local anesthetics before the injection of the neurolytics. Imaged findings at the celiac plexus block were classified into 4 types according to the pattern of CT images. Paticularly interesting is a finding that the contrast media injected in the retrocrural space for retrocrural splanchnic nerve block (RSB) permeates through the aortic hiatus as far as the area surrounding the celiac plexus and so-called transcrural celiac plexus block (TCB) takes place. Thus, it was found that the celiac plexus block so far used was a complex of RSB and TCB. (author)

  3. Lumbar myelography using water-soluble contrast media

    International Nuclear Information System (INIS)

    Langlotz, M.

    1981-01-01

    With the new water-soluble contrast media developed in the last 10 years, lumbar myelography has become a simple and low-risk diagnostic method of great value which is hardly ever omitted before surgery is undertaken. The book attempts a synopsis of radiology and clinical examinations. In its first part, the pathological, clinical, and radiological aspects of diseases of the lumbosacral spinal duct are reviewed. The second part contains more than 300 myelographic pictures in original size. Each of the myelograms is supplemented by the case history of the patient (anamnesis, neurological examination, therapy and course). Interpretation is facilitated by drawings at the beginning of each chapter which show the major pathological and radiological changes. (orig./MG) [de

  4. SU-E-QI-21: Iodinated Contrast Agent Time Course In Human Brain Metastasis: A Study For Stereotactic Synchrotron Radiotherapy Clinical Trials

    Energy Technology Data Exchange (ETDEWEB)

    Obeid, L; Esteve, F; Adam, J [Grenoble Institut des Neurosciences, La Tronche, Isere (France); Tessier, A; Balosso, J [Centre Hospitalier Universitaire, La Tronche, Isere (France)

    2014-06-15

    Purpose: Synchrotron stereotactic radiotherapy (SSRT) is an innovative treatment combining the selective accumulation of heavy elements in tumors with stereotactic irradiations using monochromatic medium energy x-rays from a synchrotron source. Phase I/II clinical trials on brain metastasis are underway using venous infusion of iodinated contrast agents. The radiation dose enhancement depends on the amount of iodine in the tumor and its time course. In the present study, the reproducibility of iodine concentrations between the CT planning scan day (Day 0) and the treatment day (Day 10) was assessed in order to predict dose errors. Methods: For each of days 0 and 10, three patients received a biphasic intravenous injection of iodinated contrast agent (40 ml, 4 ml/s, followed by 160 ml, 0.5 ml/s) in order to ensure stable intra-tumoral amounts of iodine during the treatment. Two volumetric CT scans (before and after iodine injection) and a multi-slice dynamic CT of the brain were performed using conventional radiotherapy CT (Day 0) or quantitative synchrotron radiation CT (Day 10). A 3D rigid registration was processed between images. The absolute and relative differences of absolute iodine concentrations and their corresponding dose errors were evaluated in the GTV and PTV used for treatment planning. Results: The differences in iodine concentrations remained within the standard deviation limits. The 3D absolute differences followed a normal distribution centered at zero mg/ml with a variance (∼1 mg/ml) which is related to the image noise. Conclusion: The results suggest that dose errors depend only on the image noise. This study shows that stable amounts of iodine are achievable in brain metastasis for SSRT treatment in a 10 days interval.

  5. Indications and contraindications for contrast-enhanced MRI and CT during pregnancy

    International Nuclear Information System (INIS)

    Junkermann, H.

    2007-01-01

    There are no reports about negative effects on the fetus of the application of gadolinium-containing contrast media to pregnant mothers. Iodine-containing contrast media may lead to a transient hypothyroidism in the newborn. This will be detected with certainty by the neonatal TSH screening. Iodine- or gadolinium-containing contrast media may be used in pregnant women if indispensable. In the gut of breastfed children less than 1% of the recommended pediatric doses of contrast media are found after both types of contrast media have been given to their mothers. Therefore there are no reasons against the use of contrast media during the nursing period. (orig.) [de

  6. Selecting appropriate gastroenteric contrast media for diagnostic fluoroscopic imaging in infants and children: a practical approach.

    Science.gov (United States)

    Callahan, Michael J; Talmadge, Jennifer M; MacDougall, Robert D; Kleinman, Patricia L; Taylor, George A; Buonomo, Carlo

    2017-04-01

    In our experience, questions about the appropriate use of enteric contrast media for pediatric fluoroscopic studies are common. The purpose of this article is to provide a comprehensive review of enteric contrast media used for pediatric fluoroscopy, highlighting the routine use of these media at a large tertiary care pediatric teaching hospital.

  7. SU-E-I-45: Feasibility for Using Iodine Quantification to Assist Diagnosis in Dual Energy Contrast-Enhanced Digital Mammography

    International Nuclear Information System (INIS)

    Hwang, Y; Lin, Y; Tsai, C; Cheung, Y

    2015-01-01

    Purpose: The objective of this study is to develop quantitative calibration between image quality indexes and iodine concentration with dual-energy (DE) contrast-enhanced digital mammography (CEDM) techniques and further serve as the assistance for diagnosis. Methods: Custom-made acrylic phantom with dimensions of 24×30 cm 2 simulated breast thickness from 2 to 6 cm was used in the calibration. The phantom contained matrix of four times four holes of 3 mm deep with a diameter of 15 mm for filling contrast agent with area density ranged from 0.1 to 10 mg/cm 2 . All the image acquisitions were performed on a full-field digital mammography system (Senographe Essential, GE) with dual energy acquisitions. Mean pixel value (MPV), and contrast-to-noise ratio (CNR) were used for evaluating the relationship between image quality indexes and iodine concentration. Iodine map and CNR map could further be constructed with these calibration curves applied pixel by pixel utilized MATLAB software. Minimum iodine concentration could also be calculated with the visibility threshold of CNR=5 according the Rose model. Results: When evaluating the DE subtraction images, MPV increased linearly as the iodine concentration increased with all the phantom thickness surveyed (R 2 between 0.989 and 0.992). Lesions with increased iodine uptake could thus be enhanced in the color-encoded iodine maps, and the mean iodine concentration could be obtained through the ROI measurements. As for investigating CNR performance, linear relationships were also shown between the iodine concentration and CNR (R 2 between 0.983 and 0.990). Minimum iodine area density of 1.45, 1.73, 1.80, 1.73 and 1.72 mg/cm 2 for phantom thickness of 2, 3, 4, 5, 6 cm were calculated based on Rose’s visualization criteria. Conclusion: Quantitative calibration between image quality indexes and iodine concentrations may further serving as the assistance for analyzing contrast enhancement for patient participating the dual

  8. Contrast amplification of the liver parenchyma in the computer tomogram by using intravenous and peroral biliary contrast media

    International Nuclear Information System (INIS)

    Justich, E.; Sager, W.D.; Dietrich, G.; Fotter, R.; Nedden, D. zur; Innsbruck Univ.

    1980-01-01

    If intravenous, biliary contrast media are used, a slight albeit specific enhancement of contrast of the liver parenchyma occurs with the applied dosage, which can be utilised in individual cases, for example for identifying isodense lesions. Contrast amplification by the peroral cholegraphic agent under examination, is insufficient for use in computer tomography of the liver. The use of biliary contrast media usually enables very good visualisation of the extrahepatic bile ducts. Attention is drawn to the possibility of pharmakokinetic studies by means of computer tomography. (orig.) [de

  9. Pregnancy outcome after hystero-salpingo-contrast-sonography (HyCoSy versus hysterosalpingography (HSG using different contrast media

    Directory of Open Access Journals (Sweden)

    Emad M. Siam

    2011-12-01

    Conclusion: The pregnancy rates after performing HyCoSy using the proposed homogenously mixed saline and water are nearly the same as those following HSG using different contrast media with inherent advantage of avoiding exposure to radiation.

  10. Effect of radioactive iodine therapy on carotid intima media thickness in patients with hyperthyroidism.

    Science.gov (United States)

    Şanal, Bekir; Işık, İlknur; Korkmaz, Mehmet; Kucur, Cüneyt; Can, Fatma; Kilit, Türkan Paşalı; Kahraman, Cüneyt; Kaçar, Emre; Koçak, Ahmet

    2016-01-01

    The aim of this study was to evaluate the carotid intima media thickness (IMT) in patients with thyrotoxicosis who received radioactive iodine (RAI) treatment. This study was planned to be conducted with two different groups of people. There were 87 patients in the patient group and 98 controls. Participants were evaluated for atherosclerosis risk factors. Mean carotid IMT was measured from three consecutive traces at the common carotid artery bifurcation. The mean carotid IMT was 0.81 ± 0.20 in patient group and this was higher than the controls (0.68 ± 0.19) (p treatment group (p = 0.029). In patients with only HT, the data of the two groups showed a significant difference, with the average IMT being higher in the patient group than that of the control group (p: 0.011). RAI used in the treatment of thyrotoxicosis increases the IMT of carotid artery independent of age and sex. This treatment yields better results with higher doses, and this effect is more marked in patients with HT. Hence, we believe that it is necessary to calculate the dose properly for hyperthyroid cases in which treatment with RAI is planned. In particular, the patients with HT need to be treated with the minimum possible dose. Further, carotid arteries should be evaluated with US following RAI treatment.

  11. A Novel Procedure for Rapid Imaging of Adult Mouse Brains with MicroCT Using Iodine-Based Contrast.

    Directory of Open Access Journals (Sweden)

    Ryan Anderson

    Full Text Available High-resolution Magnetic Resonance Imaging (MRI has been the primary modality for obtaining 3D cross-sectional anatomical information in animals for soft tissue, particularly brain. However, costs associated with MRI can be considerably high for large phenotypic screens for gross differences in the structure of the brain due to pathology and/or experimental manipulations. MicroCT (mCT, especially benchtop mCT, is becoming a common laboratory equipment with throughput rates equal or faster than any form of high-resolution MRI at lower costs. Here we explore adapting previously developed contrast based mCT to image adult mouse brains in-situ. We show that 2% weight per volume (w/v iodine-potassium iodide solution can be successfully used to image adult mouse brains within 48 hours post-mortem when a structural support matrix is used. We demonstrate that hydrogel can be effectively used as a perfusant which limits the tissue shrinkage due to iodine.

  12. Contrast Media for X-ray and Magnetic Resonance Imaging: Development, Current Status and Future Perspectives.

    Science.gov (United States)

    Frenzel, Thomas; Lawaczeck, Rüdiger; Taupitz, Matthias; Jost, Gregor; Lohrke, Jessica; Sieber, Martin A; Pietsch, Hubertus

    2015-09-01

    Over the last 120 years, the extensive advances in medical imaging allowed enhanced diagnosis and therapy of many diseases and thereby improved the quality of life of many patient generations. From the beginning, all technical solutions and imaging procedures were combined with dedicated pharmaceutical developments of contrast media, to further enhance the visualization of morphology and physiology. This symbiosis of imaging hardware and contrast media development was of high importance for the development of modern clinical radiology. Today, all available clinically approved contrast media fulfill the highest requirements for clinical safety and efficacy. All new concepts to increase the efficacy of contrast media have also to consider the high clinical safety standards and cost of goods of current marketed contrast media. Nevertheless, diagnostic imaging will contribute significantly to the progresses in medicine, and new contrast media developments are mandatory to address the medical needs of the future.

  13. Evaluation of the acute adverse reaction of contrast medium with high and moderate iodine concentration in patients undergoing computed tomography

    International Nuclear Information System (INIS)

    Nagamoto, Masashi; Gomi, Tatsuya; Terada, Hitoshi; Terada, Shigehiko; Kohda, Eiichi

    2006-01-01

    The aim of this prospective study was to evaluate and compare acute adverse reactions between contrast medium containing moderate and high concentrations of iodine in patients undergoing computed tomography (CT). A total of 945 patients undergoing enhanced CT were randomly assigned to receive one of two doses of contrast medium. We then prospectively investigated the incidence of adverse reactions. Iopamidol was used as the contrast medium, with a high concentration of 370 mgI/ml and a moderate concentration of 300 mgI/ml. The frequency of adverse reactions, such as pain at the injection site and heat sensation, were determined. Acute adverse reactions were observed in 2.4% (11/458) of the moderate-concentration group compared to 3.11% (15/482) of the high-concentration group; there was no significant difference in incidence between the two groups. Most adverse reactions were mild, and there was no significant difference in severity. One patient in the high-concentration group was seen to have a moderate adverse reaction. No correlation existed between the incidence of adverse reactions and patient characteristics such as sex, age, weight, flow amount, and flow rate. The incidence of pain was not significantly different between the two groups. In contrast, the incidence of heat sensation was significantly higher in the high-concentration group. The incidence and severity of acute adverse reactions were not significantly different between the two groups, and there were no severe adverse reactions in either group. (author)

  14. Effects of computed tomography contrast medium factors on contrast enhancement

    International Nuclear Information System (INIS)

    Terasawa, Kazuaki; Hatcho, Atsushi; Okuda, Itsuko

    2011-01-01

    The various nonionic iodinated contrast media used in contrast computed tomography (CT) studies differ in terms of their composition, characteristics, and iodine concentration (mgI/ml), as well as the volume injected (ml). Compared with ionic iodinated contrast media, nonionic iodinated contrast media are low-osmolar agents, with different agents having different osmotic pressures. Using a custom-made phantom incorporating a semipermeable membrane, the osmotic flow rate (hounsfield unit (HU)/s) could easily be measured based on the observed increase in CT numbers, and the relationship between the osmotic pressure and the osmotic flow rate could be obtained (r 2 =0.84). In addition, taking the effects of patient size into consideration, the levels of contrast enhancement in the abdominal aorta (AA) and inferior vena cava (IVC) were compared among four types of CT contrast medium. The results showed differences in contrast enhancement in the IVC during the equilibrium phase depending on the type of contrast medium used. It was found that the factors responsible for the differences observed in enhancement in the IVC were the osmotic flow rate and the volume of the blood flow pathways in the circulatory system. It is therefore considered that the reproducibility of contrast enhancement is likely to be reduced in the examination of parenchymal organs, in which scanning must be performed during the equilibrium phase, even if the amount of iodine injected per unit body weight (mgI/kg) is maintained at a specified level. (author)

  15. Accuracy of MRI-compatible contrast media injectors.

    Science.gov (United States)

    Saake, M; Wuest, W; Becker, S; Uder, M; Janka, R

    2014-03-01

    To analyze the exactness of MRI-compatible contrast media (CM) injectors in an experimental setup and clinical use. Ejected fluid volumes and amounts of CM were quantified for single and double piston injections. The focus was on small volumes, as used in pediatric examination and test-bolus measurements. Samples were collected before and after clinical MRI scans and amounts of CM were measured. For single piston injections the volume differences were minimal (mean difference 0.01  ml). For double piston injections the volume of the first injection was decreased (mean 20.74  ml, target 21.00  ml, p pistons of modern CM injectors work exactly. However, for small CM volumes the injected amount of CM can differ significantly from the target value in both directions. Influence factors are an incomplete elimination of air and exchange processes between the CM and saline chaser in the injection system. • In MRI examinations of children and test-bolus measurements, small amounts of CM are used. • The accuracy of single piston injections is high. • In double piston injections the injected amount of CM can differ significantly from the target value. © Georg Thieme Verlag KG Stuttgart · New York.

  16. Examination of hepatic dynamic CT images following infusion of high-concentration contrast media

    International Nuclear Information System (INIS)

    Takeyama, Nobuyuki; Hayashi, Takaki; Kinebuchi, Yuko; Kitahara, Tadashi; Ohbuchi, Masao; Shinjyo, Hidenori; Ohgiya, Yoshimitsu

    2008-01-01

    There are scarce examinations on the integrated effects of given iodine weight (mgI) and its rate (mgI/sec) on the quality and diagnostic accuracy in the hepatic contrast CT imaging while the former is known to affect the image of parenchyma and the latter, of arterial systems. The purpose of this study is to analyze and evaluate the effects qualitatively and quantitatively in hepatic dynamic CT images of patients with moderate body weight in whom different concentrations of I are given at the same flux rate and total weight. Patients having chronic hepatitis suspicious of carcinoma, or cirrhosis were 52-84 years old (M 50/F 55, b. wt. 50-65 kg) and were randomly divided in A and B group. A group received infusion of 25 sec in the right elbow vein of iopamidol, 300 mgI/100 mL, and B group, 370 mgI/80 mL: the I flux of ca. 1.2 gI/sec and total I of ca. 30 gI. Before and at 25 (early arterial phase), 40 (late art. phase), 70 (portal vein) and 180 (equilibrium) sec after infusion, CT images were obtained with the machine Light Speed select (GE Healthcare), Housfield Units before and after enhancing were used for quantitative evaluation, three experts qualitatively read images, and PACS system in Synapse 3.1.0 (Fuji Film Med.) was used for observation of tumor nodules if present. Neither qualitative nor quantitative differences were found in these CT images of the 4 phases and use of high-concentration contrast media was confirmed to be possible for lowered infusion rate. Authors also pointed out the importance of care for radiation exposure in this CT technique. (R.T.)

  17. CT contrasting theory. Effects of the concentration, volume and infusion rate of iodine contrast medium on TDC

    International Nuclear Information System (INIS)

    Yamachi, Jun

    2007-01-01

    This study was performed to evaluate the effects in the title on TDC (time-density curve) using a phantom. CT machine used was Toshiba Aquilion Multi 64, TDC phantom was the product of Nemoto-Kyorindo Co., and the contrast medium was Eisai iomeprol, in syringe-sealed formulations of 300 and 350 mg I/mL. The medium was infused at 1-5 mL/sec in the phantom equivalent to body weight of 78 kg (total water volume=1 min circulation=6,000 mL, 800 mL/heart) to obtain 30 TDCs. Evaluated were the relationships of the infusion rate (mL/sec), volume (mL) or time (sec) with TDC parameters of the detection time of the medium, slope, time to reach the maximum CT value, the maximum CT value, time to keep the CT concentration and its actual concentration. Results revealed that, regardless to the difference of formulations of the contrast medium, TDC with high reproducibility can be obtainable by making the infusion rate of I per unit time and body weight (mgI/sec/kg) constant when the infusion time is made identical for CT of the same diagnostic purpose. (R.T.)

  18. Adrenal and nephrogenic hypertension: an image quality study of low tube voltage, low-concentration contrast media combined with adaptive statistical iterative reconstruction.

    Science.gov (United States)

    Li, Zhen; Li, Qiong; Shen, Yaqi; Li, Anqin; Li, Haojie; Liang, Lili; Hu, Yao; Hu, Xuemei; Hu, Daoyu

    2016-09-01

    The aim of this study was to investigate the effect of using low tube voltage, low-concentration contrast media and adaptive statistical iterative reconstruction (ASIR) for reducing the radiation and iodine contrast doses in adrenal and nephrogenic hypertension patients. A total of 148 hypertension patients who were suspected for adrenal lesions or renal artery stenoses were assigned to two groups and. Group A (n=74) underwent a low tube voltage, low molecular weight dextran enhanced multi-detector row spiral CT (MDCT) (80 kVp, 270 mg I/mL contrast agent), and the raw data were reconstructed with standard filtered back projection (FBP) and ASIR at four different levels of blending (20%, 40%, 60% and 80%, respectively). The control group (Group B, n=74) underwent conventional MDCT (120 kVp, 370 mg I/mL contrast agent), and the data were reconstructed with FBP. The CT values, standard deviation (SD), signal-noise-ratio (SNR) and contrast-noise-ratio (CNR) were measured in the renal vessels, normal adrenal tissue, adrenal neoplasms and subcutaneous fat. The volume CT dose index (CTDIvol ) and dose length product (DLP) were recorded, and an effective dose (ED) was obtained. Two-tailed independent t-tests, paired Chi-square tests and Kappa consistency tests were used for statistical analysis of the data. The CTDIvol , DLP and total iodine dose in group A were decreased by 47.8%, 49.0% and 26.07%, respectively, compared to group B (Pcontrast media and 60% ASIR provides similar enhancement and image quality with a reduced radiation dose and contrast iodine dose. © 2016 John Wiley & Sons Ltd.

  19. Evaluation of renal scintigraphy and renography for the cases of severe allergic reactions to urinary contrast media

    International Nuclear Information System (INIS)

    Yanagisawa, Munetoshi; Machida, Toyohei; Miki, Makoto; Ohishi, Yukihiko; Ueda, Masataka

    1981-01-01

    The evaluation of nuclear medical examination had been observed in eight cases who had had severe complications of urinary contrast media. These were 2 ureter calculus, 2 pyelonephritis, 2 idiopathic renal hematuria, 1 renal cell carcinoma and 1 renal tuberculosis. All of the eight cases were performed by renal scintigraphy with sup(99m)Tc-DTPA, four cases by renography with 131 I-Hippuran and one case was performed by renography with sup(99m)Tc-DTPA. Allergie complications were not observed in all of the eight cases with satisfactory informations by the nuclear medical examinations. In conclusion we think that the nuclear medical examinations are helpful in patients with iodine-allergy complication by using other urological examinations together. (author)

  20. Low tube voltage computed tomography urography using low-concentration contrast media: Comparison of image quality in conventional computed tomography urography.

    Science.gov (United States)

    Hwang, Inpyeong; Cho, Jeong Yeon; Kim, Sang Youn; Oh, Seung-June; Ku, Ja Hyeon; Lee, Joongyup; Kim, Seung Hyup

    2015-12-01

    The aim of the present study was to investigate the feasibility and image quality of excretory CT urography performed using low iodine-concentration contrast media and low tube voltage. This prospective study enrolled 63 patients who undergoing CT urography. The subjects were randomized into two groups of an excretory phase CT urography protocol and received either 240 mg I/mL of contrast media and 80 kVp of tube voltage (low-concentration protocol, n=32) or 350 mg I/mL and 120 kVp (conventional protocol, n=31). Two readers qualitatively evaluated images for sharpness of the urinary tract, image noise, streak artifact and overall diagnostic acceptability. The mean attenuation, signal-to-noise ratio, contrast-to-noise ratio and figure of merit were measured in the urinary tract. The non-inferiority test assessed the diagnostic acceptability between the two protocol groups. The low-concentration protocol showed a significantly lower effective radiation dose (3.44 vs. 5.70 mSv, Pcontrast-to-noise ratio and figure of merit were significantly higher in the low-concentration protocol along the entire urinary tract (Pcontrast media, 80 kVp tube voltage and an iterative reconstruction algorithm is beneficial to reduce radiation dose and iodine load, and its objective image quality and subjective diagnostic acceptability is not inferior to that of conventional CT urography. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  1. Spiral CT and optimization of the modalities of the iodinated intravenous contrast material: Experimental studies in human pathology

    International Nuclear Information System (INIS)

    Bonaldi, V.

    1998-01-01

    Spiral (or helical) CT represents the most recent improvement in the field of computed assisted tomography (CAT scan). The capabilities of this new imaging modality are much superior to these of conventional CT scanning; then result from the rapid acquisition and from the volumetric nature of the derived data set. The short time of data acquisition had made mandatory the revision of protocols for intravenous administration of iodinated contrast material. By the means of several studies, carried out on pathologic and healthy patients, we have attempted to improve knowledge in factors influencing CT attenuation values after injection of contrast material, in the aim of improving contrast administration performed during spiral CT scanning. Anatomical landmarks that we have studied till now have been liver, the pancreas, the kidney and the cervical spine. In addition, a paired based methodology has been used. The volumetric set of data derived from spiral CT scanning leads to optimal post-processing tasks, the most interesting being related to cine-display and multiplanar reformatting; both modalities have been evaluated, about the pancreas and the musculo-skeletal system respectively. Conversely, this new modality, as for other imaging modalities, is responsible for additional costs derived from restless increase in the number of images to be dealt with and from the occurrence of new tasks (in post-processing particularly). The place of spiral CT in diagnostic strategies among other modern imaging modalities should be assessed, especially with respect to Magnetic Resonance Imaging (MRI). (author)

  2. The impact of iodinated X-ray contrast agents on formation and toxicity of disinfection by-products in drinking water.

    Science.gov (United States)

    Jeong, Clara H; Machek, Edward J; Shakeri, Morteza; Duirk, Stephen E; Ternes, Thomas A; Richardson, Susan D; Wagner, Elizabeth D; Plewa, Michael J

    2017-08-01

    The presence of iodinated X-ray contrast media (ICM) in source waters is of high concern to public health because of their potential to generate highly toxic disinfection by-products (DBPs). The objective of this study was to determine the impact of ICM in source waters and the type of disinfectant on the overall toxicity of DBP mixtures and to determine which ICM and reaction conditions give rise to toxic by-products. Source waters collected from Akron, OH were treated with five different ICMs, including iopamidol, iopromide, iohexol, diatrizoate and iomeprol, with or without chlorine or chloramine disinfection. The reaction product mixtures were concentrated with XAD resins and the mammalian cell cytotoxicity and genotoxicity of the reaction mixture concentrates was measured. Water containing iopamidol generated an enhanced level of mammalian cell cytotoxicity and genotoxicity after disinfection. While chlorine disinfection with iopamidol resulted in the highest cytotoxicity overall, the relative iopamidol-mediated increase in toxicity was greater when chloramine was used as the disinfectant compared with chlorine. Four other ICMs (iopromide, iohexol, diatrizoate, and iomeprol) expressed some cytotoxicity over the control without any disinfection, and induced higher cytotoxicity when chlorinated. Only iohexol enhanced genotoxicity compared to the chlorinated source water. Copyright © 2017. Published by Elsevier B.V.

  3. Evaluation of adverse reactions to contrast media in the hospital

    Science.gov (United States)

    Ryu, J-H; Kim, E-Y

    2013-01-01

    Objective: To determine and analyse the characteristics of contrast media adverse reactions (CM-ARs) reported in a hospital. Methods: A retrospective review of CM-ARs from the electronic spontaneous adverse drug reaction (ADR) report system between January 2011 and August 2012 was conducted. CM-ARs were evaluated in terms of causality, severity, preventability and affected organs. Also, agreement and correlation among the tools used to evaluate CM-ARs were analysed. Results: The overall reaction rate was 1.5% (n = 286). In total, 269 CM-ARs were identified. For ADR causality, 96.7% (n = 260) and 98.5% (n = 265) were evaluated as “probable” ADR using the Naranjo probability scale and the World Health Organization–Uppsala Monitoring Centre causality categories, whereas 98.1% (n = 264) were evaluated as “certain” with Korean algorithm v. II. Of these, 91.4% (n = 246) were mild in severity and 96.7% (n = 260) were unpreventable. Most patients (n = 233, 86.7%) could be managed with observation and/or simple treatment. The most frequent reaction (n = 383, 79.5%) was dermatological. Spearman's correlation coefficient was 0.667 (p < 0.01), and the agreement was 98.1% between the Naranjo scale and the World Health Organization–Uppsala Monitoring Centre categories. No relationship was seen between CM-AR severity and gender or between in- and outpatients. Conclusion: In our study, most CM-ARs were mild and managed with simple treatment. However, as the number of patients undergoing CT procedures continues to increase, it is essential to identify and observe patients at risk for CM-ARs to prevent severe ADRs. Advances in knowledge: Continuous careful review of reporting and treatment protocols of CM-ARs is needed to prevent morbidity and mortality. PMID:24191123

  4. Ionic and non-ionic contrast media used for contrast-enhanced computed tomography in experimental pancreatitis

    International Nuclear Information System (INIS)

    Kivisaari, L.; Nuutinen, P.; Lehtola, A.; Saari, A.; Pitkaeranta, P.; Standertskjoeld-Nordenstam, C.G.; Lempinen, M.; Schroeder, T.; Helsinki Univ. Central Hospital

    1988-01-01

    Contrast enhancement of the pancreas was studied in pigs using dynamic computed tomography in experimental oedematous and haemorrhagic/necrotizing pancreatitis during the first two minutes after injection of an intravenous bolus of non-ionic contrast medium (iohexol). The prospects of separating the two forms of the disease, known to be possible with ionic contrast media, were tested with a non-ionic contrast medium. In the oedematous form, contrast enhancement after 5 hours of the disease was significantly higher than in the haemorrhagic/necrotizing form. Contrast enhancement after 30 hours of disease tended to vary with the severity of the disease, showing that the course of oedematous pancreatitis is dynamic. Intermediate forms occur and follow-up studies are needed during the disease. A non-ionic contrast medium proved as good for separating the two forms of the disease in the early phase as were ionic contrast media. In severely ill patients, non-ionic contrast media should therefore be used. (orig.)

  5. Adverse reactions following administration of contrast media for diagnostic imaging in anaesthetized dogs and cats: a retrospective study.

    Science.gov (United States)

    Scarabelli, Stefania; Cripps, Peter; Rioja, Eva; Alderson, Briony

    2016-09-01

    To evaluate incidences of adverse reaction after the administration of contrast media. Retrospective observational study. Animals included 356 dogs and 58 cats receiving non-ionic iodinated contrast agents, and 425 dogs and 49 cats receiving gadolinium-based contrast agents. Anaesthesia records of dogs and cats receiving intravenous (IV) gadobutrol for magnetic resonance imaging (MRI) or IV iohexol for computed tomography (CT) were reviewed. Changes in pulse rate, respiratory rate and mean arterial pressure at 5 minutes after administration of the contrast medium were evaluated. Changes of 10-20% were considered mild, those of >20% moderate, and reactions that required immediate treatment were considered severe. Associations of sex, age and weight with contrast reaction were investigated using logistic regression. Differences in the incidences of reactions to CT and MRI contrast media were examined with chi-squared tests. A p-value of  0.2). Of dogs receiving iohexol, 64 (18.0%) had mild, 65 (18.3%) had moderate and three (0.8%) had severe reactions. Of dogs receiving gadobutrol, 42 (9.9%) had mild, 87 (20.5%) had moderate and one (0.2%) had a severe reaction. When dogs receiving iohexol were compared with those receiving gadobutrol, the odds ratio of a moderate reaction was 2.0 (95% confidence interval 1.34-3.10; p = 0.001). These estimates did not change substantially after adjustment for age, weight and sex. Severe reactions to iohexol and gadobutrol are rare in dogs and cats; moderate reactions are more likely with iohexol than with gadobutrol. © 2015 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesia and Analgesia.

  6. Which Iodine concentration in chest CT? - A prospective study in 300 patients

    Energy Technology Data Exchange (ETDEWEB)

    Muehlenbruch, Georg [RWTH Aachen University Hospital, Department of Diagnostic and Interventional Radiology, Aachen (Germany); University Hospital, RWTH Aachen University, Aachen (Germany); Behrendt, Florian F.; Eddahabi, Mohammed A.; Das, Marco; Guenther, Rolf W.; Mahnken, Andreas H. [RWTH Aachen University Hospital, Department of Diagnostic and Interventional Radiology, Aachen (Germany); Knackstedt, Christian [RWTH Aachen University Hospital, Department of Cardiology, Pulmonology and Angiology, Aachen (Germany); Stanzel, Sven [RWTH Aachen University Hospital, Institute of Medical Statistics, Aachen (Germany); Seidensticker, Peter [Bayer Schering Pharma AG, Berlin (Germany); Wildberger, Joachim E. [University Hospital Maastricht, Department of Radiology, Maastricht (Netherlands)

    2008-12-15

    In computed tomography(CT) several contrast media with different iodine concentrations are available. The aim of this study is to prospectively compare contrast media with iodine concentrations of 300, 370 and 400 mg iodine/ml for chest- CT. 300 consecutive patients were prospectively enrolled, under a waiver of the local ethics committee. The first (second, third) 100 patients, received contrast medium with 300(370, 400)mg iodine/ml. Injection protocols were adapted for an identical iodine delivery rate(1.3 mg/s) and total iodine load(33 g) for all three groups. Standardized MDCT of the chest (16 x 0.75 mm, 120 kVp, 100 mAseff.) was performed. Intravascular attenuation values were measured in the pulmonary trunk and the ascending aorta; subjective image quality was rated on a 3-point-scale. Discomfort during and after injection was evaluated. There were no statistically significant differences in contrast enhancement comparing the three contrast media at the pulmonary trunk(p = 0.3198) and at the ascending aorta(p = 0.0840). Image quality(p = 0.0176) and discomfort during injection(p = 0.7034) were comparable for all groups. General discomfort after injection of contrast media with 300 mg iodine/ml was statistically significant higher compared to 370 mg iodine/ml(p = 0.00019). Given identical iodine delivery rates of 1.3 g/s and iodine loads of 33 g, contrast media with concentrations of 300, 370 and 400 mg iodine/ml do not result in different intravascular enhancement in chest-CT. (orig.)

  7. Renal excretion of water-soluble contrast media after enema in the neonatal period.

    Science.gov (United States)

    Kim, Hee Sun; Je, Bo-Kyung; Cha, Sang Hoon; Choi, Byung Min; Lee, Ki Yeol; Lee, Seung Hwa

    2014-08-01

    When abdominal distention occurs or bowel obstruction is suspected in the neonatal period, a water-soluble contrast enema is helpful for diagnostic and therapeutic purposes. The water-soluble contrast medium is evacuated through the anus as well as excreted via the kidneys in some babies. This study was designed to evaluate the incidence of renal excretion after enemas using water-soluble contrast media and presume the causes. Contrast enemas using diluted water-soluble contrast media were performed in 23 patients under 2 months of age. After the enema, patients were followed with simple abdominal radiographs to assess the improvement in bowel distention, and we could also detect the presence of renal excretion of contrast media on the radiographs. Reviewing the medical records and imaging studies, including enemas and consecutive abdominal radiographs, we evaluated the incidence of renal excretion of water-soluble contrast media and counted the stay duration of contrast media in urinary tract, bladder, and colon. Among 23 patients, 12 patients (52%) experienced the renal excretion of water-soluble contrast media. In these patients, stay-in-bladder durations of contrast media were 1-3 days and stay-in-colon durations of contrast media were 1-10 days, while stay-in-colon durations of contrast media were 1-3 days in the patients not showing renal excretion of contrast media. The Mann-Whitney test for stay-in-colon durations demonstrated the later evacuation of contrast media in the patients with renal excretion of contrast media (p = 0.07). The review of the medical records showed that 19 patients were finally diagnosed as intestinal diseases, including Hirschsprung's disease, meconium ileum, meconium plug syndrome, and small bowel atresia or stenosis. Fisher's exact test between the presence of urinary excretion and intestinal diseases indicated a statistically significant difference (p = 0.04). The intestinal diseases causing bowel obstruction may increase the

  8. The significance of the allergy history in the use of intravenous X-ray contrast media

    International Nuclear Information System (INIS)

    Schmidt, M.; Kroczek, U.

    1986-01-01

    A restrospective study correlating allergy histories and reactions to X-ray contrast media was performed with a study group containing 519 patients receiving intravenous and infusion cholangiograms and 827 patients receiving intravenous and infusion pyelograms. Reactions against X-ray contrast media were observed significantly more frequently among patients with a positive allergy history independent of the suspected allergy (p [de

  9. Correlation Between Bile Reflux Gastritis and Biliary Excreted Contrast Media in the Stomach.

    Science.gov (United States)

    Hyun, Jong Jin; Yeom, Suk Keu; Shim, Euddeum; Cha, Jaehyung; Choi, Inyoung; Lee, Seung Hwa; Chung, Hwan Hoon; Cha, Sang Hoon; Lee, Chang Hee

    This study aimed to evaluate the relationship between biliary excreted contrast media in the stomach and the presence of bile reflux gastritis. Consecutive 111 patients who underwent both gadoxetic acid-enhanced magnetic resonance cholangiography (gadoxetic MRC) and gastric endoscopy were included in this study. We performed a review of the gadoxetic-MRC image sets acquired 60 minutes after intravenous injection of contrast media and endoscopic images. We recorded amount of contrast media in the stomach. The sensitivity, specificity, and accuracy of duodenogastric bile reflux diagnosis were evaluated for the gadoxetic MRC. Statistical analysis was performed using the Fisher exact test and the linear-by-linear association test. Among the 111 patients, 39 had 60-minute delayed images showing the presence of contrast media in the stomach. Of these 39 patients, 13 had bile reflux gastritis and 5 showed bile in the stomach without evidence of erythematous gastritis. Of the 72 patients who did not show contrast media in the stomach, none had bile reflux gastritis and 2 patients showed bile staining in the stomach without evidence of erythematous gastritis. Bile reflux gastritis was significantly more frequent in patients with contrast media in the stomach on gadoxetic MRC than in those without. Patients with high-grade extension of contrast media in the stomach had significantly frequent bile reflux gastritis than did those with low-grade extension. Biliary excreted contrast media in the stomach on 60-minute delayed gadoxetic MRC has a correlation with the presence of bile reflux gastritis on endoscopic examination.

  10. Contrast media effect on interleukin-2 levels in human plasma in vitro

    International Nuclear Information System (INIS)

    Napolov, Yu.K.; Borsukova, N.M.; Shimanovskij, N.L.

    1992-01-01

    As shown in the study of bilignost, iodamide and triombrast action on interleukin-2 (IL-2) level in human plasma in vitro, these contrast media (2.5x10 -2 -2.5x10 -4 M) elevate IL-2 content in blood plasma of sensitive to contrast media subjects in dose-dependent manner

  11. ''Iodine delivery rate'' with catheterangiography under pressure conditions of hand injection

    International Nuclear Information System (INIS)

    Busch, H.P.; Stocker, K.P.

    1998-01-01

    Purpose: The aim of this study was to record the flow-rate and to calculate the 'iodine delivery rate' (IDR) of contrast media of various viscosities when the contrast media are injected by hand. Methods: Five different catheters for coronary angiography were tested with the injection system Medral Mark V Plus. Injections were performed with pressures of 100, 200 and 400 PSI. The contrast media examined were Imeron 350, Imeron 400, Omnipaque 350 and Ultravist 370. The IDR was calculated on the basis of the measured flow rate and the Iodine content of the contrast medium. Results: As was expected, the IDR was higher as the pressure increased. In addition to the iodine content the viscosity of the contrast medium is a very important factor for the IDR. At both 100 PSI and 200 PSI the increase of the IDR was higher with Imeron 350 than with Imeron 400. The comparison of contrast media with identical iodine contents but differing viscosities (Imeron 350, Omnipaque 350) clearly showed that the IDR depended on viscosity. Conclusion: The 'iodine delivery rate' is a decisive factor in the opacification of arterial vessels. Both iodine content and viscosity of a contrast medium are important for the IDR. Because of the low pressure at manual injection, contrast media with low viscosities should be used. A further possibility to increase the IDR is warming-up the contrast medium to body temperature. (orig.) [de

  12. Correlation between image quality of CT scan and amount of intravenous contrast media

    International Nuclear Information System (INIS)

    Yoon, Dae Young; Choi, Dae Seob; Kim, Seung Hyup; Han, Joon Koo; Choi, Byung Ihn; Im, Jung Gi; Han, Moon Hee; Chang, Kee Hyun; Kim, Jong Hyo; Han, Man Chung

    1993-01-01

    A blind, comparative clinical study was performed prospectively to examine the correlation between image quality of CT scan in terms of contrast enhancement effect and amount of intravenous contrast media. A total of 357 patients were randomized into two groups. Ionic high-osmolality contrast media (68% meglumine ioglicate) was administered intravenously as 100 ml bolus in one group and as 50 ml bolus in the other group. Statistically significant differences of image quality were found in CT scans of the brain, head and neck, chest and abdomen (p 0.05). We suggest that amount of contrast media may be reduced in pelvis CT without significant degradation of image quality

  13. Usefulness of enteral contrast media in MR evaluation of pelvic mass

    International Nuclear Information System (INIS)

    Kim, Hun; Kim, Jung Sik; Kim, Hong; Shon, Chul Ho; Lee, Hee Jung; Lee, Sung Moon; Woo, Sung Ku; Suh, Soo Jhi

    1999-01-01

    To assess the value of enteral contrast media for the evaluation of pelvic masses by MR imaging. Between April and July 1998, 16 women with pelvic masses were examined by MRI. The origin of the lesion was the ovary in twelve cases, the uterus in three, and the sigmoid in one. Using a 1.5T scanner(Magnetom Vision, Siemens), T1-weighted axial spin echo(SE), T2-weighted turbo spin echo(TSE), two dimensional fast low-angle shot(FLASH 2D), and half-Fourier TSE(HASTE) images were obtained in all patients after the administration of Magnevist Enteral (Shering, Berlin, Germany). In each MR imagine sequence, distinction between the lesion and adjacent bowel (1, not distinguished; 2, partly distinguished; 3, clearly distinguished), artifact (0, absent; 1, mild; 2, severe), image quality (1, poor; 2, fair; 3, good), were compared before and after the use of enteral contrast media. Changes in MRI impression after the use of enteral contrast media were also evaluated. Two radiologists reached a consensus after reviewing the images. Statistical significance was determined by Wilcoxon's signed ranked test. For distinguishing lesions, SE T1WI and FLASH 2D with enteral contrast media were significantly superior to SE T1WI without enteral contrast media (p < 0.05). With regard to image quality, FLASH 2D and HASTE, both with enteral contrast media, were significantly superior to SE T1WI and TSE T2WI, respectively, both without enteral contrast media (p < 0.05). Artefacts were more frequently found after the application of enteral contrast media in conventional sequences but were not present in breathhold sequences. In two patients, MRI impression changed after the application of enteral contrast media. In a limited number of cases, enteral contrast media improved lesion detection, image quality and diagnostic accuracy when breathhold fast MR imaging was applied

  14. Survey of the pharmacology of non-ionic X-ray contrast media

    International Nuclear Information System (INIS)

    Turnheim, K.

    1986-01-01

    The non-ionic X-ray contrast media metrizamide, iopamidol, iohexol, and iopromide do not bind calcium and are less hyperosmolar than the conventional ionic contrast media, for instance amidotrizoate (diatrizoate), iothalamte, or ioglicate. Hence the use of non-ionic contrast media is associated with less undesirable side-effects that are attributable to hypertonicity such as an increase in circulating plasma volume, decreased deformability of red blood cells, damage of vascular endothelium with consequent activation of blood coagulation, the complement system and fibrinolysis, increased release of bradykinin and histamine, cardiac arrhythimas, diuresis, vasodilation and decreased blood pressure, pain and heat sensation. Because of less dilution the quality of imaging is also better. According to the intravenous LD 50 in experimental animals the acute toxicity of non-ionic contrast media is lower than that of ionic media. With respect to contrast quality and the rate of side-effects tha various non-ionic contrast media appear to be equivalent. Despite their higher price and higher viscosity it is probable that the non-ionic contrast media will replace the classical ionic media, especially in angio- and myelography. (Author)

  15. Comparative evaluation of the fecal-tagging quality in CT colonography: barium vs. iodinated oral contrast agent.

    Science.gov (United States)

    Nagata, Koichi; Singh, Anand Kumar; Sangwaiya, Minal Jagtiani; Näppi, Janne; Zalis, Michael E; Cai, Wenli; Yoshida, Hiroyuki

    2009-11-01

    The purpose of this evaluation was to compare the tagging quality of a barium-based regimen with that of iodine-based regimens for computed tomographic (CT) colonography. Tagging quality was assessed retrospectively in three different types of fecal-tagging CT colonographic cases: 24 barium-based cases, 22 nonionic iodine-based cases, and 24 ionic iodine-based cases. For the purpose of evaluation, the large intestine was divided into six segments, and the tagging homogeneity of a total of 420 segments (70 patients) was graded by three blinded readers from 0 (heterogeneous) to 4 (homogeneous). For barium-based cases, the average score for the three readers was 2.4, whereas it was 3.4 for nonionic iodine and 3.6 for ionic iodine. The percentages of segments that were assigned scores of 4 (excellent tagging [100%]) were 11.6%, 61.9%, and 72.9% for the barium-based, nonionic iodine-based, and ionic iodine-based regimens, respectively. The homogeneity scores of iodine-based fecal-tagging regimens were significantly higher than those of the barium-based fecal-tagging regimen (P barium-based regimen (P barium-based fecal-tagging regimen. Iodine-based fecal-tagging regimens can provide an appropriate method for use in nonlaxative or minimum-laxative CT colonography.

  16. Experimental research on the contrast production of the chemical elements with the atomic numbers 1-83 in a computer-totalbody-tomogram

    International Nuclear Information System (INIS)

    Kirschner, H.; Burmester, U.; Stringaris, K.

    1979-01-01

    The contrast production for the chemical elements with the atomic numbers Z=1-83 were determined by computer-tomography. With the formula relation of the Δ-number and the atomic number can one compute the contrast production of any chosen chemical compound. Iodine-free and inorganic iodine-containing contrast media are examined for their contrast production and compared with presently used organic iodine-containing contrast media. The contrast enhancement of organic contrast media in tissue are discussed. (orig.) [de

  17. Intraarterial CT Angiography Using Ultra Low Volume of Iodine Contrast – Own Experiences

    International Nuclear Information System (INIS)

    Garcarek, Jerzy; Kurcz, Jacek; Guziński, Maciej; Banasik, Mirosław; Miś, Marcin; Gołębiowski, Tomasz

    2015-01-01

    High volume of intravenous contrast in CT-angiography may result in contrast-induced nephropathy. Intraarterial ultra-low volume of contrast medium results in its satisfactory blood concentration with potentially good image quality. The first main purpose was to assess the influence of the method on function of transplanted kidney in patients with impaired graft function. The second main purpose of the study was to evaluate the usefulness of this method for detection of gastrointestinal and head-and-neck haemorrhages. Between 2010 and 2013 intraarterial CT-angiography was performed in 56 patients, including 28 with chronic kidney disease (CKD). There were three main subgroups: 18 patients after kidney transplantation, 10 patients with gastrointestinal hemorrhage, 8 patients with head-and-neck hemorrhage. Contralateral or ipsilateral inguinal arterial approach was performed. The 4-French vascular sheaths and 4F-catheters were introduced under fluoroscopy. Intraarterial CT was performed using 64-slice scanner. The scanning protocol was as follows: slice thickness 0.625 mm, pitch 1.3, gantry rotation 0.6 sec., scanning delay 1–2 sec. The extent of the study was established on the basis of scout image. In patients with CKD 6–8 mL of Iodixanol (320 mg/mL) diluted with saline to 18–24 mL was administered at a speed of 4–5 mL/s. Vasculature was properly visualized in all patients. In patients with impaired renal function creatinine/eGFR levels remained stable in all but one case. Traditional arteriography failed and CT-angiography demonstrated the site of bleeding in 3 of 10 patients with symptoms of gastrointestinal bleeding (30%). In 8 patients with head-and-neck bleeding CT-angiography did not prove beneficial when compared to traditional arteriography. 1. Ultra-low contrast intraarterial CT-angiography does not deteriorate the function of transplanted kidneys in patients with impaired graft function. 2. 3D reconstructions allow for excellent visualization of

  18. Improvements in gastric diagnosis by using high density contrast media with low viscosity

    International Nuclear Information System (INIS)

    Toischer, H.P.

    1983-01-01

    In a retrospective clinical study, 150 unselected double contrast examinations of the stomach using conventional contrast media (100 g/100 ml barium sulphate) were compared with a similar number of examinations using a high density contrast medium of flow viscosity (250 g/100 ml barium sulphate). The high density contrast medium was distinctly better for demonstrating detail of the gastric mucosa. The uneveness of coating and instability of the older high density contrast media was observed in 15.5% of cases and, in no instance, did this make it impossible to reach a diagnosis. (orig.) [de

  19. Labelling of some iodinated organic compounds by halogen exchange in organic media

    International Nuclear Information System (INIS)

    Hallaba, E.; Suhybani, A.Al-; Khowaiter, S.Al-; Abdel-Wahid, M.

    1983-01-01

    Describes a general method for labelling Rose Bengal in an organic medium. An isotopic exchange technique with interactive iodine as carrier for radioiodine is used. The effect of temperature, carrier, pH of the solvent and solvent are investigated. The optimum conditions for maximum yield of exchange are: .0.2 micro mole carrier inactive iodine per one micro mole of Rose Bengal, reaction mixture is 10ml ethyl alcohol 96% as a solvent for Rose Bengal and 3ml of ether or carbon tetrachloride containing the inactive and radioiodine. In case of ether, the reaction is slow and is completed in two hours with maximum yield of 90% at boiling temperature. Addition of 175 λ of 1 M acetate buffer with carbon tetrachloride gave a yield of 90% in one hour. This method can be applied successfully to label any iodinated organic compound, such as hypuran, thyroxine, tyrosine or aliphatic fatty acids, for application in nuclear medicine. 10 Ref

  20. A prospective study on the hemodynamic changes by intracardiac injection of contrast media

    International Nuclear Information System (INIS)

    Byun, Young Sook; Lee, Hyun; Seo, Heung Suk; Hahm, Chang Kok

    1983-01-01

    It has been known that alteration in blood pressure, heart rate and other systemic reactions can occur after introduction of contrast media into the vascular system. And the factory of these alterations are the sudden changes of the circulating blood volume, hypertonicity of the injected contrast media and adverse reactions to the contrast media. This prospective study included evaluations of the hemodynamic changes, adverse reactions and its relationship with sensitivity test and allergic history in 105 patients who had been performed angiocardiography during the period of 1 year from October, 1981 to September, 1982. The results were as follows: 1. 14 out of 105 patient showed minor reactions to contrast media such as nausea, vomiting , coughing, etc. There is no close relationship between adverse reaction and sensitivity test or previous allergic history. 2. In the group of right sided angiocardiography, 47.6% of patient showed elevation of blood pressure after injection of contrast media. 38.1% of patient, however, showed lowered blood pressure. The changes of the pulse rate were quite similar to those of blood pressure; increased in 47.7% and decreased in 40.9% of patient. 3. In the group of left sided angiocardiography, 61.6% of patient showed elevation of blood pressure immediately after injection of contrast media, and 17.5% of patient showed lowered blood pressure. 5 minutes after injection of contrast media, large group of patient showed normalized blood pressure. The pulse ratio was also increased in the 66.3% of patient

  1. Variable effects of radiological contrast media on thrombus growth in a rabbit jugular vein thrombosis model

    NARCIS (Netherlands)

    Levi, M. [=Marcel M.; Biemond, B. J.; Sturk, A.; Hoek, J.; ten Cate, J. W.

    1991-01-01

    We studied the effect of an ionic high osmolar contrast medium (Ioxitalamate), an ionic low osmolar contrast medium (Ioxaglate) and various nonionic low osmolar contrast media (Iopamidol, Iopromide and Iohexol) on thrombus growth in a rabbit jugular vein thrombosis model. Thrombus growth was

  2. Application of synchrotron radiation phase-contrast microtomography with iodine staining to Rhodnius prolixus head during ecdysis period

    Science.gov (United States)

    Sena, G.; Nogueira, L. P.; Braz, D.; Colaço, M. V.; Azambuja, P.; Gonzalez, M. S.; Tromba, G.; Mantuano, A.; Costa, F. N.; Barroso, R. C.

    2018-05-01

    Synchrotron radiation phase-contrast microtomography (SR-PHC-CT) has become an important tool in studies of insects, mainly Rhodinius prolixus, the insect vector of Chagas disease. A previous work has shown that SR-PHC-CT is an excellent technique in studies about the ecdysis process of R.prolixus head. The term ecdysis refers to the set of behaviors by which an insect extracts itself from an old exoskeleton. The exoskeleton formation is indispensable for the evolutionary success of insect species, so failure to complete ecdysis will, in most cases result in death, making this process an excellent target in the search for new insect pest management strategies. Understanding the behavior of the ecdysis process is fundamental for the non-proliferation of Chagas disease. Despite it has been possible to identify the moulting process in the first work, main structures of the R.prolixus head could not be identified. In this work, it was developed a staining protocol which enabled the identification of these important structures using Iodine at SYRMEP beamline of ELETTRA. In the 3D images, it was possible to segment essential structures in the process of ecdysis. These structures have never been presented previously in the moulting period with SR-PHC-CT.

  3. Effects of radiographic contrast media on cellular electrophysiology in the beating heart

    Energy Technology Data Exchange (ETDEWEB)

    Wolpers, H.G.; Baller, D.; Ensink, F.B.M.; Hoeft, A.; Korb, H.; Hellige, G.

    1982-01-01

    Electrophysiological effects of intracoronarily administered contrast media have been documented in 12 thoracotomized dogs at the cellular level by use of a modified microelectrode technique. Injections (n = 63) of 4 different contrast media uniformly led to a temporary cellular hyperpolarisation of the resting potential and prolongation of the action potential. Additional experiments with intracoronary injections of several electrolyte concentrations, mainly by a local deficiency of potassium ions and an excess of sodium ions. The significance of the findings for mechanisms underlying ECG-changes and ventricular arrhythmia by radiographic contrasts media will be discussed.

  4. Formation of Toxic Iodinated Disinfection By-Products from Compounds Used in Medical Imaging

    Science.gov (United States)

    Iodinated X-ray contrast media (ICM) were investigated as a source of iodine in the formation of iodo-trihalomethane (iodo-THM) and iodo-acid disinfection byproducts (DBPs), both of which are highly genotoxic and/or cytotoxic in mammalian cells. ICM are widely used at medical cen...

  5. Extracellular gadolinium-based contrast media: An overview

    International Nuclear Information System (INIS)

    Bellin, Marie-France; Van Der Molen, Aart J.

    2008-01-01

    Increasing use is made of extracellular MRI contrast agents that alter the image contrast following intravenous administration; they predominantly shorten the T1 relaxation time of tissues. The degree and location of these changes provide substantial diagnostic information. However gadolinium-based contrast agents (Gd-CA) are not inert drugs. They may cause acute non-renal adverse reactions (e.g. anaphylactoid reactions), acute renal adverse reactions (e.g. contrast induced nephropathy), delayed adverse reactions (nephrogenic systemic fibrosis) and problems at the site of injection (e.g. local necrosis). This review describes the current status of Gd-CA, their mechanism of action, chemical structure, pharmacokinetics, dosage, elimination, nephrotoxicity and adverse events

  6. Extracellular gadolinium-based contrast media: An overview

    Energy Technology Data Exchange (ETDEWEB)

    Bellin, Marie-France [University Paris-Sud 11, Department of Radiology, University Hospital Paul-Brousse, AP-HP, 12, Avenue Paul Vaillant-Couturier, 94804 Villejuif Cedex (France)], E-mail: marie-france.bellin@pbr.aphp.fr; Van Der Molen, Aart J. [University Paris-Sud 11, Department of Radiology, University Hospital Paul-Brousse, AP-HP, 12, Avenue Paul Vaillant-Couturier, 94804 Villejuif Cedex (France)

    2008-05-15

    Increasing use is made of extracellular MRI contrast agents that alter the image contrast following intravenous administration; they predominantly shorten the T1 relaxation time of tissues. The degree and location of these changes provide substantial diagnostic information. However gadolinium-based contrast agents (Gd-CA) are not inert drugs. They may cause acute non-renal adverse reactions (e.g. anaphylactoid reactions), acute renal adverse reactions (e.g. contrast induced nephropathy), delayed adverse reactions (nephrogenic systemic fibrosis) and problems at the site of injection (e.g. local necrosis). This review describes the current status of Gd-CA, their mechanism of action, chemical structure, pharmacokinetics, dosage, elimination, nephrotoxicity and adverse events.

  7. Quality of roentgenological visualization and tolerance of various intravenous cholegraphic contrast media

    International Nuclear Information System (INIS)

    Tischendorf, P.

    1980-01-01

    The recently introduced intravenous cholegraphic contrast media produce a greater diagnostic yield in radiological routine thanks to improved roentgenological contrasting. Whereas the percentage share of roentgenologically clearly assessable cases is about 75% when using Biligrafin, this percentage is much higher with the more recent contrast media, especially Biliscopin, namely, up to 88%. These new contrast media are also superior in respect of tolerance, since they produce fewer side effects. While side effects must be expected in about 28% of the cases when injecting Biligrafin, the side effect quota is about 10% only with Biliscopin or Endomirabil. If the contrast medium is infused instead of injected, the quota of side effect drops to 2.3% with Biliscopin or 3.9% with Endomirabil. Slight and medium side effects have definitely decreased with the more recent contrast media. The slower and more continually the contrast medium is administered, the fewer are the side effects observed; this becomes particularly noticeable in the case of long-term infusions. However, the likelihood of severe incidents caused by the contrast medium remains unchanged at about 1% of the examined patients, even with the more recently introduced contrast media. (orig.) [de

  8. Diffusible iodine-based contrast-enhanced computed tomography (diceCT): an emerging tool for rapid, high-resolution, 3-D imaging of metazoan soft tissues.

    Science.gov (United States)

    Gignac, Paul M; Kley, Nathan J; Clarke, Julia A; Colbert, Matthew W; Morhardt, Ashley C; Cerio, Donald; Cost, Ian N; Cox, Philip G; Daza, Juan D; Early, Catherine M; Echols, M Scott; Henkelman, R Mark; Herdina, A Nele; Holliday, Casey M; Li, Zhiheng; Mahlow, Kristin; Merchant, Samer; Müller, Johannes; Orsbon, Courtney P; Paluh, Daniel J; Thies, Monte L; Tsai, Henry P; Witmer, Lawrence M

    2016-06-01

    Morphologists have historically had to rely on destructive procedures to visualize the three-dimensional (3-D) anatomy of animals. More recently, however, non-destructive techniques have come to the forefront. These include X-ray computed tomography (CT), which has been used most commonly to examine the mineralized, hard-tissue anatomy of living and fossil metazoans. One relatively new and potentially transformative aspect of current CT-based research is the use of chemical agents to render visible, and differentiate between, soft-tissue structures in X-ray images. Specifically, iodine has emerged as one of the most widely used of these contrast agents among animal morphologists due to its ease of handling, cost effectiveness, and differential affinities for major types of soft tissues. The rapid adoption of iodine-based contrast agents has resulted in a proliferation of distinct specimen preparations and scanning parameter choices, as well as an increasing variety of imaging hardware and software preferences. Here we provide a critical review of the recent contributions to iodine-based, contrast-enhanced CT research to enable researchers just beginning to employ contrast enhancement to make sense of this complex new landscape of methodologies. We provide a detailed summary of recent case studies, assess factors that govern success at each step of the specimen storage, preparation, and imaging processes, and make recommendations for standardizing both techniques and reporting practices. Finally, we discuss potential cutting-edge applications of diffusible iodine-based contrast-enhanced computed tomography (diceCT) and the issues that must still be overcome to facilitate the broader adoption of diceCT going forward. © 2016 The Authors. Journal of Anatomy published by John Wiley & Sons Ltd on behalf of Anatomical Society.

  9. A new procedure for imaging liver and spleen with water soluble contrast media in liposomes

    International Nuclear Information System (INIS)

    Zherbin, E.A.; Davidenkova, E.F.; Khanson, K.P.; Gubareva, A.V.; Zhdanova, N.V.; Aliyakparov, M.T.; Loshakova, L.V.; Fomina, Eh.V.; Rozenberg, O.A.

    1983-01-01

    The problems of long-term, reversible, and safe contrast investigation of liver and spleen and reduction of the irritating action of water-soluble contrast media on the wall of blood vessels are unresolved. The production and experimental application of contrast media encapsulated in liposomes are described. It is possible to produce a liposome preparation with 10-20 % Verografin content. After intravenous injection it leads to a quick (after 16-30 min), persisting (10-12 h) and reversible (24-30 h) contrast imaging of liver and spleen in rodents. The contrast medium has no pathological effects on heart, blood and circulatory system and on the morphology of liver, spleen, heart, lungs, kidneys and urinary bladder. The perspectives of clinical application of such contrast media are discussed. (author)

  10. Pulmonary 64-MDCT angiography with 50 mL of iodinated contrast material in an unselected patient population: a feasible protocol

    Energy Technology Data Exchange (ETDEWEB)

    Trad, Henrique Simao; Boasquevisque, Gustavo Santos; Giacometti, Tiago Rangon; Trad, Catherine Yang; Zoghbi Neto, Orlando Salomao; Trad, Clovis Simao, E-mail: hsimtrad@gmail.com [Central de Diagnostico Ribeirao Preto (CEDIRP), Ribeirao Preto, SP (Brazil)

    2016-03-15

    Objective: To propose a protocol for pulmonary angiography using 64-slice multidetector computed tomography (64-MDCT) with 50 mL of iodinated contrast material, in an unselected patient population, as well as to evaluate vascular enhancement and image quality. Materials and methods: We evaluated 29 patients (22-86 years of age). The body mass index ranged from 19.0 kg/m{sup 2} to 41.8 kg/m{sup 2}. Patients underwent pulmonary CT angiography in a 64-MDCT scanner, receiving 50 mL of iodinated contrast material via venous access at a rate of 4.5 mL/s. Bolus tracking was applied in the superior vena cava. Two experienced radiologists assessed image quality and vascular enhancement. Results: The mean density was 382 Hounsfield units (HU) for the pulmonary trunk; 379 and 377 HU for the right and left main pulmonary arteries, respectively; and 346 and 364 HU for the right and left inferior pulmonary arteries, respectively. In all patients, subsegmental arteries were analyzed. There were streak artifacts from contrast material in the superior vena cava in all patients. However, those artifacts did not impair the image analysis. Conclusion: Our findings suggest that pulmonary angiography using 64-MDCT with 50 mL of iodinated contrast can produce high quality images in unselected patient populations. (author)

  11. Consideration of Adverse Reaction to MDCT Contrast Media

    International Nuclear Information System (INIS)

    Yang, Won Seok; Shin, Seong Gyu

    2012-01-01

    In this experiment, we investigated 82 patients who suffered adverse reactions due to contrast medium. We selected the subjects out of 21,178 people who had an intravenous injection of contrast medium to undergo MDCT examination at one university hospital in Busan in 2007. As a result, the largest groups of the patients were as follows. 52.4% of the patients were male when classify by gender; 28.0% of the patients were 50's by age; 45% of the patients got when it was spring(April and March); 75.6% of the patients had a side effects when the speed of injection is 2.5 mL/sec; 58.5% of the patients were suffered when the volume of injected contrast medium is over 130 mL. Urticaria was the main symptom of side effect as 26.8%. And the main treatment for the effect was alleviating the symptoms before making patients to return home. Thus, practical preventive measures are needed as follows: use the OCS system to observe warning signs at risky patients, secure warming spaces for patients to cope with season changing, prepare enough emergency kits for the patients in danger, and establish CPR call systems, explain the risk of contrast medium and get agree about using contrast medium.

  12. An animal experimental model for evaluating endothelial damage caused by various angiographic contrast media

    International Nuclear Information System (INIS)

    Gottlob, R.

    1981-01-01

    The endothelial damage caused by X-ray contrast media is tested on en face preparations of the rat aorta after silver staining. Hypertonic contrast media cause dehydration of the vessels so that solutions of silver nitrate penetrate into the media during the phase of rehydration whereby medial transverse lines are stained. These artifacts can be avoided by 3 minute rehydration of the vessels by Ringer solution prior to silver staining. In addition it is recommended to add highly diluted silver nitrate to the fixing media in order to intensify the pattern of the endothelial silver lines. Modern contrast media may cause very little endothelial damage, however, significant differences can be detected when in addition to the evaluation of larger foci damages of single endothelial cells ( brown cells with sparing of the nuclei and pseudonuclei ) are evaluated as well. No significant differences were found between the endothelial toxicity of meglumin diatrizoate and meglumin iothalamate. (orig.) [de

  13. Perfusion imaging with magnetic-susceptibility contrast media

    International Nuclear Information System (INIS)

    Rosen, B.R.; Belliveau, J.W.; Betteridge, D.; Cohen, M.S.; Weisskoff, R.M.; Vevea, J.M.; Rzedzian, R.P.; Brady, T.J.

    1989-01-01

    In animal models, transient signal los on T2-weighted images has been well documented following intravenous injection of high-magnetic-susceptibility contrast agents that are compartmentalized within the brain intravascular space. These signal changes have been correlated with physiologic parameters, such as blood flow and volume. The advent of whole-body single-shot imaging capability, coupled with the approval of paramagnetic contrasts agents for human use, has enabled the authors to demonstrate susceptibility contrast in the human brain, allowing for generation of functional images. With use of a 1.5-T imaging system gradient-echo images (TE = 60 msec) were acquired in 75 msec. Sequential single-sections images were sampled every 1 second following bolus administration of 0.1 mmol/kg of Gd-DTPA

  14. The optimal dose of the contrast media for spiral CT portography

    International Nuclear Information System (INIS)

    Zhang Jiansheng; Xiao Peiyu; Meng Xiaochun; Xu Chuan

    2007-01-01

    Objective: To investigate the optimal dose of the contrast media in SCTP. Methods: 40 healthy patients were divided into 2 groups according to their body weight (20 cases in group A with weight below 60kg, 20 cases in group B with weight over 70kg). They all received 90ml contrast media at a rate of 4.0 ml/sec in the contrast-enhanced CT ex- amination. And non-cirrhosis cases, liver cirrhosis without ascites cases and liver cirrhosis with ascites cases were selected respectively, 60 patients in each group. Then, the patients of each group were randomly divided into 3 sub-groups, 20 cases in each of them, which respectively received 1.5ml/kg, 2.0ml/kg, 2.5ml/kg contrast media at a rate of 4.0 ml/sec in the contrast-enhanced CT examination. The effect of the dose of the contrast material on the imaging quality of portal vein system in patients with different weight and different state of illness was analyzed. Results: In 40 healthy patients, the density difference between portal vein and hepatic parenchyma was significantly higher in Group A than in Group B (P 0.05), and both of them showed significant difference while using 1.5ml/kg contrast media (P 0.05), and they both had significant difference when using 1.5ml/kg contrast media (P< 0.05). Besides these, the imaging quality of portal vein branches and collateral vessels were better in 2.0ml/kg group than others. Conclusion: The patient's body weight and the state of liver disease influenced the extent of portal vein enhancement. To calculate the dose of contrast media according to patient's weight is crucial for ensuring the imaging quality of portal vein system. 2.0ml/kg contrast media can provide a better effect. (authors)

  15. Contrast venography of the leg: diagnostic efficacy, tolerance, and complication rates with ionic and nonionic contrast media

    International Nuclear Information System (INIS)

    Bettmann, M.A.; Robbins, A.; Braun, S.D.; Wetzner, S.; Dunnick, N.R.; Finkelstein, J.

    1987-01-01

    A prospective, three-center study of two contrast agents for leg venography was performed to evaluate both the relative frequency of adverse effects and whether low-osmolality agents provided significant advantages for this procedure. Fifty-four patients were studied with the standard preparation (iothalamate meglumine) and 57 with a nonionic agent (iopamidol). Both were used at an iodine concentration of 200 mg/mL, and there were no differences in volume of contrast material, duration of infusion, percentage of positive studies, or overall diagnostic adequacy. Patient discomfort was less with iopamidol than with iothalamate (18% vs. 44%), although discomfort was generally mild in both groups. By objective follow-up studies, the frequency of postvenographic thrombosis was not significantly different in the two groups (8% vs. 9%). Contrast venography, then, had a low frequency of complications when either a dilute conventional or a low-osmolality agent was employed. Although the frequency of postvenographic thrombosis was low with both agents, patient discomfort was less with the low-osmolality formulation

  16. Comparison of in vitro histamine release by ionic and nonionic radiographyic contrast media

    International Nuclear Information System (INIS)

    Faraj, B.A.; Martin, L.G.

    1989-01-01

    This paper discusses a study whose results showed that in 53 hospitalized patients undergoing cardiovascular catheterization, incubation of their blood samples with varying concentrations of an ionic contrast medium (Angiovist-370, 60--631 mM) induced a significant (P < .005) amount of histamine release from whole blood (3.5%--10%), as compared with the histamine release following incubation with a nonionic contrast medium. Data suggest that the use of nonionic contrast media may induce minimal histamine release and thereby involve less patient risk from the histamine-mediated allergic and hemodynamic side effects associated with radiographic contrast media procedures

  17. Effect on thrombus growth and thrombolysis of two types of osmolar contrast media in rabbits

    NARCIS (Netherlands)

    Levi, M. [=Marcel M.; Pascucci, C.; Agnelli, G.; Sturk, A.; Hoek, J.; ten Cate, J. Wouter

    1990-01-01

    Thromboembolic complications have been reported after diagnostic or interventional radiological procedures. However, contrast media inhibit platelet function and blood coagulation in vitro. To investigate these characteristics in vivo, we determined the effect of nonionic and ionic low osmolar

  18. Value of intravenous injection of contrast media for computerized tomography of the thorax

    International Nuclear Information System (INIS)

    Beyer-Enke, S.A.; Goerich, J.; Mueller, M.; Kaick, G. van; Tuengerthal, S.

    1988-01-01

    107 patients with thoracal or mediastinal growths underwent computerized tomography of the thorax both in normal condition and after receiving intravenous applications of non-ionic X-ray contrast media. The additional information obtained by use of contrast media was established in relation to the histological findings. The method led to enhanced demarcation of the tumor of the mediastinum or hilus in 40% of the patients. Tumor perfusion was helpful in 20% of the cases for differential diagnosis. Vessel infiltrations or abnormal conditions were found in about 30% of patients. 24% of the tests yielded no additional information. Analysing CT as compared to the histological examination of lymph nodes proved CT under normal conditions to be a sensitive method in 29% of cases if the hilus was the site of the tumor; contrast media raised this sensitivity to 43%. In the mediastinal area, sensitivity was 44% without and 56% with contrast media. (orig.) [de

  19. Contrast media for radiological examination in gastrointestinal tract leakage

    NARCIS (Netherlands)

    A.Z. Ginai (Abida)

    1987-01-01

    textabstractThe aim of this investigation has been to find a safe and suitable contrast medium for radiological evaluation of the gastrointestinal tract in cases where leakage outside the GIT can be suspected. Leakage outside the gastro-intestinal tract lumen can occur in many ways eg.,

  20. The influence of contrast media on kidney function in patients with stable coronary artery disease

    DEFF Research Database (Denmark)

    Reuter, Simon Bertram; Harutyunyan, Marina; Mygind, Naja Dam

    2014-01-01

    AIMS: To investigate the incidence of contrast media-induced nephropathy (CIN) in patients with stable coronary artery disease (CAD) referred for elective coronary intervention following hydration routines. The reversibility of CIN was followed in a 6 month-period. METHODS AND RESULTS: A total...... coronary interventions. Kidney function and the amount of contrast media used was not a predictor of CIN development. The induced CIN was not completely normalized in a 6-month follow-up period....

  1. Intraoperative iodinated contrast swallow with CT-scan delayed control for detection of early complications in laparoscopic gastric bypass: A case series of 260 cases

    Directory of Open Access Journals (Sweden)

    Vincenzo Consalvo, M.D.

    2017-01-01

    Conclusions: This study gives a contribute to the existing issue of fast track in bariatric surgery for the early diagnosis of complications and patients' readmission or non-discharge. In conclusion, the use of intraoperative iodinated water soluble contrast swallow and abdominal CT-scan at 48 h was a safe and accurate test in order to detect and treat any potential early surgical complication in LRYGB.

  2. Fundamental study of DSA images using gadolinium contrast agent

    International Nuclear Information System (INIS)

    Nagashima, Hiroyuki; Shiraishi, Akihisa; Igarashi, Hitoshi; Sakamoto, Hajime; Sano, Yoshitomo

    2002-01-01

    Most contrast agents used in digital subtraction angiography (DSA) are non-ionic iodinated contrast agents, which can cause severe side effects in patients with contraindications for iodine or allergic reactions to iodine. Therefore, DSA examinations using carbon dioxide gas or examinations done by magnetic resonance imaging (MRI) and ultrasound (US) were carried out in these patients. However, none of these examinations provided mages as clear as those of DSA with an iodinated contrast agent. We experienced DSA examination using a gadolinium contrast agent in a patient contraindicated for iodine. The patient had undergone MRI examination with a gadolinium contrast agent previously without side effects. The characteristics of gadolinium and the iodinated contrast agent were compared, and the DSA images obtained clinically using these media were also evaluated. The signal-to-noise (SN) ratio of the gadolinium contrast agent was the highest at tube voltages of 70 to 80 kilovolts and improved slightly when the image intensifier (I.I.) entrance dose was greater than 300 μR (77.4 nC/kg). The dilution ratios of five iodinated contrast agents showed the same S/N value as the undiluted gadolinium contrast agent. Clinically, the images obtained showed a slight decrease in contrast but provided the data necessary to make a diagnosis and made it possible to obtain interventional radiology (IVR) without any side effects. DSA examinations using a gadolinium contrast agent have some benefit with low risk and are thought to be useful for patients contraindicated for iodine. (author)

  3. SU-G-IeP2-12: The Effect of Iterative Reconstruction and CT Tube Voltage On Hounsfield Unit Values of Iodinated Contrast

    Energy Technology Data Exchange (ETDEWEB)

    Ogden, K; Greene-Donnelly, K; Vallabhaneni, D; Scalzetti, E [SUNY Upstate Medical University, Syracuse, New York (United States)

    2016-06-15

    Purpose: To investigate the effects of changing iterative reconstruction strength and tube voltage on Hounsfield Unit (HU) values of varying concentrations of Iodinated contrast medium in a phantom. Method: Iodinated contrast (Omnipaque 300, GE Healthcare, Princeton NJ) was diluted with distilled water to concentrations of 0.6, 0.9, 1.8, 3.6, 7.2, and 10.8 mg/mL of Iodine. The solutions were scanned in a patient equivalent water phantom on two MDCT scanners: VCT 64 slice (GE Medical Systems, Waukesha, WI) and an Aquilion One 320 slice scanner (Toshiba America Medical Systems, Tustin CA). The phantom was scanned at 80, 100, 120, 140 kV using 400, 255, 180, and 130 mAs, respectively, for the VCT scanner, and 80, 100, 120, and 135 kV using 400, 250, 200, and 150 mAs, respectively, on the Aquilion One. Images were reconstructed at 2.5 mm (VCT) and 0.5 mm (Aquilion One). The VCT images were reconstructed using Advanced Statistical Iterative Reconstruction (ASIR) at 6 different strengths: 0%, 20%, 40%, 60%, 80%, and 100%. Aquilion One images were reconstructed using Adaptive Iterative Dose Reduction (AIDR) at 4 strengths: no AIDR, Weak AIDR, Standard AIDR, and Strong AIDR. Regions of interest (ROIs) were drawn on the images to measure the HU values and standard deviations of the diluted contrast. Second order polynomials were used to fit the HU values as a function of Iodine concentration. Results: For both scanners, there was no significant effect of changing the iterative reconstruction strength. The polynomial fits yielded goodness-of-fit (R2) values averaging 0.997. Conclusion: Changing the strength of the iterative reconstruction has no significant effect on the HU values of Iodinated contrast in a tissue-equivalent phantom. Fit values of HU vs Iodine concentration are useful in quantitative imaging protocols such as the determination of cardiac output from time-density curves in the main pulmonary artery.

  4. Myelography Iodinated Contrast Media. 2. Conformational Versatility of Iopamidol in the Solid State.

    Science.gov (United States)

    Bellich, Barbara; Di Fonzo, Silvia; Tavagnacco, Letizia; Paolantoni, Marco; Masciovecchio, Claudio; Bertolotti, Federica; Giannini, Giovanna; De Zorzi, Rita; Geremia, Silvano; Maiocchi, Alessandro; Uggeri, Fulvio; Masciocchi, Norberto; Cesàro, Attilio

    2017-02-06

    The phenomenon of polymorphism is of great relevance in pharmaceutics, since different polymorphs have different physicochemical properties, e.g., solubility, hence, bioavailability. Coupling diffractometric and spectroscopic experiments with thermodynamic analysis and computational work opens to a methodological approach which provides information on both structure and dynamics in the solid as well as in solution. The present work reports on the conformational changes in crystalline iopamidol, which is characterized by atropisomerism, a phenomenon that influences both the solution properties and the distinct crystal phases. The conformation of iopamidol is discussed for three different crystal phases. In the anhydrous and monohydrate crystal forms, iopamidol molecules display a syn conformation of the long branches stemming out from the triiodobenzene ring, while in the pentahydrate phase the anti conformation is found. IR and Raman spectroscopic studies carried out on the three crystal forms, jointly with quantum chemical computations, revealed that the markedly different spectral features can be specifically attributed to the different molecular conformations. Our results on the conformational versatility of iopamidol in different crystalline phases, linking structural and spectroscopic evidence for the solution state and the solid forms, provide a definite protocol for grasping the signals that can be taken as conformational markers. This is the first step for understanding the crystallization mechanism occurring in supersaturated solution of iopamidol molecules.

  5. Campania preventability assessment committee: a focus on the preventability of the contrast media adverse drug reactions.

    Science.gov (United States)

    Sessa, Maurizio; Rossi, Claudia; Rafaniello, Concetta; Mascolo, Annamaria; Cimmaruta, Daniela; Scavone, Cristina; Fiorentino, Sonia; Grassi, Enrico; Reginelli, Alfonso; Rotondo, Antonio; Sportiello, Liberata

    2016-12-01

    The current study aims to assess the preventability of the contrast media adverse drug reactions reported through the Campania spontaneous reporting system, identifying the possible limitations emerged in this type of evaluation. All the individual case safety reports validated by the Campania Pharmacovigilance Regional Centre from July 2012 to September 2015 were screened to select those that reported contrast media as suspected drug. Campania Preventability Assessment Committee, in collaboration with clinicians specialized in Radiology, assessed the preventability according to the P-Method, through a case-by-case approach. From July 2012 to September 2015, 13798 cases were inserted by pharmacovigilance managers in the Italian Pharmacovigilance Network database (in the geographical contest of the Campania Region), of which 67 reported contrast media as suspected drug. Five preventable cases were found. The most reported causes for preventability were the inappropriate drug use for the case clinical conditions and the absence of the preventive measure administrated prior to the contrast media administration. Several limitations were found in the evaluation of the critical criteria for the preventability assessment. Educational initiatives will be organized directly to the healthcare professionals involved in the contrast media administration, to promote an appropriate use of the contrast media.

  6. Shoulder arthrography: comparison of morbidity after use of various contrast media

    International Nuclear Information System (INIS)

    Hall, F.M.; Goldberg, R.P.; Wyshak, G.; Kilcoyne, R.F.

    1985-01-01

    This prospective study compares immediate and delayed patient discomfort in 177 patients following shoulder arthrography using intraarticular combinations of metrizamide, meglumine/sodium diatrizoate, meglumine diatrizoate, lidocaine, epinephrine, and air. Patients receiving conventional ionic monomeric positive contrast media had a 60% (90/150) incidence of moderate or severe delayed exacerbation of their baseline symptoms; only 14% (3/21) of patients receiving metrizamide, a nonionic contrast medium had similar levels of postprocedural discomfort. Morbidity was somewhat diminished with the use of double-contrast (45%, 34/75) rather than single-contrast (75%, 56/75) examinations, and with avoidance of sodium-containing contrast agents or epinephrine. Nonionic or monovalent polymeric contrast media, despite their present high cost, may be the agents of choice if single-contrast arthrography is performed in joints associated with a high incidence of postprocedural pain

  7. Transport phenomena in sharply contrasting media with a diffusion barrier

    International Nuclear Information System (INIS)

    Dvoretskaya, O A; Kondratenko, P S

    2011-01-01

    Using the advection–diffusion equation, we analytically study contaminant transport in a sharply contrasting medium with a diffusion barrier due to localization of a contaminant source in a low-permeability medium. Anomalous diffusion behavior and a crossover between different transport regimes are observed. The diffusion barrier results in exponential attenuation of the source power, retardation of the contaminant plume growth and modification of the concentration distribution at large distances. (paper)

  8. High and low osmolar contrast media: Who pays?

    International Nuclear Information System (INIS)

    Goethlin, J.H.

    1988-01-01

    To possibly avoid a case of contrast medium-related death in Norway every second or third year will mean a cost of many millions of dollars. It is not feasible without many patients being deprived of diagnostic possibilities. The solution is at present to use LOCM in high risk patients and small children until sufficient data (large, controlled series) can give a reliable answer to if or when LOCM should be used. (orig.)

  9. Diazepam prophylaxis of contrast media-induced seizures during computed tomography of patients with brain metastases

    International Nuclear Information System (INIS)

    Pagani, J.J.; Hayman, L.A.; Bigelow, R.H.; Libshitz, H.I.; Lepke, R.A.; Wallace, S.

    1983-01-01

    The effect of 5 mg of intravenous diazepam (Valium) on contrast media-associated seizer incidence was studied in a randomized controlled trial involving 284 patients with known or suspected brain metastases undergoing cerebral computed tomography. Of these patients, 188 were found to have brain metastases, and it is estimated that for this subgroup prophylactic diazepam reduces the risk of contrast-assocated seizure by a factor of 0.26. Seizures occurred in three of 96 patients with metastases on diazepam and in 14 of 92 patients with metastases but without diazepam. Factors related to increased risk of contrast media-associated seizures are: (1) prior seizure history due to brain metatases and/or prior contrast, (2) progressive cerebral metastases, and (3) prior or concurrent brain antineoplastic therapy. Factors not related to an increased risk of these seizures are: (1) contrast media dosage, chemical composition, or osmolarity, (2) computed tomographic appearance of metastases, and (3) type of primary malignancy. Concomitant therapeutic levels of diphenylhydantoin (Dilantin) do not protect completely against contrast media-associated seizures. Pathophysiology of contrast media-associated seizures is discussed in view of the risk factors determined by this study

  10. Do nonionic contrast media reduce the health hazards of diagnostic exminations?

    International Nuclear Information System (INIS)

    Schmiedel, E.

    1989-01-01

    Statistics reveal the significantly lower rate of adverse reactions to nonionic contrast media in comparison to the conventional ionic media. The statistical data have been collected over many years of clinical experience and are verified by a great number of controlled studies. The only question that remains to be answered with certainty is whether it is possible to further reduce, by applying nonionic contrast media, the number of rare, serious adverse reactions or even lethal cases. Latest results of studies support this expectation, although currently statistical configuration cannot be presented. (orig.) [de

  11. Contrast media for radiological examination in gastrointestinal tract leakage

    International Nuclear Information System (INIS)

    Ginai-Karamat, A.Z.

    1987-01-01

    The aim of this investigation has been to find a safe and suitable contrast medium (CM) for radiological evaluation of the gastrointestinal tract (GIT) in cases where leakage outside the GIT can be suspected. An experimental study was carried out to evaluate the reactions of various available CM in the bronchi and lungs, mediastinum, pleura and peritoneum of rats. The CM evaluated in the experimental study were, pure barium sulphate (without any additives), commercial barium sulphate (Micropaque, with additives), Dionosil, Hytrast, Gastrografin, Amipaque (in pleura Omnipaque) and Hexabrix. (Auth.)

  12. Contrast media inhibit exogenous surfactant therapy in rats with acute respiratory distress syndrome

    NARCIS (Netherlands)

    Kesecioglu, Jozef; Haitsma, Jack J.; Schultz, Marcus J.; den Heeten, Gerard J.; Lachmann, Burkhard

    2006-01-01

    AIM: To test the effects of various contrast media on the pulmonary surfactant system. MATERIAL AND METHODS: In a rat model of acute respiratory distress syndrome (ARDS) induced by lung lavage, the effects of surfactant suspended in saline were compared with surfactant suspended in the contrast

  13. Activation of platelets by low-osmolar contrast media: differential effects of ionic and nonionic agents

    NARCIS (Netherlands)

    Hardeman, M. R.; Konijnenberg, A.; Sturk, A.; Reekers, J. A.

    1994-01-01

    To determine the effects of an ionic low-osmolar contrast medium (ioxaglate) and two nonionic low-osmolar contrast media (iohexol and iopamidol) on human platelet activation in vitro. Flow cytometry analysis subsequent to reaction with fluorescence-labeled monoclonal antibodies was used to detect

  14. Usefulness of low dose oral contrast media in 18F-FDG PET/CT

    International Nuclear Information System (INIS)

    An, Young Sil; Yoon, Joon Kee; Hong, Seon Pyo; Joh, Chul Woo; Yoon, Seok Nam

    2006-01-01

    The standard protocol using large volume of oral contrast media may cause gastrointestinal discomfort and contrast-related artifacts in PET/CT. The aim of this study was to evaluate the usefulness of low dose oral contrast in 18 F-FDG PET/CT. We retrospectively reviewed the whole-body PET/CT images in a total of 435 patients. About 200 ml of oral contrast agent (barium sulfate) was administered immediately before injection of 18 F-FDG. The FDG uptake of intestines was analyzed by visual and semi-quantitative method on transaxial, coronal and saggital planes. Seventy (16%, 113 sites) of 435 images showed high FDG uptake (peak SUV > 4); 50 (74%, 84 sites) with diffuse and 20 (26%, 29 sites) with focal uptake. The most commonly delivered site of oral contrast media was small bowel (n = 27, 39%). On PET/CT images, FDG uptake coexisted with oral contrast media in 26 patients (54%, 38 sites) with diffuse pattern and 9 (45%, 9 sites) with focal pattern, and by sites, those were 38 (45%) and 9 (31%), respectively. In small bowel regions, the proportion of coexistence reached as high as 61% (29/47 sites). A visual analysis of available non-attenuation corrected PET images of 27 matched regions revealed no contrast-related artifact. We concluded that the application of low dose contrast media could be helpful in the evaluation of abdominal uptake in the FDG PET/CT image

  15. Contrast media induced acute renal failure in diabetics

    International Nuclear Information System (INIS)

    Rambausek, M.

    1985-01-01

    Dehydration, preexisting renal insufficiency, multiple myeloma and insulin-dependent diabetes mellitus are known risk factors for a radiocontrast medium induced acute renal failure. In 90% of patients with insulin-dependent diabetes mellitus, renal insufficiency and proteinuria, a further detoriation of renal function can be expected after i.v. administration of radiocontrast medium. Recent concepts on the genesis of acute renal failure after radiocontrast medium in multiple myeloma emphasize the role of tubular blocade (tubular precipitation of myeloma protein with contrast medium). In insulin-dependent diabetic patients we found altered carbohydrate composition of urinary Tamm Horsfall Protein (THP), with increased glucose and diminished N-acetyl-neuraminicacid content. This was paralleled by a difference in an in-vitro system of coprecipitation where THP of diabetes triggered more pronounced calcium dependent coprecipitation of contrast medium and albumin. These in-vitro findings might be important for the explanation of the genesis of radiocontrast medium-induced acute renal failure in insulin-dependent diabetes mellitus. (orig.) [de

  16. Quantitative contrast-enhanced mammography for contrast medium kinetics studies

    Science.gov (United States)

    Arvanitis, C. D.; Speller, R.

    2009-10-01

    Quantitative contrast-enhanced mammography, based on a dual-energy approach, aims to extract quantitative and temporal information of the tumour enhancement after administration of iodinated vascular contrast media. Simulations using analytical expressions and optimization of critical parameters essential for the development of quantitative contrast-enhanced mammography are presented. The procedure has been experimentally evaluated using a tissue-equivalent phantom and an amorphous silicon active matrix flat panel imager. The x-ray beams were produced by a tungsten target tube and spectrally shaped using readily available materials. Measurement of iodine projected thickness in mg cm-2 has been performed. The effect of beam hardening does not introduce nonlinearities in the measurement of iodine projected thickness for values of thicknesses found in clinical investigations. However, scattered radiation introduces significant deviations from slope equal to unity when compared with the actual iodine projected thickness. Scatter correction before the analysis of the dual-energy images provides accurate iodine projected thickness measurements. At 10% of the exposure used in clinical mammography, signal-to-noise ratios in excess of 5 were achieved for iodine projected thicknesses less than 3 mg cm-2 within a 4 cm thick phantom. For the extraction of temporal information, a limited number of low-dose images were used with the phantom incorporating a flow of iodinated contrast medium. The results suggest that spatial and temporal information of iodinated contrast media can be used to indirectly measure the tumour microvessel density and determine its uptake and washout from breast tumours. The proposed method can significantly improve tumour detection in dense breasts. Its application to perform in situ x-ray biopsy and assessment of the oncolytic effect of anticancer agents is foreseeable.

  17. A prospective evaluation of the contrast, radiation dose and image quality of contrast-enhanced CT scans of paediatric abdomens using a low-concentration iodinated contrast agent and low tube voltage combined with 70% ASIR algorithm.

    Science.gov (United States)

    Wang, Xiaoxia; Zhong, Yumin; Hu, Liwei; Xue, Lianyan; Shi, Meihua; Qiu, Haisheng; Li, Jianying

    2016-09-01

    To quantitatively and subjectively assess the image quality of and radiation dose for an abdominal enhanced computed tomography (CT) scan with a low tube voltage and a low concentration of iodinated contrast agent in children. Forty-eight patients were randomised to one of the two following protocols: Group A (n=24, mean age 46.96±44.65 months, mean weight 15.71±9.11 kg, BMI 16.48±2.40 kg/m(2) ) and Group B (n=24, mean age 41.33±44.59 months, mean weight 18.15±17.67 kg, BMI 17.50±3.73 kg/m(2) ). Group A: 80 kVp tube voltage, 270 mg iodine (I)/mL contrast agent (Visipaque, GE Healthcare) and images were reconstructed using 70% adaptive statistical iterative reconstruction (ASIR). Group B: 100 kVp tube voltage, 370 mg I/mL contrast agent (Iopamiro, Bracco) and images were reconstructed using 50% ASIR. The volume of the contrast agent was 1.30 mL/kg in both Groups A and B. The degree of enhancement and noise in the abdominal aorta (AO) in the arterial phase (AP) and the portal vein (PV) in the portal venous phase (PVP) was measured; while the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) for the AO and PV were calculated. A 5-point scale was used to subjectively evaluate the image quality and image noise by two radiologists with more than 10 years of experience. Dose-length product (DLP) (mGy-cm) and CTDIvol (mGy) were calculated. Objective measurements and subjective quality scores for the two groups were compared using paired t-tests and Mann-Whitney U tests, respectively. There was no significant difference in age, weight or body mass index (BMI) between the two groups (all P>.5). The iodine load in Group A (5517.3±3197.2 mg I) was 37% lower than that in Group B (8772.1±8474.6 mg I), although there was no significant difference between them (P=.111). The DLP and the CT dose index (CTDIvol ) for Group A were also lower than for Group B, but were not statistically significantly different (DLP, 104 mGy-cm±45.81 vs 224.5

  18. Value of MR contrast media in image-guided body interventions.

    Science.gov (United States)

    Saeed, Maythem; Wilson, Mark

    2012-01-28

    In the past few years, there have been multiple advances in magnetic resonance (MR) instrumentation, in vivo devices, real-time imaging sequences and interventional procedures with new therapies. More recently, interventionists have started to use minimally invasive image-guided procedures and local therapies, which reduce the pain from conventional surgery and increase drug effectiveness, respectively. Local therapy also reduces the systemic dose and eliminates the toxic side effects of some drugs to other organs. The success of MR-guided procedures depends on visualization of the targets in 3D and precise deployment of ablation catheters, local therapies and devices. MR contrast media provide a wealth of tissue contrast and allows 3D and 4D image acquisitions. After the development of fast imaging sequences, the clinical applications of MR contrast media have been substantially expanded to include pre- during- and post-interventions. Prior to intervention, MR contrast media have the potential to localize and delineate pathologic tissues of vital organs, such as the brain, heart, breast, kidney, prostate, liver and uterus. They also offer other options such as labeling therapeutic agents or cells. During intervention, these agents have the capability to map blood vessels and enhance the contrast between the endovascular guidewire/catheters/devices, blood and tissues as well as direct therapies to the target. Furthermore, labeling therapeutic agents or cells aids in visualizing their delivery sites and tracking their tissue distribution. After intervention, MR contrast media have been used for assessing the efficacy of ablation and therapies. It should be noted that most image-guided procedures are under preclinical research and development. It can be concluded that MR contrast media have great value in preclinical and some clinical interventional procedures. Future applications of MR contrast media in image-guided procedures depend on their safety, tolerability

  19. Contrast medium-induced nephropathy: Aspects on incidence ...

    African Journals Online (AJOL)

    Contrast media-induced nephropathy (CIN) is a well-known complication of radiological examinations employing iodine contrast media (I-CM). The rapid development and frequent use of coronary interventions and multi-channel detector computed tomography with concomitant administration of relatively large doses of ...

  20. The diagnostic effectiveness of contrast media in the excretory urography in dogs

    International Nuclear Information System (INIS)

    Velesova, M.; Ledecky, V.

    2005-01-01

    A clinical study was conducted to investigate the use of four different positive contrast media, Omnipaque (Nycomed Imaging As.), Optiray (Maliincrodt Medical GmbH), Ultravist (Schering AG), and Urografin (Schering AG) in normograde excretory urography. Investigations were carried out on thirteen dogs. Each group of dogs was administered a different contrast medium. Radiographs were obtained immediately after the administration of contrast media and after a lapse of 5, 10 and 15 minutes. The effectiveness of the application was evaluated by assessing the radiographs of abdominal cavities in ventro-dorsal and latero-lateral positions. None of the dogs showed pronounced side effect after the application of contrast media. Ectopic ureter was diagnosed in three and a prostate cyst in one of the patients. Our results showed that Omnipaque and Ultravist were the contrast agents most suitable for the examination of the urinary apparatus by intravenous contrast excretory urography. Their advantage is that visualisation of the kidneys and ureters achieved by these media are sufficiently long and contrastive

  1. Prevention of generalized reactions to contrast media: a consensus report and guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Morcos, S.K. [Dept. of Diagnostic Imaging, Northern General Hospital, Sheffield (United Kingdom); Thomsen, H.S. [Dept. of Diagnostic Radiology, Herlev Hospital, University of Copenhagen (Denmark); Webb, J.A.W. [Diagnostic Radiology Department, St. Bartholomew' s Hospital, London (United Kingdom)

    2001-09-01

    The aim of this study was to document, using consensus methodology, current practice for prevention of generalized reactions to contrast media, to identify areas where there is disagreement or confusion and to draw up guidelines for reducing the risk of generalized contrast media reactions based on the survey and a review of the literature. A document with 165 questions was mailed to 202 members of the European Society of Urogenital Radiology. The questions covered risk factors and prophylactic measures for generalized contrast media reactions. Sixty-eight members (34%) responded. The majority indicated that a history of moderate and severe reaction(s) to contrast media and asthma are important risk factors. The survey also indicated that patients with risk factors should receive non-ionic contrast media. In patients at high risk of reaction, if the examination is deemed absolutely necessary, a resuscitation team should be available at the time of the procedure. The majority (91%) used corticosteroid prophylaxis given at least 11 h before contrast medium to patients at increased risk of reaction. The frequency of the dosage varied from one to three times. Fifty-five percent also use antihistamine Hl, mainly administered orally and once. Antihistamine H2 and ephedrine are rarely used. All essential drugs are available on the emergency resuscitation trolley. Patients with risk factors are observed up to 30 min by 48% and up to 60 min by 43% of the responders. Prophylactic measures are not taken before extravascular use of contrast media. Prophylactic drugs are given to patients with a history of moderate or severe generalized reaction to contrast media. In patients with asthma, opinion is divided with only half of the responders giving prophylactic drugs. Aspirin, {beta}-blockers, interleukin-2 and non-steroid anti-inflammatory drugs are not considered risk factors and therefore are not stopped before injection of contrast media. The survey showed some variability in

  2. Prevention of generalized reactions to contrast media: a consensus report and guidelines

    International Nuclear Information System (INIS)

    Morcos, S.K.; Thomsen, H.S.; Webb, J.A.W.

    2001-01-01

    The aim of this study was to document, using consensus methodology, current practice for prevention of generalized reactions to contrast media, to identify areas where there is disagreement or confusion and to draw up guidelines for reducing the risk of generalized contrast media reactions based on the survey and a review of the literature. A document with 165 questions was mailed to 202 members of the European Society of Urogenital Radiology. The questions covered risk factors and prophylactic measures for generalized contrast media reactions. Sixty-eight members (34%) responded. The majority indicated that a history of moderate and severe reaction(s) to contrast media and asthma are important risk factors. The survey also indicated that patients with risk factors should receive non-ionic contrast media. In patients at high risk of reaction, if the examination is deemed absolutely necessary, a resuscitation team should be available at the time of the procedure. The majority (91%) used corticosteroid prophylaxis given at least 11 h before contrast medium to patients at increased risk of reaction. The frequency of the dosage varied from one to three times. Fifty-five percent also use antihistamine Hl, mainly administered orally and once. Antihistamine H2 and ephedrine are rarely used. All essential drugs are available on the emergency resuscitation trolley. Patients with risk factors are observed up to 30 min by 48% and up to 60 min by 43% of the responders. Prophylactic measures are not taken before extravascular use of contrast media. Prophylactic drugs are given to patients with a history of moderate or severe generalized reaction to contrast media. In patients with asthma, opinion is divided with only half of the responders giving prophylactic drugs. Aspirin, β-blockers, interleukin-2 and non-steroid anti-inflammatory drugs are not considered risk factors and therefore are not stopped before injection of contrast media. The survey showed some variability in

  3. Renal streaky artifact during contrast-enhanced abdominal and pelvic CT: Comparison of high versus low osmolality contrast media

    International Nuclear Information System (INIS)

    Kim, Dae Hong; Kim, Jong Chul; Lee, Chung Keun; Shin, Kyoung Suk

    1994-01-01

    Introduction of low osmolality contrast agent(LOCA) has allowed safer, more comfortable contrast-enhanced CT examination, but there has been significant increase in image degradation when evaluating the kidneys due to streaky artifact. The authors reviewed findings of contrast- enhanced abdominal and pelvic computed tomography(CT) to know the difference of renal streaky artifact between a high osmolality contrast agent (HOCA) and LOCA. This study included two hundred contrast-enhanced CT in 200 patients, 100 performed with HOCA(meglumine ioglicate, 150 ml) and 100 performed with LOCA (iopromide,150 ml). The severity of renal streaky artifact was compared between HOCA and LOCA groups. Of the scans performed with HOCA, 40 had no artifact, 52 had grade I artifact, 6 had grade II artifact, and 2 had grade III artifact. Of the scans preformed with LOCA, 23 had no artifact, 44 had grade I artifact, 29 had grade II artifact, and 4 had grade III artifact. There was significant difference in the degree of the streaky artifact depending upon the osmolality of the contrast media used(by χ 2 -test, P=.0001). The results of this study revealed a statistically significant increased incidence of artifacts and distortions of renal image with LOCA when compared with HOCA

  4. Extracellular gadolinium-based contrast media: Differences in diagnostic efficacy

    Energy Technology Data Exchange (ETDEWEB)

    Molen, Aart J. van der [Department of Radiology C-2S, Leiden University Medical Centre, Albinusdreef 2, NL-2333 ZA Leiden (Netherlands)], E-mail: molen@lumc.nl; Bellin, Marie-France [Universite Paris-Sud XI, AP-HP, Service de Radiologie, Hopital Paul Brousse, 12-14 Avenue Paul Vaillant Couturier, F-94804 Villejuif Cedex (France)

    2008-05-15

    Since the introduction of the first gadolinium-based contrast agent (Gd-CA) in 1988 it has become clear that these agents significantly improve the diagnostic efficacy of MRI. Studies on single agents have shown that, in comparison to unenhanced sequences, all agents help to improve the detection and delineation of lesions which can alter diagnosis in up to 40% of patients. Doubling or tripling the standard dose of 0.1 mmol/kg body weight may be beneficial for selected indications (e.g. brain perfusion, equivocal single dose study in MRI for brain metastasis, small vessel MR angiography). A more limited number of studies have compared the various agents. These studies do not show clinically significant differences in diagnostic efficacy between the various extracellular Gd-CA. Agents with higher concentration or protein binding may be relatively better suitable for selected applications (e.g. perfusion MRI). The higher relaxivity agents may be used in somewhat lower doses than the extracellular agents.

  5. Extracellular gadolinium-based contrast media: Differences in diagnostic efficacy

    International Nuclear Information System (INIS)

    Molen, Aart J. van der; Bellin, Marie-France

    2008-01-01

    Since the introduction of the first gadolinium-based contrast agent (Gd-CA) in 1988 it has become clear that these agents significantly improve the diagnostic efficacy of MRI. Studies on single agents have shown that, in comparison to unenhanced sequences, all agents help to improve the detection and delineation of lesions which can alter diagnosis in up to 40% of patients. Doubling or tripling the standard dose of 0.1 mmol/kg body weight may be beneficial for selected indications (e.g. brain perfusion, equivocal single dose study in MRI for brain metastasis, small vessel MR angiography). A more limited number of studies have compared the various agents. These studies do not show clinically significant differences in diagnostic efficacy between the various extracellular Gd-CA. Agents with higher concentration or protein binding may be relatively better suitable for selected applications (e.g. perfusion MRI). The higher relaxivity agents may be used in somewhat lower doses than the extracellular agents

  6. Study of abdominal CT angiography in low tube voltage setting combined with personalized contrast media application

    International Nuclear Information System (INIS)

    Cao Jianxin; Wang Yiming; Zhang Yu; Tao Wei; Zhang Xiaodong; Wang Aijun; Liu Li; Wang Peng

    2012-01-01

    Objective: To investigate the feasibility of decreasing radiation dose and contrast media dose of abdominal CTA using low tube voltage setting combined with personalized contrast media application. Methods: One hundred and twenty patients were randomly divided into 3 groups, and there were 40 patients in each group. 120 kV tube voltage was used in group A, and 100 kV tube voltage was used in group B and C. Personalized injection flow rate of contrast media which determined according to patient's body mass (injection flow rate =λ × body mass) was used for all groups, and the λ values for group A, B and C were 0.07, 0.07 and 0.06 ml · kg -1 · s -1 respectively. CT dose index volume (CTDIvol) effective dose (ED) and contrast media dose were evaluated,and these parameters were all analyzed using one-way ANOVA analysis. Image quality of abdominal aorta and branch arteries was rated using a three-point ordinal for all 3 groups, and image quality score was analyzed using Kruskal-Wallis test. Results: CTDIvol were (8.2±0.8), (6.0 ±1.0) and (6.1 ±1.1)mGy for group A, B and C, ED were (5.2 ±0.8), (3.5 ± 0.7) and (3.6 ± 0.6) mSv, and contrast media dose were (72.3 ± 10.3),(73.5 ± 11.3) and (61.6 ±9.4) ml, respectively. There were significant differences in CTDIvol, ED and contrast media dose among 3 groups (F=66.094, 77.812,15.919; P=0.000). Compare with group A, the ED of group B was decreased 32.7%, and the ED and contrast media dose of group C were decreased 30.8% and 14.8%, respectively. Image quality was rated as excellent, good, and general for 20, 19 and 1 patients in group A, 25, 15 and 0 patients in group B, and 23, 17 and 0 patients in group C, respectively. There was no significant difference in image quality score among 3 groups (χ 2 =1.492, P=0.474). Conclusions: The radiation dose and contrast media dose can be decreased in abdominal CTA using low tube voltage and personalized contrast media application while image quality can be preserved

  7. Low osmolar (non-ionic) contrast media versus high osmolar (ionic) contrast media in intravenous urography and enhanced computerized tomography: a cost-effectiveness analysis.

    Science.gov (United States)

    Wangsuphachart, S

    1991-12-01

    The cost-effectiveness of three alternative policies for the use of intravenous contrast media for urography and enhanced computerized tomography (CT) are analyzed. Alternative #1 is to use high osmolar contrast media (HOCM) in all patients, the historical policy. Alternative #2 is to replace it with low osmolar contrast media (LOCM) in all patients. Alternative #3 is to use LOCM only in the high risk patients. Data on the 6,242 patients who underwent intravenous urography and enhanced CT at the Department of Radiology, Chulalongkorn Hospital in 1989 were used. Both societal and hospital viewpoints were analyzed. The incremental cost-effectiveness (ICE) between #2 and #1 was 26,739 Baht (US$1,070) per healthy day saved (HDS), while the ICE between #3 and #1 was 12,057 Baht (US$482) per HDS. For fatal cases only, ICE between #2 and #1 was 35,111 Baht (US$1,404) per HDS, while the ICE between #3 and #1 was 18,266 Baht (US$731) per HDS. The incremental cost (IC) per patient was 2,341 Baht (US$94) and 681 Baht (US$27) respectively. For the hospital viewpoint the ICE between #2 and #1 was 13,744 (US$550) and between #3 and #1 was 6,127 Baht (US$245) per HDS. The IC per patient was 1,203 Baht (US$48) and 346 Baht (US$14), respectively. From the sensitivity analysis, #3 should be used if the LOCM price is reduced more than 75% (equal to 626 Baht or less) and more than 80% of the patients are able to pay for the contrast media.

  8. [Diagnostic Significance of BAT in Anaphylaxis to Non-ionic Contrast Media].

    Science.gov (United States)

    Zhang, Hao-yue; Xu, Su-jun; Tang, Xiao-xian; Niu, Ji-jun; Guo, Xiang-jie; Gao, Cai-rong

    2015-06-01

    To investigate the diagnostic significance of basophil activation test (BAT) in anaphylaxis to non-ionic contrast media through testing the content of CD63, mast cell-carboxypeptidase A3 (MC-CPA3), and terminal complement complex SC5b-9 of the individuals by testing their levels in the normal immune group and the anaphylaxis groups to β-lactam drugs and non -ionic contrast media. The CD63 expression of basophilic granulocyte in blood was detected by flow cytometry. The levels of MC-CPA3 in blood serum and SC5b-9 in blood plasma were detected by ELISA. The CD63 expression of basophilic granulocyte in blood, the levels of MC-CPA3 and SC5b-9 of anaphylaxis to non-ionic contrast media and β-lactam drugs were significantly higher than that in normal immune group (P contrast media. BAT can be used to diagnose the anaphylaxis to non-ionic contrast media.

  9. Signal effects of various radiographic contrast media and their interaction with gadolinium DTPA during MRT

    International Nuclear Information System (INIS)

    Kopka, L.; Funke, M.; Fischer, U.; Vosshenrich, R.; Schroeder, M.; Grabbe, E.

    1994-01-01

    T 1 and T 2 weighted signals dereived from various radiological contrast media were studied during MRT spin-echo sequences. In addition, the interaction between radiological contrast media and Gadolinium-DTPA concerning T 1 signals was evaluated. Ionic (ioxitalaminic acid) and non-ionic radiological contrast media (Iopromid, Iotrolan) were used in diagnostic concentrations. Measurements were carried out with a superconductive magnet of 1.5 Tesla. Radiological contrast media produced significantly higher signals than a physiological sodium chloride solution in T 1 -weighted spin-echo sequences. Evn small amounts (15% of total volume) of radiological contrast media during T 1 -weighted spin-echo sequences led to a significant reduction (about 25%) of the signal intensity of a 2 mM Gadolinium-DTPA solution. This may lead to diagnostic problems, as was shown in a series of 25 MR arthrograms of the shoulder. It is recommended than an interval of at least 6 hours should elapse between the use of a radiological contrst medium and an MRT examination. (orig.) [de

  10. In situ fabricated iodine-adlayer assisted selective electrooxidation of uric acid in alkaline media

    Energy Technology Data Exchange (ETDEWEB)

    Miah, Md. Rezwan [Department of Electronic Chemistry, Interdisciplinary Graduate School of Science and Engineering, Tokyo Institute of Technology, Mail Box G1-5, 4259 Nagastuta, Midori-ku, Yokohama 226-8502 (Japan)], E-mail: mrmche@yahoo.com; Masud, Jahangir [Department of Electronic Chemistry, Interdisciplinary Graduate School of Science and Engineering, Tokyo Institute of Technology, Mail Box G1-5, 4259 Nagastuta, Midori-ku, Yokohama 226-8502 (Japan); Ohsaka, Takeo [Department of Electronic Chemistry, Interdisciplinary Graduate School of Science and Engineering, Tokyo Institute of Technology, Mail Box G1-5, 4259 Nagastuta, Midori-ku, Yokohama 226-8502 (Japan)], E-mail: ohsaka@echem.titech.ac.jp

    2008-12-30

    This work presents the electrooxidation of uric acid (UA) at an iodine-adlayer-modified gold, Au (I|Au (poly)) electrode in 0.1 M NaOH solution using cyclic voltammetric, amperometric and open-circuit potential measurement techniques. A tremendous enhancement of the electrode activity towards the electrooxidation of UA was achieved by virtue of the simple modification of the Au (poly) electrode surface with a neutral iodine-adlayer, fabricated in situ through the spontaneous oxidative chemisorption of iodide present in the sample solution. The cyclic voltammetric peak current increases remarkably for the oxidation of UA and the peak potential shifts by 365 mV to the negative direction of potential compared to the bare Au (poly) electrode. Oxidation of ascorbic acid (AA) at the I|Au (poly) electrode takes place at the same potential as that at the bare electrode, but the peak current intensity is almost twice at the bare Au (poly) electrode as compared to the modified one. In the mixture of the AA and UA, the cyclic voltammetric signals corresponding to the oxidations of AA and UA were resolved by 340 mV. The electrode response in the mixture was highly reproducible because of the inhibition of adsorption of oxidation products and UA.

  11. Bioadhesive agents in addition to oral contrast media - evaluation in an animal model

    International Nuclear Information System (INIS)

    Conrad, R.; Schneider, G.; Textor, J.; Schild, H.H.; Fimmers, R.

    1998-01-01

    Purpose: To evaluate the additional effect of bioadhesives in combination with iotrolan and barium as oral contrast media in an animal model. Method: The bioadhesives Noveon, CMC, Tylose and Carbopol 934 were added to iotrolan and barium. The solutions were administered to rabbits by a feeding tube. The animals were investigated by computed tomography (CT) and radiography after 0,5, 4, 12, 24 and in part after 48 hours. Mucosal coating and contrast filling of the bowel were evaluated. Results: Addition of bioadhesives to oral contrast media effected long-term contrast in the small intestine and colon, but no improvement in continuous filling and coating of the gastrointestinal tract was detected. Mucosal coating was seen only in short regions of the caecum and small intestine. In CT the best results for coating were observed with tylose and CMC, in radiography additionally with carbopol and noveon. All contrast medium solutions were well tolerated. Conclusion: The evaluated contrast medium solutions with bioadhesives have shown long-term contrast but no improvement in coating in comparison to conventional oral contrast media. (orig.) [de

  12. An experimental study on radiological examination of obstructed small bowel with various contrast media

    International Nuclear Information System (INIS)

    Lee, Yong; Kim, Sung Jin; Han, Moon Hee; Park, Jae Hyung

    1991-01-01

    For the evaluation of the level and cause of small bowel obstruction, an oral barium study is usually chosen. When perforation is whether barium or a water-soluble contrast agent should be used, because barium causes from foreign body reactions as well as adhesions in the extraluminal tissues. Water-soluble contrast agent, on the other hand, are less satisfactory but in general have no untoward effects in the extraluminal tissues. Because of hyperosomolarity, water-soluble contrast agents attract large amounts of fluid with subsequent dilution and loss of contrast and pose a risk of pulmonary edema if aspirated. The use of the newer non-ionic and low-osmolarity water-soluble contrast will likely avoid pulmonary complications due to aspiration. The author performed this experimental study to compare the radiological efficacy of different contrast media in enteric follow-through examinations of obstructed small bowel. Rate had a ligature applied to the distal ileum via laparotomy. Four contrast media were subjected to testing by instillation via oro-gastric tube immediately after laparotomy. Radiographs were exposed at 1, 4 and 8 hours and evaluated later. After 24 hours the animals were sacrificed and the stomach and small bowels, free from mesentery and omental tissue, were weighted with contrasts. The progression in the bowel was proportionate to the osmolarity of the contrast media. After 1 hour, the observations indicated sodium diatrizoate (Gastrografin, Schering) to be the least favorable medium with respect to sharpness of the mucosal border. After 8 hours, barium gave a poorer delineation compared to Ioxaglate (Hexabric, Guerbet) and Iopromide (Ultravist, Schering). Early deaths were noted in the sodium diatrizoate and ioxaglate groups. So we conclude that when using a rather high-volume bolus, low-osmolar non-ionic contrast media seem to have significant prospects for general diagnostic use in patients with suspected intestinal obstruction

  13. Multiscale modeling of high contrast brinkman equations with applications to deformable porous media

    KAUST Repository

    Brown, Donald

    2013-06-18

    Simulating porous media flows has a wide range of applications. Often, these applications involve many scales and multi-physical processes. A useful tool in the analysis of such problems in that of homogenization as an averaged description is derived circumventing the need for complicated simulation of the fine scale features. In this work, we recall recent developments of homogenization techniques in the application of flows in deformable porous media. In addition, homogenization of media with high-contrast. In particular, we recall the main ideas of the homogenization of slowly varying Stokes flow and summarize the results of [4]. We also present the ideas for extending these techniques to high-contrast deformable media [3]. These ideas are connected by the modeling of multiscale fluid-structure interaction problems. © 2013 American Society of Civil Engineers.

  14. Contrast media-associated nephrotoxicity - pathogenenesis and prevention; Kontrastmittelnephropathie - Pathogenese und Praevention

    Energy Technology Data Exchange (ETDEWEB)

    Erley, C.M. [Abt. Innere Medizin III, Sektion Nieren- und Hochdruckkrankheiten, Tuebingen Univ. (Germany); Duda, S.H. [Tuebingen Univ. (Germany). Abt. fuer Radiologische Diagnostik

    1997-07-01

    Contrast media-associated nephrotoxicity continues to be a relevant cause of acute renal failure, especially in patients with pre-existing renal insufficiency. Alterations in renal hemodynamics and direct tubular toxicity by contrast media are the primary factors believed to be responsible for contrast media-associated nephrotoxicity. We review recent insights into the pathogenesis of this complication and summarize prophylactic strategies focussing on hydration, vasoactive pharmacological agents, and prophylactic hemodialysis`. (orig.) [Deutsch] Die Kontrastmittelnephropathie (KMN) stellt insbesondere bei Patienten mit eingeschraenkter Nierenfunktion ein erhebliches medizinisches Problem dar. Die Genese der KMN ist nach wie vor nicht eindeutig geklaert. Neben haemodynamischen Veraenderungen durch die Kontrastmittel spielen tubulotoxische Schaeden eine grosse Rolle. Die vorliegende Uebersicht beschreibt die zur Zeit bekannten pathophysiologischen Vorgaenge bei der KMN und die zur Zeit angewendeten Praeventivmassnahmen. (orig.)

  15. Review: kinetics of water-soluble contrast media in the central nervous system

    International Nuclear Information System (INIS)

    Sage, M.R.

    1983-01-01

    In neuroradiology, intraarterial, intravenous, and intrathecal injections of water-soluble contrast media are made. With the growing importance of water-soluble myelography, interventional angiography, and enhanced computed tomography (CT), it is essential to have a clear understanding of the response of the nervous system to such procedures. The blood, cerebrospinal fluid (CSF), and extracellular fluid of the parenchyma form the fluid compartments of the brain with three interfaces between, namely, the blood-brain interface, the CSF-brain interface, and the blood-CSF interface. One of more of these interfaces are exposed to water-soluble contrast media after intraarterial, intravenous, or intrathecal administration. The behavior of water-soluble contrast media at these interfaces is discussed on the basis of local experience and a review of the literature

  16. Renal function, nephrogenic systemic fibrosis and other adverse reactions associated with gadolinium-based contrast media.

    Science.gov (United States)

    Canga, Ana; Kislikova, Maria; Martínez-Gálvez, María; Arias, Mercedes; Fraga-Rivas, Patricia; Poyatos, Cecilio; de Francisco, Angel L M

    2014-01-01

    Nephrogenic systemic fibrosis is a fibrosing disorder that affects patients with impaired renal function and is associated with the administration of gadolinium-based contrast media used in MRI. Despite being in a group of drugs that were considered safe, report about this potentially serious adverse reaction was a turning point in the administration guidelines of these contrast media. There has been an attempt to establish safety parameters to identify patients with risk factors of renal failure. The close pharmacovigilance and strict observation of current regulations, with special attention being paid to the value of glomerular filtration, have reduced the published cases involving the use of gadolinium-based contrast media. In a meeting between radiologists and nephrologists we reviewed the most relevant aspects currently and recommendations for its prevention.

  17. [Visualization of laryngopharynx during swallowing of negative contrast media (air) with cine mode 64-row MDCT].

    Science.gov (United States)

    Fudeya, Taku; Otake, Shoichiro; Watabe, Hirotaka; Mitsuoka, Takashi; Yoshikawa, Akitoshi

    2010-05-20

    Video fluoroscopic examination of swallowing generally needs a contrast media such as a barium sulfate. Since the examination is usually performed in patients with dysphasia, there is a risk of aspiration. We tried to visualize the laryngopharynx during swallowing of negative contrast media (air) with 64-row multi-detector computed tomography (64-MDCT). Cine mode 64-MDCT was performed to visualize the laryngopharynx in 4 healthy volunteers during swallowing of negative contrast media (air). The data were converted to three-dimensional (3D) images of 2 conditions (air and bone) and sagittal images of the soft tissue condition at a workstation. These images were sent to a personal computer and modeled to 3D cine images with Digital Imaging and Communication in Medicine (DICOM) Viewer and Quick Time Player. 3D cine images demonstrated movements of the epiglottis, vallecula, piriform sinus, tongue, pharyngeal wall, hyoid bone and thyroid cartilage.

  18. Economic considerations for the use of low osmolality contrast media in radiology

    International Nuclear Information System (INIS)

    Latchaw, R.

    1989-01-01

    The new low-osmonality contrast media (LOCM) have been shown to be better tolerated, more physiologic, and safer than the older ionic media. Unfortunately, the LOCM are significantly more expensive than the latter and therefore one must wiegh the differential costs of the new drugs against their benefits. In this paper an overview is given of discussions by a number of investigators of the economic implications of the use of LOCM. (H.W.). 25 refs.; 10 tabs

  19. Remote Ischemic Preconditioning To Reduce Contrast-Induced Nephropathy: A Randomized Controlled Trial

    NARCIS (Netherlands)

    Menting, T.P.; Sterenborg, T.B.; Waal, Y.R. de; Donders, R.; Wever, K.E.; Lemson, M.S.; Vliet, J.A. van der; Wetzels, J.F.M.; Schultze Kool, L.J.; Warle, M.C.

    2015-01-01

    BACKGROUND: Despite the increasing use of pre- and post-hydration protocols and low osmolar instead of high osmolar iodine containing contrast media, the incidence of contrast induced nephropathy (CIN) is still significant. There is evidence that contrast media cause ischemia reperfusion injury of

  20. Contrast Media Delivery in the Assessment of Anomalous Left Coronary Artery From the Pulmonary Artery.

    Science.gov (United States)

    Saade, Charbel; Al-Hamra, Salam; Al-Mohiy, Hussain; El-Merhi, Fadi

    2016-05-01

    A patient with a history of mitral valve prolapse and regurgitation that was corrected with a mitral ring repair 15 years earlier received a diagnosis of anomalous left coronary artery arising from the pulmonary artery and underwent repair. Coronary computed tomography angiography (CTA) was employed to image the patient before surgical intervention. Synchronizing contrast media administration to opacify the right coronary artery in the arterial phase and the left coronary artery in the venous phase required a test-bolus approach. Matching compromised cardiovascular dynamics with patient-specific contrast media administration protocols was improved considerably with the use of a test-bolus technique during electrocardiography-gated coronary CTA.

  1. Synthesis and Preclinical Characterization of a Cationic Iodinated Imaging Contrast Agent (CA4+) and Its Use for Quantitative Computed Tomography of Ex Vivo Human Hip Cartilage.

    Science.gov (United States)

    Stewart, Rachel C; Patwa, Amit N; Lusic, Hrvoje; Freedman, Jonathan D; Wathier, Michel; Snyder, Brian D; Guermazi, Ali; Grinstaff, Mark W

    2017-07-13

    Contrast agents that go beyond qualitative visualization and enable quantitative assessments of functional tissue performance represent the next generation of clinically useful imaging tools. An optimized and efficient large-scale synthesis of a cationic iodinated contrast agent (CA4+) is described for imaging articular cartilage. Contrast-enhanced CT (CECT) using CA4+ reveals significantly greater agent uptake of CA4+ in articular cartilage compared to that of similar anionic or nonionic agents, and CA4+ uptake follows Donnan equilibrium theory. The CA4+ CECT attenuation obtained from imaging ex vivo human hip cartilage correlates with the glycosaminoglycan content, equilibrium modulus, and coefficient of friction, which are key indicators of cartilage functional performance and osteoarthritis stage. Finally, preliminary toxicity studies in a rat model show no adverse events, and a pharmacokinetics study documents a peak plasma concentration 30 min after dosing, with the agent no longer present in vivo at 96 h via excretion in the urine.

  2. Double blind evaluation of the effects of various contrast media on extremity veins in the dog

    International Nuclear Information System (INIS)

    Laerum, F.; Dehner, L.P.; Rysavy, J.; Amplatz, K.; Minnesota Univ., Minneapolis

    1987-01-01

    Canine superficial extremity veins were examined grossly and microscopically in a double blind fashion for endothelial damage and phlebitis one hour and four days after the injection of ionic monomeric or dimeric, and non-ionic monomeric, 300 mg I/ml, contrast media. Superficial veins of all four extremities and the tail vein were injected with the same amounts of contrast medium after application of tourniquets for 20 minutes following the injections. Silver staining and prefixation of the veins were done in situ. The specimens were evaluated together with cross-sectioned, hematoxylin-eosin stained biopsies. On the basis of a randomized study of 77 dogs, endothelial damage or thrombosis caused by various contrast media as seen in man was not demonstrated. This may be due to species differences. It is postulated that canine endothelium may have a higher resistance to contrast medium injury than human endothelium. (orig.)

  3. Transcatheter aortic-valve implantation with one single minimal contrast media injection.

    Science.gov (United States)

    Arrigo, Mattia; Maisano, Francesco; Haueis, Sabine; Binder, Ronald K; Taramasso, Maurizio; Nietlispach, Fabian

    2015-06-01

    Performing transcatheter aortic valve implantation (TAVI) with the use of minimal contrast in patients at high-risk for acute kidney injury (AKI). Contrast-induced nephropathy (CIN) is a major cause of AKI following TAVI and is associated with increased morbidity and mortality. The amount of contrast media used increases the risk for CIN. Computed tomography was omitted during the screening process. For the procedure transfemoral access was default. The self-expanding CoreValve prosthesis was chosen in all patients to minimize the risk of annular rupture in case of oversizing. Valve sizing was based on echocardiography, aortography, calcification on fluoroscopy, as well as weight and height of the patient. A single contrast injection was performed to confirm correct position of the pigtail catheter at the level of the annulus. The pigtail then served as the marker for the device landing zone. Intraprocedural assessment of the implantation result relied on echocardiography and hemodynamics. Five patients with severe aortic stenosis and at high risk for developing CIN were included. Device success was achieved in all patients and no major complications occurred. The median dose of injected contrast media was 8 ml (4-9). All but one patient had improved renal function after the intervention compared to baseline. Our study shows feasibility of performing TAVI with a single minimal contrast media injection, using a self-expandable valve. This technique has the potential to reduce the incidence of CIN. © 2015 Wiley Periodicals, Inc.

  4. A study on utility of magnetic resonance imaging for female pelvic cavity using enteral MRI contrast media

    International Nuclear Information System (INIS)

    Kim, Ham Gyum

    1997-01-01

    For radiological test in soft tissue or neighboring part with same signal intensity, proper test method and equipment shall be selected as needed. In case of female pelvic cavity, ultrasonography or computed tomography alternatively used, but MRI can be more usefully applied to design treatment method or operation plan by improving the diagnostic accuracy and careful observation of lesion characteristics. Magnetic Resonance Imaging using recently developed Enteral MRI contrast media can acquire more diagnostic information than using only intravenous contrast media. Thus this study attempted to examine the utility of anatomic structure and diagnostic acquisition by imaging the female pelvic cavity using Enteral MRI contrast media. As a result of analyzing magnetic resonance imaging after administering Enteral MRI contrast media to pelvic cavity suspect patients, more diagnostic information media could be acquired than only using intravenous contrast. Especially, in the diagnosis of lesion position, shape, distinction from neighboring tissues it is thought that external Enteral MRI contrast media should be used

  5. Contrast media induced nephropathy: a literature review of the available evidence and recommendations for practice.

    Science.gov (United States)

    Deek, Hiba; Newton, Phillip; Sheerin, Noella; Noureddine, Samar; Davidson, Patricia M

    2014-11-01

    Contrast media induced nephropathy (CIN) is a sudden compromise of renal function 24-48 h after administering contrast medium during a CT scan or angiography. CIN accounts for 10% of hospital acquired renal failure and is ranked the third cause of acquiring this condition. Identifying patients at risk through proper screening can reduce the occurrence of this condition. This review paper aims to critique current evidence, provide a better understanding of CIN, inform nursing practice and make recommendations for bedside nurses and future research. An integrative review of the literature was made using the key terms: "contrast media", "nephritis", "nephropathy", "contrast media induced nephropathy scores", "acute kidney failure", "acute renal failure" and "acute kidney injury". MeSH key terms used in some databases were: "prevention and control", "acute kidney failure" and "treatment". Databases searched included Medline, CINAHL and Academic Search Complete, and references of relevant articles were also assessed. The search included all articles between the years 2000 and 2013. Sixty-seven articles were obtained as a result of the search, including RCTs, systematic reviews, and retrospective studies. Contrast media induced nephropathy is an iatrogenic complication occurring secondary to diagnostic or therapeutic procedures. At times it is unavoidable but a systematic method of risk assessment should be adopted to identify high risk patients for tailored and targeted approaches to management interventions. As the use of contrast media is increasing for diagnostic purposes, it is important that nurses be aware of the risk factors for CIN, identify and monitor high risk patients to prevent deterioration in renal function when possible. Copyright © 2014 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.

  6. Did low tube voltage CT combined with low contrast media burden protocols accomplish the goal of "double low" for patients? An overview of applications in vessels and abdominal parenchymal organs over the past 5 years.

    Science.gov (United States)

    Shen, Yaqi; Hu, Xuemei; Zou, Xianlun; Zhu, Di; Li, Zhen; Hu, Daoyu

    2016-09-01

    Imaging communities have already reached a consensus that the radiation dose of computed tomography (CT) should be reduced as much as reasonably achievable to lower population risks. Increasing attention is being paid to iodinated contrast media (CM) induced nephrotoxicity (CIN); a decrease in the intake of iodinated CM is required by increasingly more radiologists. Theoretically, the radiation dose varies with the tube current time and square of the tube voltage, with higher iodine contrast at low photon energies (Huda et al. [2000] Radiology, 21 7, 430-435).The use of low tube voltage is a promising strategy to reduce both the radiation dose and CM burden. The term 'double low' has been coined to describe scanning protocols that reduce radiation dose and iodine intake synchronously. These protocols are becoming increasingly popular in the clinical setting. The aim of this review was to describe all original studies using the 'double low' strategy in the last 5 years. We searched an online electronic database (PubMed) from January 2011 to December 2015 for original studies published on the relationship of low tube voltage with low radiation dose and low iodine contrast media burden in patients undergoing CT scans. Studies that failed to reduce radiation dose or iodine CM burden were excluded in this study. Thirty-seven studies aimed at reducing radiation dose using low tube voltage combined with iodine CM reduced protocols were included in this study. Most studies evaluated conditions associated with arteries. Four were cerebral and neck computed tomography angiography (CTA) studies, 15 were pulmonary CTA (pCTA) and coronary CTA (cCTA) studies, one concerned myocardial perfusion, five studies focused on the thoracic and abdominal aorta, and one investigated renal arteries. Three studies consisted of CT venography (CTV) of the pelvis and lower extremities. Six publications examined the liver, and two focused on the kidney. Overall, this review demonstrates that

  7. Technology consumption and cognitive control: Contrasting action video game experience with media multitasking.

    Science.gov (United States)

    Cardoso-Leite, Pedro; Kludt, Rachel; Vignola, Gianluca; Ma, Wei Ji; Green, C Shawn; Bavelier, Daphne

    2016-01-01

    Technology has the potential to impact cognition in many ways. Here we contrast two forms of technology usage: (1) media multitasking (i.e., the simultaneous consumption of multiple streams of media, such a texting while watching TV) and (2) playing action video games (a particular subtype of video games). Previous work has outlined an association between high levels of media multitasking and specific deficits in handling distracting information, whereas playing action video games has been associated with enhanced attentional control. Because these two factors are linked with reasonably opposing effects, failing to take them jointly into account may result in inappropriate conclusions as to the impacts of technology use on attention. Across four tasks (AX-continuous performance, N-back, task-switching, and filter tasks), testing different aspects of attention and cognition, we showed that heavy media multitaskers perform worse than light media multitaskers. Contrary to previous reports, though, the performance deficit was not specifically tied to distractors, but was instead more global in nature. Interestingly, participants with intermediate levels of media multitasking sometimes performed better than both light and heavy media multitaskers, suggesting that the effects of increasing media multitasking are not monotonic. Action video game players, as expected, outperformed non-video-game players on all tasks. However, surprisingly, this was true only for participants with intermediate levels of media multitasking, suggesting that playing action video games does not protect against the deleterious effect of heavy media multitasking. Taken together, these findings show that media consumption can have complex and counterintuitive effects on attentional control.

  8. Method for the preparation of new X-ray contrast media

    International Nuclear Information System (INIS)

    1977-01-01

    The chemical preparation is described of contrast media possessing an optimal combination of the following parameters: non-toxicity, non-ionogenicity, osmolality, viscosity, stability, ease and cheapness of preparation. Triiodinated and substituted isophtalamides are used with hydroxyethyl or hydroxypropyl groups as substituents. The result is an aqueous solution of isomers, from which the meso-isomer was removed by crystallization

  9. Saving radiation dose and contrast media in intravenous digital subtraction angiography by use of bolus chasing

    International Nuclear Information System (INIS)

    Rueckforth, J.; Schuermann, K.; Vorwerk, D.; Guenther, R.W.

    1998-01-01

    Purpose: This study evaluates the dose area product, the amount of contrast media and the examination quality of the bolus chasing technique compared to the single-step technique in intravenous digital subtraction angiography. Material and Methods: 15 examinations each with bolus chasing and single-step technique were compared. The dose area product and the volume of contrast media were recorded. The examination quality was scored by two examiners. Results: With bolus chasing the volume of the administered contrast media could be decreased on average by 114 ml (43%). The difference between the dose area product of bolus chasing (722 dGy/cm 2 ) and single-step technique (1910 dGy/cm 2 ) was significant. No significant difference in examination quality was found. Conclusions: The intravenous bolus chasing technique is a practicable method. Compared to the single-step technique it allows a remarkable dose reduction and a low consumption of contrast media without restriction of examination quality. (orig.) [de

  10. Application of contrast media in post-mortem imaging (CT and MRI).

    Science.gov (United States)

    Grabherr, Silke; Grimm, Jochen; Baumann, Pia; Mangin, Patrice

    2015-09-01

    The application of contrast media in post-mortem radiology differs from clinical approaches in living patients. Post-mortem changes in the vascular system and the absence of blood flow lead to specific problems that have to be considered for the performance of post-mortem angiography. In addition, interpreting the images is challenging due to technique-related and post-mortem artefacts that have to be known and that are specific for each applied technique. Although the idea of injecting contrast media is old, classic methods are not simply transferable to modern radiological techniques in forensic medicine, as they are mostly dedicated to single-organ studies or applicable only shortly after death. With the introduction of modern imaging techniques, such as post-mortem computed tomography (PMCT) and post-mortem magnetic resonance (PMMR), to forensic death investigations, intensive research started to explore their advantages and limitations compared to conventional autopsy. PMCT has already become a routine investigation in several centres, and different techniques have been developed to better visualise the vascular system and organ parenchyma in PMCT. In contrast, the use of PMMR is still limited due to practical issues, and research is now starting in the field of PMMR angiography. This article gives an overview of the problems in post-mortem contrast media application, the various classic and modern techniques, and the issues to consider by using different media.