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Sample records for soluble contrast media

  1. 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

  2. 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

  3. 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

  4. 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

  5. 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

  6. 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)

  7. 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

  8. Water-soluble contrast media compared with barium in enteric follow-through

    International Nuclear Information System (INIS)

    Laerum, F.; Stordahl, A.; Aase, S.

    1988-01-01

    The local effects and radiographic efficacy of 4 water-soluble contrast media, barium and saline were evaluated in 86 anaesthetized rats with the distal ileum ligated. The rats were observed for 8 hours after instillation of 3 ml of the test substance via orogastric tube. Radiographs were taken after 1, 4 and 8 hours of observation. After 8 hours the intestines were weighed and biopsied for light microscopy, and blood and urine were sampled for testing. Sodium diatrizoate caused increased fluid influx to the bowel lumen and, like barium, provided poorer radiographic images as compared with iohexol, ioxaglate or iodixanol. Barium showed slower progression through the small bowel than the other agents, while sodium diatrizoate was the most rapidly progressing contrast medium and caused the greatest distension. Correlation to osmolality was obvious. No significant morphologic effects on the small bowel mucosa were seen in any of the groups. Low-osmolar, water-soluble contrast media may have prospects for clinical use in patients with suspected small bowel obstruction. (orig.)

  9. Ventriculography and cisternography with water-soluble contrast media in infants with myelomeningocele

    International Nuclear Information System (INIS)

    Yamada, H.; Nakamura, S.; Tanaka, Y.; Tajima, M.; Kageyama, N.

    1982-01-01

    Fifty-four newborn infants with myelomeningocele and hydrocephalus were studied by ventriculography using water-soluble contrast media; 20 were also studied by metrizamide myeloencephalography and computerized tomographic (CT) cisternography. Ventriculography suggested that the aqueduct was patent in all cases. Outflow of contrast medium from the fourth ventricle was slow in most cases, complete obstruction was seen in 15%, communication was delayed at the outlet in 54%, and rather free communication was observedin 31%. Metrizamide myeloencephalography and CT cisternography suggested a partial block at the level of the ambient cisterns in approximately one-third of infants. These findings support the concept that flow of cerebrospinal fluid is reduced in several areas. Aqueductal stenosis was not considered an important factor in hydrocephalus, while the most important site of obstruction was felt to be the lowest portion of the fourth ventricle

  10. 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

  11. Lumbar myelography using water-soluble contrast media. Lumbale Myelographie mit wasserloelichen Kontrastmitteln. Lehrbuch und Atlas

    Energy Technology Data Exchange (ETDEWEB)

    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.

  12. 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)

  13. 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

  14. 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.)

  15. 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.

  16. Skin necrosis following extravasation of water soluble contrast media-report of 2 cases

    Energy Technology Data Exchange (ETDEWEB)

    Park, Jae Hyung; Kim, Seung Hyup; Shin, Myung Jin; Minn, Kyung Won; Park, Chul Kyu [College of Medicine, Seoul National University, Seoul (Korea, Republic of); Kim, Jong Chul [Kyung Sang Medical College, Jinju (Korea, Republic of)

    1987-08-15

    Two cases of skin necrosis following extravasation of contrast media for intravenous pyelography and computed tomography were experienced in the Department of Radiology, Seoul National University Hospital. The first case was 4 years old girl who suffered from known nephrotic syndrome. About 15cc of meglumine ioxitalamate (Telebrix 30) was injected through 25G needle at dorsum of left foot to visualize the urinary tract for renal biopsy. The 2nd case was 3 years old girl who suffered from seizure. About 12cc of meglumine ioxitalamate (Telebrix 30) was injected through 25G needle at dorsum of left foot. In both cases the dorsum of foot was swollen immediately after the extravastion of the contrast media. Following discoloration the skin showed vesicles with erythema. Consequently the skin showed white discoloration and ulcerated to form crust. In the former case, skin graft was applied successfully. However, in the latter, the lesion healed with only supportive dressings.

  17. 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

  18. Penetration of the brain by nonionic water soluble tri- and hexaiodinated contrast media

    International Nuclear Information System (INIS)

    Castel, J.C.; Corcier, F.; Caille, J.M.

    1987-01-01

    After suboccipital injection of Iotrol and Iopamidol labelled with iodine 125 in rabbits, we measured residual radioactivity in the whole brain and measured optical density on autoradiographs of brain sections obtained 2, 8 and 24 h after injection. Residual radioactivity is higher with Iotrol than with Iopamidol after 8 h and 24 h. At densitometry, while the penetration of the cortex is the same with both media at 2 h (although subcortical passage of Iotrol is greater) by 8 h the concentration of Iopamidol is twice that of Iotrol, and at 24 h it is three times as high. A similar pattern was seen in the subcortical region. These densitometric findings are in agreement with previous electrophysiological studies, in which changes were less severe and more transient with Iotrol than with Iohexol. There is nevertheless an apparent lack of agreement between the studies of radioactivity studies and the electrical findings. The lower neurotoxicity of Iotrol may be explained by: 1. a longer half-life in the subarachnoid space; 2. its larger molecules, which inhibit diffusion in the extracellular fluid, and 3. its more hydrophilic nature, which reduces intracellular penetration. (orig.)

  19. 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.)

  20. Interindividual testing of water-soluble oral contrast media in respect of diagnostic ranking, side effects and taste

    International Nuclear Information System (INIS)

    Staebler, A.; Fink, U.; Siuda, S.; Neville, S.

    1989-01-01

    Three groups of patients (n = 55, 52 and 54) were examined with the X-ray contrast media Gastrografin, Peritrast-Oral GI, and Telebrix Gastro to assess the diagnostic ranking, side effects and taste of watersoluble oral contrast media. No significant differences were seen in respect of diagnostic ranking and side effects. Side effects were exclusively abdominal symptoms; there was no difference with regard to laxative action. Telebrix Gastroas accepted significantly better in respect of taste than Gastrografin and Peritrast-Oral GI. (orig.) [de

  1. 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.)

  2. 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.)

  3. 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.)

  4. 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)

  5. 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.)

  6. 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.)

  7. Radiculography with water-soluble contraste medium

    International Nuclear Information System (INIS)

    Araujo Pinheiro, R.S. de

    1987-01-01

    The etiologic diagnosis of the lumbar pain is discussed. The radiculography with water-soluble contrast medium is used and 250 cases are studied. Some practical criteria of indication executation and interpretation of the examination are reported. (M.A.C.) [pt

  8. 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

  9. 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

  10. Solubility limited radionuclide transport through geologic media

    International Nuclear Information System (INIS)

    Muraoka, Susumu; Iwamoto, Fumio; Pigford, T.H.

    1980-11-01

    Prior analyses for the migration of radionuclides neglect solubility limits of resolved radionuclide in geologic media. But actually some of the actinides may appear in chemical forms of very low solubility. In the present report we have proposed the migration model with no decay parents in which concentration of radionuclide is limited in concentration of solubility in ground water. In addition, the analytical solutions of the space-time-dependent concentration are presented in the case of step release, band release and exponential release. (author)

  11. 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

  12. 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.)

  13. 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.)

  14. 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

  15. 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.)

  16. 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.)

  17. 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

  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. 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

  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. 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.)

  6. 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).

  7. 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.)

  8. 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.)

  9. 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.

  10. 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)

  11. 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

  12. 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.)

  13. 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)

  14. Oral water soluble contrast for malignant bowel obstruction.

    Science.gov (United States)

    Syrmis, William; Richard, Russell; Jenkins-Marsh, Sue; Chia, Siew C; Good, Phillip

    2018-03-07

    Malignant bowel obstruction (MBO) is a common problem in patients with intra-abdominal cancer. Oral water soluble contrast (OWSC) has been shown to be useful in the management of adhesive small bowel obstruction in identifying patients who will recover with conservative management alone and also in reducing the length of hospital stay. It is not clear whether the benefits of OWSC in adhesive small bowel obstruction are also seen in patients with MBO. To determine the reliability of OWSC media and follow-up abdominal radiographs in predicting the success of conservative treatment in resolving inoperable MBO with conservative management.To determine the efficacy and safety of OWSC media in reducing the duration of obstruction and reducing hospital stay in people with MBO. We identified studies from searching Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and MEDLINE in Process, Embase, CINAHL, Science Citation Index (Web of Science) and Conference Proceedings Citation Index - Science (Web of Science). We also searched registries of clinical trials and the CareSearch Grey Literature database. The date of the search was the 6 June 2017. Randomised controlled trials (RCTs), or prospective controlled studies, that evaluated the diagnostic potential of OWSC in predicting which malignant bowel obstructions will resolve with conservative treatment.RCTs, or prospective controlled studies, that assessed the therapeutic potential of OWSC in managing MBO at any level compared with placebo, no intervention or usual treatment or supportive care. We used standard methodological procedures expected by Cochrane. We assessed risk of bias and assessed the evidence using GRADE and created a 'Summary of findings' table. We found only one RCT meeting the selection criteria for the second objective (therapeutic potential) of this review. This study recruited nine participants. It compared the use of gastrografin versus placebo in adult patients with MBO with no

  15. 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

  16. 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.)

  17. 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.)

  18. 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

  19. 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

  20. 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...

  1. 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

  2. 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.)

  3. 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

  4. 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

  5. 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)

  6. 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

  7. 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

  8. 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...

  9. 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.

  10. 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.)

  11. 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.

  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. 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 ...

  15. [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

  16. 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)

  17. 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

  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. 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

  20. 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

  1. Solubility and stability of dalcetrapib in vehicles and biological media.

    Science.gov (United States)

    Gross, Günter; Tardio, Joseph; Kuhlmann, Olaf

    2012-11-01

    Dalcetrapib solubility was determined in aqueous and in non-aqueous vehicles and in biorelevant media. In a pure aqueous environment the solubility was low but could be increased by addition of surfactants or complexing agents. This was also reflected in the solubility seen in simulated gastrointestinal (GI) fluids, with almost no solubility in simulated gastric fluid, but reasonable solubilisation in simulated intestinal fluids containing lecithin and bile salt. Additionally, the stability of dalcetrapib was determined in simulated GI fluids with and without pancreatic lipase. In solutions without lipase, dalcetrapib was slowly hydrolysed, but in the presence of lipase the hydrolysis rate was significantly faster depending on pH and enzyme activity. In biological fluids, dissolved dalcetrapib appeared to behave similarly being rapidly hydrolysed in human intestinal fluids with a half-life below 20s with no degradation observed in human gastric fluids at low pH. The results provide supportive evidence that absorption is higher under fed conditions and indicate lipase inhibitors might interfere with oral absorption of dalcetrapib. Copyright © 2012 Elsevier B.V. All rights reserved.

  2. 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

  3. 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)

  4. 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

  5. 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....

  6. 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

  7. 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.)

  8. 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)

  9. 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)...

  10. 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...

  11. 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...

  12. 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.

  13. 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)

  14. 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

  15. 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

  16. 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...

  17. 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

  18. 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

  19. 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.)

  20. 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.)

  1. 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

  2. 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

  3. Radiographic and Histologic Study After Infusion of Contrast Media into Rabbit Submandibular Gland

    International Nuclear Information System (INIS)

    Nah, Kyung Soo; Park, Tae Won

    1990-01-01

    50 submandibular glands of rabbits were examined historadiologically after infusion with normal and over volumes of physiologic saline and 5 radiographic contrast media. The results were as follows: 1. All water soluble contrast media showed similar radiographic contrasts and absorbed about 5 minutes after infusion except Telebrix 30 which took 30 minutes in both normal and overfilled glands. 2. Lipid soluble medium, Lipiodol UF had excellent radiographic contrast and could be seen on the radiograms even after 24 hours after infusion. 3. Salivary glands infused with physiologic saline didn't show any histologic changes except slight duct dilation right after infusion. 4. Telebrix 30 caused mild to moderate duct dilation and inflammation at immediate and 24 hours after infusion which was more severe in overfilled glands. At 7 days after infusion, there were mild to moderate fibrosis of the gland and areas of necrosis was seen in overfilled glands. 5. Hypaque 60% showed similar histologic reactions to Telebrix 30 except more severe tissue destruction at 7 days after infusion. 6. Urografin 60% showed mildest histologic changes among the media used in the study. 7. Biliscopin had mild duct dilation which returned to normal after 7 days but there were moderate inflammation and tissue necrosis at that time. 8. Lipiodol UF showed severe duct dilation with numerous vacuoles and there were tissue fibrosis at 7 days after infusion but no tissue necrosis was seen.

  4. 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.

  5. 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.)

  6. 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.).

  7. 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.)

  8. 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)

  9. 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

  10. 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.

  11. 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

  12. 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

  13. 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.)

  14. 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.

  15. 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

  16. 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.

  17. 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.

  18. 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.)

  19. 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)

  20. 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

  1. 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

  2. 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.

  3. 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.)

  4. 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

  5. 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

  6. 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.)

  7. 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.

  8. 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....

  9. 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

  10. Ultrastructural study on the effects of retrograde infusion of water-soluble contrast medium the rabbit submandibular gland

    International Nuclear Information System (INIS)

    Kim, Eun Kyung; Park, Tae Won

    1987-01-01

    The author observed the effects of retrograde infusion of water soluble contrast media (Telebrix 30) on the rabbit submandibular glands and compared the effects of different degrees of filling. 26 rabbit were divided into 2 group of 1 2 each as experimental and 1 group of 2 as normal controls. One experimental group was filed with 0.2 ml and the other with 0.4 ml. Right submandibular gland of each rabbit was infused with contrast media and left one with physiologic saline as a ex perimental control, at a constant rate of 0.12 ml/min. Using an infusion pump via the main excretory duct. Immediately after the inclusion of contrast media, oblique lateral radiographs of the glands were made with occlusal film in order to confirm the glandular filling. The rabbit were sacrificed after varying periods (1, 8, 24 hours and 3, 6, 10 days) and the tissues were prepared for light and electron microscopic examination. The results were as follows: 1. In glands filled with 0.2 ml contrast media, the initial changes were a few vacuole formation in the acini and slight dilation of the intralobular duct. The moderately severe changes such as vacuole formation in the acini, the abnormal substructure within the secretory granule, dilation of acinar and intercalated duct lumen, scalloping of striated duct lumen and inflammatory cell infiltrate were observed at 3 days. The general appearance was successively recovered, so the tissue had a normal appearance at 10 days. 2. In glands filled with 0.4 ml contrast media, the most prominent alterations such as severe acinar atrophy, decreased number of secretory granules, proliferation of connective tissue stroma and pronounced inflammatory cell infiltrates appeared at 6 days. Although the general appearance returned to be almost normal at 10 days, acinar cells showed some atrophy and decreased secretory granules. 3. In glands subjected to 0.4 ml infusion, the alterations were more severe and recovery was slower than those seen in the glands

  11. 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.

  12. 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

  13. Indirect caudal lymphography using a new water-soluble contrast agent - animal experimental studies in pigs

    International Nuclear Information System (INIS)

    Apitzsch, D.E.; Kroll, H.U.; Zuehlke, H.V.

    1981-01-01

    Animal experiments on caudal lymphography in pigs are presented, using a new water-soluble contrast medium which is renally excreted. Indirect cutaneous administration renders possible the radiological visualization of the entire lymphatic drainage system of the lower limb, the retro-peritoneal space and the thoracic duct. Visualization of the lymphatic system is rapid, homogeneous and can be repeated as often as desired. The quality of the lymphogram is as good as that obtained by the current methods in common use. (orig.)

  14. 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.

  15. 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

  16. 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.

  17. 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.)

  18. 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

  19. 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.

  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. 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

  2. Importance of critical micellar concentration for the prediction of solubility enhancement in biorelevant media.

    Science.gov (United States)

    Ottaviani, G; Wendelspiess, S; Alvarez-Sánchez, R

    2015-04-06

    This study evaluated if the intrinsic surface properties of compounds are related to the solubility enhancement (SE) typically observed in biorelevant media like fasted state simulated intestinal fluids (FaSSIF). The solubility of 51 chemically diverse compounds was measured in FaSSIF and in phosphate buffer and the surface activity parameters were determined. This study showed that the compound critical micellar concentration parameter (CMC) correlates strongly with the solubility enhancement (SE) observed in FaSSIF compared to phosphate buffer. Thus, the intrinsic capacity of molecules to form micelles is also a determinant for each compound's affinity to the micelles of biorelevant surfactants. CMC correlated better with SE than lipophilicity (logD), especially over the logD range typically covered by drugs (2 < logD < 4). CMC can become useful to guide drug discovery scientists to better diagnose, improve, and predict solubility in biorelevant media, thereby enhancing oral bioavailability of drug candidates.

  3. 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

  4. 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

  5. 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)

  6. The effects of water soluble contrast agents on the respiratory tract

    International Nuclear Information System (INIS)

    Lovett, I.; Donchey, S.; Doust, B.; Branson, J.; Munro, V.

    1989-01-01

    The water soluble contrast agents Gastrografin R (Sodium diatrizoate and meglumine diatrizoate, Schering, Berlin), Iopamiro 300 R (Iopamidol, Schering, Berlin), and Dionosil Aqueous R (propyliodone BP, Glaxo, England) were instilled into the tracheobronchial tree of rats in doses of either 0.1 ml and 0.25 ml. Rats being used as controls, underwent sham operations with the instillation of air instead of contrast agent. In all, 85 rats were used. All rats that had not already died from the effects of contrast agent were sacrificed 30 minutes after instillation. The relative effects of the contrast agents were measured by comparing: survival time; radiographic effects of the contrast agents on the lungs; and pathological changes as estimated by post mortem lung section and microscopy. The least toxic agent was the one with the lowest osmotic activity, namely Aqueous Dionosil. It is therefore recommended that Aqueous Dionosil be used in preference to Gastrografin or Iopamidol for studies of the oesophagus whenever there is a danger of aspiration of contrast agent into the tracheobronchial tree. 11 refs., 3 figs., 5 tabs

  7. 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

  8. 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

  9. 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.

  10. Application To Bilayer System With Water-Soluble Contrast Enhancing Material

    Science.gov (United States)

    Yabuta, Mitsuo; Ito, Naoki; Yamazaki, Hiroyuki; Nakayama, Toshimasa

    1987-09-01

    We have developed ,a water-soluble contrast enhancing material, TAD-436 ( Tokyo Ohka. Anti-Defocus Material ) which is consisted of a water-soluble diazonium salt as bleaching compounds and a water-soluble anion type polymer as binder polymers. Needless to say that water is used as solvent in TAD; therefore, it can be spincoated directly on a positive photoresist layer of a quinonediazide-novolak resin type without causing intermixing and furtheremore the bilayer can be developed without stripping TAD immediately after exposure. TAD shows a satisfactory bleaching characteristics on g-line, increases r-value of underlying photoresist and reduces the thickness loss of photoresist layer in unexposed area. Application to bilayer system with TAD will raise the resolution of underlying photoresist and when the focus depth is changed it will make the change in the resist profile small. As the result of it, the notches in the resist patterns on steps is reduced, making the difference in the linewidth between the top and the bottom of steps small.

  11. 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.)

  12. 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

  13. Improved Bilayer Resist System Using Contrast-Enhanced Lithography With Water-Soluble Photopolymer

    Science.gov (United States)

    Sasago, Masaru; Endo, Masayuki; Hirai, Yoshihiko; Ogawa, Kazufurni; Ishihara, Takeshi

    1986-07-01

    A new water-soluble contract enhanced material, WSP (Water-soluble Photopolymer), has been developed. The WSP is composed of a mainpolymer and a photobleachable reagents. The mainpolymer is a water-soluble polymer mixed with pullulan (refined through biotechnological process) and polyvinyl-pyrolidone (PVP). The photo-bleachable reagent is of a diazonium compound gorup. The introduction of the mainpolymer and photobleach-able reagent mixture has improved filmity, gas transparency, photobleaching characteristics and solubility in alkaline which are essential to the device fabrication. Submicron photoresist patterns are successfully fabricated by a simple sequence of photolithography process. The WSP layer has been applied to the bilayer resist system--deep-UV portable conformable masking (PCM)--that is not affected by VLSI's topography, and is able to fabricate highly accurate pattern. The aqueous developable layer, PMGI, with high organic solvent resistance is used in the bottom layer. Therefore, no interfacial mixing with conventional positive resist top layer is observed. Furthermore, deep-UV exposure method has been used for the KrF excimer laser optical system in order to increase high throughput. From the experiments, it has been confirmed that good resist transfer profile can be realized by the use of WSP, and that the submicron resist patterns with high aspect-ratio can be developed on the nonplaner wafer with steps of up to 41m by the combination of the WSP with the PCM system. By this technology, has been improved the weak point: variation in the line width due to the thickness of contrast-enhanced layer when the CEL technology is applied, and dependency of both the finished resist profile and the line-width accuracy on the thickness of the top layer resist when the PCM system is adopted.

  14. 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.

  15. 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.

  16. Weak bases and formation of a less soluble lauryl sulfate salt/complex in sodium lauryl sulfate (SLS) containing media.

    Science.gov (United States)

    Bhattachar, Shobha N; Risley, Donald S; Werawatganone, Pornpen; Aburub, Aktham

    2011-06-30

    This work reports on the solubility of two weakly basic model compounds in media containing sodium lauryl sulfate (SLS). Results clearly show that the presence of SLS in the media (e.g. simulated gastric fluid or dissolution media) can result in an underestimation of solubility of some weak bases. We systematically study this phenomenon and provide evidence (chromatography and pXRD) for the first time that the decrease in solubility is likely due to formation of a less soluble salt/complex between the protonated form of the weak base and lauryl sulfate anion. Copyright © 2011 Elsevier B.V. All rights reserved.

  17. 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.

  18. 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.

  19. The use of low-osmolar water-soluble contrast in videofluoroscopic swallowing exams.

    Science.gov (United States)

    Harris, Julie A; Bartelt, Detlef; Campion, Molly; Gayler, Bob W; Jones, Bronwyn; Hayes, Andrea; Haynos, Judith; Herbick, Seanne; Kling, Therese; Lingaraj, Arpana; Singer, Michele; Starmer, Heather; Smith, Christine; Webster, Kim

    2013-12-01

    The selection of the contrast agent used during fluoroscopic exams is an important clinical decision. The purpose of this article is to document the usage of a nonionic, water-soluble contrast (iohexol) and barium contrast in adult patients undergoing fluoroscopic exams of the pharynx and/or esophagus and provide clinical indications for the use of each. For 1 year, data were collected on the use of iohexol and barium during fluoroscopic exams. The contrast agent used was selected by the speech language pathologist (SLP) or the radiologist based on the exam's indications. A total of 1,978 fluoroscopic exams were completed in the 12-month period of documentation. Of these exams, 60.6 % were completed for medical reasons and 39.4 % for surgical reasons. Fifty-five percent of the exams were performed jointly by a SLP and a radiologist and 45 % were performed by a radiologist alone. Aspiration was present in 22 % of the exams, vestibular penetration occurred in 38 %, extraluminal leakage of contrast was observed in 4.6 %, and both aspiration and leakage were seen in 1 % of the exams. In cases with aspiration, iohexol was used alone in 8 %, iohexol and barium were both used in 45 %, and barium was used alone in 47 %. In cases with extraluminal leakage, iohexol was used alone in 58 %, iohexol and barium were both used in 31 %, and barium was used alone in 11 %. No adverse effects were seen with the use of iohexol. When barium was used in cases of aspiration and extraluminal leakage, the amount of aspirated barium was small and the extraluminal barium in the instances of leakage was small. Iohexol is a useful screening contrast agent and can safely provide information, and its use reduces the risk of aspiration and the chance of leakage of large amounts of barium.

  20. 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.

  1. 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.

  2. Solubility of iron from combustion source particles in acidic media linked to iron speciation.

    Science.gov (United States)

    Fu, Hongbo; Lin, Jun; Shang, Guangfeng; Dong, Wenbo; Grassian, Vichi H; Carmichael, Gregory R; Li, Yan; Chen, Jianmin

    2012-10-16

    In this study, iron solubility from six combustion source particles was investigated in acidic media. For comparison, a Chinese loess (CL) dust was also included. The solubility experiments confirmed that iron solubility was highly variable and dependent on particle sources. Under dark and light conditions, the combustion source particles dissolved faster and to a greater extent relative to CL. Oil fly ash (FA) yielded the highest soluble iron as compared to the other samples. Total iron solubility fractions measured in the dark after 12 h ranged between 2.9 and 74.1% of the initial iron content for the combustion-derived particles (Oil FA > biomass burning particles (BP) > coal FA). Ferrous iron represented the dominant soluble form of Fe in the suspensions of straw BP and corn BP, while total dissolved Fe presented mainly as ferric iron in the cases of oil FA, coal FA, and CL. Mössbauer measurements and TEM analysis revealed that Fe in oil FA was commonly presented as nanosized Fe(3)O(4) aggregates and Fe/S-rich particles. Highly labile source of Fe in corn BP could be originated from amorphous Fe form mixed internally with K-rich particles. However, Fe in coal FA was dominated by the more insoluble forms of both Fe-bearing aluminosilicate glass and Fe oxides. The data presented herein showed that iron speciation varies by source and is an important factor controlling iron solubility from these anthropogenic emissions in acidic solutions, suggesting that the variability of iron solubility from combustion-derived particles is related to the inherent character and origin of the aerosols themselves. Such information can be useful in improving our understanding on iron solubility from combustion aerosols when they undergo acidic processing during atmospheric transport.

  3. 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

  4. Follow-up barium study after a negative water-soluble contrast examination for suspected esophageal leak: is it necessary?

    Science.gov (United States)

    Sanchez, Thomas R; Holz, Grant S; Corwin, Michael T; Wood, Robert J; Wootton-Gorges, Sandra L

    2015-10-01

    The purpose of this study was to determine the value of follow-up barium esophogram in diagnosing esophageal injury or leak if the initial water-soluble contrast examination of the esophagus is normal. An institutional review board (IRB)-approved retrospective review of all pediatric patients less than 18 years old referred to the radiology department for evaluation of esophageal injury or leak was performed for a 9-year period from 2005 to 2014. The majority of patients had unexplained pneumomediastinum, chest trauma (gunshot or puncture wound), or foreign body ingestion as the reason for the referral. Forty-nine patients (age range 10 days to 17 years) underwent an initial water-soluble esophogram immediately followed by a barium esophogram. Forty-six studies were negative on both water-soluble contrast and barium studies. Two studies were both positive on the initial water-soluble contrast and subsequent barium studies. A single study showed the esophageal leak only in the water-soluble study, with the follow-up barium exam being normal. The result of this study indicates that a single-contrast water-soluble esophogram alone is sensitive in the diagnosis of esophageal injury or leak. It has a 100 % sensitivity and negative predictive value. A follow-up barium esophogram only increases the study time and radiation dose to the patient.

  5. 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

  6. 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.)

  7. 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

  8. 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.

  9. 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...

  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. 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)

  12. 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.)

  13. 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

  14. 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

  15. 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.)

  16. 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.)

  17. 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)

  18. 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.

  19. 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

  20. 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

  1. 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

  2. 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.

  3. 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

  4. 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

  5. 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.

  6. 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

  7. 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.

  8. Effect of composition of simulated intestinal media on the solubility of poorly soluble compounds investigated by design of experiments

    DEFF Research Database (Denmark)

    Madsen, Cecilie Maria; Feng, Kung-I; Leithead, Andrew

    2018-01-01

    The composition of the human intestinal fluids varies both intra- and inter-individually. This will influence the solubility of orally administered drug compounds, and hence, the absorption and efficacy of compounds displaying solubility limited absorption. The purpose of this study was to assess...... studies feasible compared to single SIF solubility studies. Applying this DoE approach will lead to a better understanding of the impact of intestinal fluid composition on the solubility of a given drug compound....

  9. 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.

  10. 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

  11. 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

  12. Acid-base equilibria and solubility of loratadine and desloratadine in water and micellar media.

    Science.gov (United States)

    Popović, Gordana; Cakar, Mira; Agbaba, Danica

    2009-01-15

    Acid-base equilibria in homogeneous and heterogeneous systems of two antihistaminics, loratadine and desloratadine were studied spectrophotometrically in Britton-Robinson's buffer at 25 degrees C. Acidity constant of loratadine was found to be pK(a) 5.25 and those of desloratadine pK(a1) 4.41 and pK(a2) 9.97. The values of intrinsic solubilities of loratadine and desloratadine were 8.65x10(-6) M and 3.82x10(-4) M, respectively. Based on the pK(a) values and intrinsic solubilities, solubility curves of these two drugs as a function of pH were calculated. The effects of anionic, cationic and non-ionic surfactants applied in the concentration exceeding critical micelle concentration (cmc) on acid-base properties of loratadine and desloratadine, as well as on intrinsic solubility of loratadine were also examined. The results revealed a shift of pK(a) values in micellar media comparing to the values obtained in water. These shifts (DeltapK(a)) ranged from -2.24 to +1.24.

  13. 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.

  14. 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

  15. 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

  16. 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)

  17. 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

  18. 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.

  19. 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

  20. 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.

  1. 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

  2. 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.

  3. 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.,

  4. 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....

  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. 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

  8. 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...

  9. A novel water soluble solvatochromic probe as a micropolarity reporter for homogeneous and microheterogeneous media

    Energy Technology Data Exchange (ETDEWEB)

    Sarkar, Amrita; Kedia, Niraja [Department of Chemical Sciences, Indian Institute of Science Education and Research, Kolkata, Mohanpur Campus, BCKV Main P.O., Mohanpur 741252, Nadia, WB (India); Bagchi, Sanjib, E-mail: bsanjibb@yahoo.com [Department of Chemistry and Biochemistry, Presidency University, 86/1 College Street, Kolkata 700073 (India)

    2014-07-01

    A new water soluble donor–acceptor dye, sodium 4-(methyl((1E,3E)-3-(1-oxo-1H-inden-2(3H)-ylidene)prop-1-enyl)amino) benzoate (DN3) has been synthesized. Optical response of the solvatochromic dye (DN3) has been studied in various homogeneous (neat and mixed binary solvents) and heterogeneous (SDS and CTAB homomicelle and β-cyclodextrin nanocavity) media. To get information regarding the change in the solvation interaction of the dye with the alteration in its microenvironment in different media, the photophysical properties of the dye have been monitored in various media using steady state and time resolved spectral analysis. Results obtained for mixed binary solvents containing water indicate that the solute is preferentially solvated by one of the component solvents and solvent–solvent interactions are also important in determining the preference. Effect of variation of pH in aqueous medium on the spectroscopic parameters of the dye has been studied and its pKa has been estimated. Studies in homomicelles (SDS and CTAB) reveal that the dye distributes itself between the aqueous and the micellar phase and the values of distribution coefficient have been estimated from the fluorescence parameters. The dye is encapsulated in β-cyclodextrin nanocavity and a 1:2 dye-β-cyclodextrin host–guest interaction is indicated. Semi-empirical quantum chemical calculations have been carried out to support the experimental results. - Highlights: • A water soluble fluorescent dye has been synthesized and studied in various media. • The dye is sensitive towards changes in micropolarity and pH of the medium. • Study in mixed binary solvent system indicates preferential solvation of the dye. • Stronger interaction of the dye is indicated with CTAB micelles compared to SDS. • Study in aqueous β-CD medium reveals favorable 1:2 binding of the dye with β-CD.

  10. 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)

  11. 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.)

  12. 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

  13. 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

  14. 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.

  15. 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

  16. 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.)

  17. 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

  18. 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

  19. 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.

  20. 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

  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. 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

  3. 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.

  4. 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

  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. 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

  7. 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

  8. 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

  9. 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

  10. 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.

  11. 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

  12. 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

  13. 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.

  14. [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.

  15. 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

  16. 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

  17. 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.

  18. 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

  19. Absence of functional renal effects of uro-angiographic contrast media on post-ischemic rat kidneys

    International Nuclear Information System (INIS)

    Verbaeys, A.; Maele, G. van; Sy, W. de; Ringoir, S.; Lameire, N.; University Hospital, Ghent; University Hospital, Ghent

    1991-01-01

    Water soluble ionic contrast media (CM) and glucose 5% were administered to Sprague-Dawley rats 36 hours after bilateral warm renal ischemia for 45 min. In all animals (n=28) the renal ischemia caused a decrease of the absolute urinary creatinine output. Intraarterial injection of glucose 5% or CM did not produce different patterns of absolute urinary creatinine output. The serum creatinine increased after 36 hours of reflow. When compared by means of a Mann-Whitney U-test to a normal median serum creatinine obtained in a separate group of 22 normal rats, the increase was statistically significant (p≤0.01). The serum creatinine medians returned to a normal level after 24 hours. It seems therefore that 45 min of warm renal ischemia and 36 hours of reflow is an insufficient challenge to the rat kidney for the detection of the nephrotoxic properties of CM as opposed to when CM are injected during ischemia. (orig.)

  20. Solubility behavior of narcotic analgesics in aqueous media: solubilities and dissociation constants of morphine, fentanyl, and sufentanil.

    Science.gov (United States)

    Roy, S D; Flynn, G L

    1989-02-01

    The pH dependence of the aqueous solubility of morphine, fentanyl, and sufentanil was investigated at 35 degrees C. Dissociation constants and corresponding pKa' values of the drugs were obtained from measured free-base solubilities (determined at high pH's) and the concentrations of saturated solutions at intermediate pH's. Morphine, fentanyl, and sufentanil exhibited pKa' values of 8.08, 8.99, and 8.51, respectively. Over the pH range of 5 to 12.5 the apparent solubilities are determined by the intrinsic solubility of the free base plus the concentration of ionized drug necessary to satisfy the dissociation equilibrium at a given pH. Consequently, the drug concentrations of saturated aqueous solutions fall off precipitously as the pH is raised and ionization is suppressed. Further, at low pH's the aqueous solubility of morphine increased in a linear fashion with increases in the molar strength of citric acid which was added to acidify the medium, suggesting the formation of a soluble morphine-citrate complex.

  1. 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.

  2. 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.

  3. 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.)

  4. 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.

  5. [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.

  6. Environmental behaviour und ecotoxiology of gadolinium-containing MRT contrast media; Umweltverhalten und Oekotoxikologie von gadoliniumhaltigen Magnetresonanztomographie-Kontrastmitteln

    Energy Technology Data Exchange (ETDEWEB)

    Neubert, Claudia

    2008-07-08

    Magnetic resonance imaging (MRI) is an essential tool in noninvasive diagnostics. In order to improve the sensitivity and specificity of diagnoses, several contrast enhancing agents have been developed in the last few decades by various pharmaceutical manufacturers. Gadolinium (Gd), a lanthanide, is the most widely used metal in MRI contrast agents. Its ion has paramagnetic properties (seven unpaired electrons) and a very long electronic relaxation time. Due to the toxicity of free Gd, clinical use is only possible in a complexed form. Commonly used chelating agents are polyamino-polycarboxylic ligands such as DTPA. Due to the exceptional stability of these highly hydrophilic chelates and the lack of human metabolism, the contrast media are quantitatively excreted unchanged after the administration, and are subsequently emitted into the aquatic environment. Several studies have shown notable increases in Gd concentrations in surface or groundwaters receiving sewage effluents, an observation which has been termed ''Gd anomaly''. The Gd anomaly results from the use of MRI contrast agents for which the most significant entry route is the effluent from wastewater treatment works. Relatively little information on the aquatic toxicity of Gd or Gd-chelates has been published up to 2006. Therefore, in a first step, the acute aquatic toxicity of several MRI contrast agents was investigated in fish, daphnia and algae at high concentrations. Furthermore, chronic toxicity tests on fish and daphnia were conducted. The results showed that contrast enhancing agents containing Gd have no toxic effects on the tested organisms at concentrations being of relevance to the environment. At high concentrations growth inhibition of green algae was observed. The environmental fate and the biological degradation of the contrast media was studied in a model wastewater treatment plant and in aquatic sediment systems. The test compounds were neither biodegradable in the

  7. 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

  8. 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

  9. 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.)

  10. 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.

  11. 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

  12. 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.

  13. The Comparison of Sorption and Solubility Behavior of Four Different Resin Luting Cements in Different Storage Media.

    Science.gov (United States)

    Giti, Rashin; Vojdani, Mahroo; Abduo, Jaafar; Bagheri, Rafat

    2016-06-01

    Structural integrity and dimensional stability are the key factors that determine the clinical success and durability of luting cements in the oral cavity. Sorption and solubility of self-adhesive resin luting cements in food-simulating solutions has not been studied sufficiently. This study aimed to compare the sorption and solubility of 2 conventional and 2 self-adhesive resin-based luting cements immersed in four different storage media. A total of 32 disc-shaped specimens were prepared from each of four resin luting cements; seT (SDI), Panavia F (Kuraray), Clearfil SA Cement (Kuraray), and Choice 2 (Bisco). Eight specimens of each material were immersed in all tested solutions including n-heptane 97%, distilled water, apple juice, or Listerine mouth wash. Sorption and solubility were measured by weighing the specimens before and after immersion and desiccation. Data were analyzed by SPSS version 18, using two-way ANOVA and Tukey's HSD test with p≤ 0.05 set as the level of significance. There was a statistically significant interaction between the materials and solutions. The effect of media on the sorption and solubility was material-dependent. While seT showed the highest values of the sorption in almost all solutions, Choice 2 showed the least values of sorption and solubility. Immersion in apple juice caused more sorption than other solutions (p≤ 0.05). The sorption and solubility behavior of the studied cements were significantly affected by their composition and the storage media. The more hydrophobic materials with higher filler content like Choice 2 resin cement showed the least sorption and solubility. Due to their lower sorption and solubility, these types of resin-based luting cements are recommended to be used clinically.

  14. 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.)

  15. 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

  16. 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

  17. 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.

  18. 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

  19. 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

  20. 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

  1. 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.

  2. Thermodynamic aspects of solubility and partitioning processes of some sulfonamides in the solvents modeling biological media

    International Nuclear Information System (INIS)

    Perlovich, German L.; Ryzhakov, Alex M.; Strakhova, Nadezda N.; Kazachenko, Vladimir P.; Schaper, Klaus-Jürgen; Raevsky, Oleg A.

    2014-01-01

    Highlights: • Solubility processes of some sulfonamide isomers in water and 1-octanol were investigated. • Transfer processes from water to 1-octanol were evaluated by analysis of enthalpic and entropic terms. • Impact of various substituents in phenyl rings on solubility and transfer processes was studied. -- Abstract: The thermodynamic aspects of solubility processes of sulfonamides (SAs) with the general structures 4-NH 2 –C 6 H 4 –SO 2 NH–C 6 H 2 (R 1 )(R 2 )-R 3 (R 1 = 2-CH 3 , 2-Cl; R 2 = 4-CH 3 , 4-Cl; R 3 =5-H, 5-Cl), 4-NH 2 -2-Cl–C 6 H 3 –SO 2 NH–C 6 H 3 (R 1 )-R 2 (R 1 = 2-H, 2-Cl; R 2 = 4-H, 4-Cl) and 4-NH 2 -2-CH 3 –C 6 H 3 –SO 2 NH–C 6 H 3 (R 1 )-R 2 (R 1 = 2-H, 2-Cl, 2-NO 2 ; R 2 = 4-H, 4-Cl) in water and 1-octanol (as phases modeling various drug delivery pathways) were studied using the isothermal saturation method. For the sulfonamides with various substituents in phenyl rings the processes of transfer from water to 1-octanol were studied by a diagram method combined with analysis of enthalpic and entropic terms. Distinguishing between enthalpy and entropy, as is possible through the present approach, leads to the insight that the contribution of these terms is different for different molecules (entropy- or enthalpy-determined). Thus, in contrast to the interpretation of only the Gibbs energy of transfer (extensively used for pharmaceuticals in the form of the partition coefficient, logP), the analysis of thermodynamic functions of the transfer process provides additional mechanistic information. This may be important for further evaluation of the physiological distribution of drug molecules and may provide a better understanding of biopharmaceutical properties of drugs

  3. 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.

  4. 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

  5. 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

  6. 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.

  7. 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.

  8. Tumor microvascular changes in antiangiogenic treatment : Assessment by magnetic resonance contrast media of different molecular weights

    NARCIS (Netherlands)

    Turetschek, K; Preda, A; Novikov, [No Value; Brasch, RC; Weinmann, HJ; Wunderbaldinger, P; Roberts, TPL

    Purpose: To test magnetic resonance (MR) contrast media of different molecular weights (MWs) for their potential to characterize noninvasively microvascular changes in an experimental tumor treatment model. Materials and Methods: MD-MBA-435, a poorly differentiated human breast cancer cell line, was

  9. Clinical courses and CT findings in the patients with contrast media-associated seizures

    International Nuclear Information System (INIS)

    Onda, Kiyoshi; Takeda, Norio; Tanaka, Ryuichi

    1987-01-01

    From February 1976 through March 1985, 12,479 patients underwent cranial computed tomography (CT) examinations with 65 % Angiografin (100 ml/kg for adults and 2 ml/kg for children). Among them, five patients experienced contrast media-associated seizures. The present study analyzed (1) the time of occurrence of seizures, (2) CT appearances at the time of seizures, (3) epileptogenecity, and (4) clinical features of seizures. Two patients had malignant gliomas, 2 metastatic brain tumors, and one hemangioendothelioma. Seizures occurred at CT examinations performed after the initial treatment, such as radiation or surgery, with the incidence for each patient varing from 2 to 5. There were lesions near the motor cortex on CT scans, and enhancement was observed in most cases. Three patients had experienced epilepsy attacks due to their underlying diseases. In the other two, contrast media-associated seizures preceded the occasional onset of epilepsy attacks. This strongly suggested the influence of their underlying diseases in the occurrence of contrast media-associated seizures. A careful use of contrast media for cranial CT examination is emphasized. (Namekawa, K.)

  10. Delayed allergy-like reactions to X-ray contrast media. Second expert meeting

    International Nuclear Information System (INIS)

    Sviridov, N.K

    1998-01-01

    Materials of the second expert meeting of medical radiologists of USA, Germany, and Japan concerning delayed allergy-like reactions to X-ray contrast media (XRCM) are briefly considered. Attention is paid to the experimental and clinical data on the application of nonionic dimers, pathophysiological and immunological aspects of the reaction to XRCM, certain models and hypotheses, allergy to XRCM

  11. Use of contrast media in computed tomography and magnetic resonance imaging in horses: Techniques, adverse events and opportunities.

    Science.gov (United States)

    Nelson, B B; Goodrich, L R; Barrett, M F; Grinstaff, M W; Kawcak, C E

    2017-07-01

    The use of contrast media in computed tomography (CT) and magnetic resonance imaging (MRI) is increasing in horses. These contrast-enhanced imaging techniques provide improved tissue delineation and evaluation, thereby expanding diagnostic capabilities. While generally considered safe, not all contrast media exhibit the same safety profiles. The safety of contrast media use and descriptions of adverse events occurring in horses are sparsely reported. This review summarises the reported evidence of contrast media use and adverse events that occur in horses, with added contribution from other veterinary species and studies in man for comparison. This comprehensive data set empowers equine clinicians to develop use and monitoring strategies when working with contrast media. Finally, it summarises the current state-of-the-art and highlights the potential applications of contrast-enhanced CT and MRI for assessment of diseased or injured equine tissues, as well as (patho)physiological processes. © 2017 EVJ Ltd.

  12. Safety of non-ionic contrast media during renal artery stenting

    International Nuclear Information System (INIS)

    Ni Jun; Shen Weifeng; Zhang Ruiyan; Zhang Qi; Zhang Xian; Zheng Aifang

    2004-01-01

    Objective: To evaluate the safety of non-ionic contras media during interventional treatment of renal artery stenosis (RAS). Methods: Fifty four coronary artery disease patients associated with RAS (luminal narrowing > 50%) underwent renal artery stent implantation and percutaneous coronary intervention, only 10 of them with merely renoarterial stenosis undergone renal artery stent implantation. The successful rates of the procedure and complication together with the volumes of contrast media were recorded respectively. And the serum creatine before and 12 hours after the successful procedure were also measured. Results: Both rates of procedural success and complication were similar among the three groups. The serum creatine levels, 12 hours after the procedure, showed no difference in comparing with the baseline. Conclusion: Non-ionic contrast media (Iopamiro 370) could be safely used in patients with RAS. (authors)

  13. Compatibility of epirubicin-loaded DC bead™ with different non-ionic contrast media.

    Science.gov (United States)

    Sarakbi, Iman; Krämer, Irene

    2016-12-01

    The aim of this study was to determine the compatibility of epirubicin-loaded DC bead™ with different non-ionic contrast media over a period of seven days when stored light protected under refrigerated conditions. DC bead™ (2 ml) (Biocompatibles UK Ltd) of the bead size 70-150 µm ( = DC bead M1) or bead size 100-300 µm were loaded with 75 mg epirubicin powder formulation (Farmorubicin® dissolved in 3 ml water for injection to a concentration of 25 mg/ml) or 76 mg epirubicin injection solution (Epimedac® 2 mg/ml) within 2 h or 6 h, respectively. After removal of the excess solution, the epirubicin-loaded beads were mixed in polypropylene syringes with an equal volume (∼1.5 ml) of contrast media, i.e. Accupaque™ 300 (Nycomed Inc.), Imeron® 300 (Bracco S.p.A), Ultravist® 300 (Bayer Pharma AG), Visipaque™ 320 (GE Healthcare) and agitated in a controlled manner to get a homogenous suspension. Syringes with loaded beads in contrast media were stored protected from light under refrigeration (2-8℃). Compatibility was determined by measuring epirubicin concentrations in the suspensions in triplicate on day 0, 1, and 7. A reversed phase high-performance liquid chromatography assay with ultraviolet detection was utilized to analyze the concentration and purity of epirubicin. Mixing of epirubicin-loaded beads with different non-ionic contrast media released 0.1-0.5% of epirubicin over a period of 24 h, irrespectively, of the DC bead™ size or type of contrast media. No further elution or degradation was observed after seven days when the admixtures were stored protected from light under refrigeration. Compatibility of epirubicin-loaded DC bead™ with an equal volume of different contrast media in polypropylene syringes is given over a period of seven days. Due to a maximum elution of 0.1-0.5% of epirubicin from loaded DC bead™, admixtures with contrast media can be prepared in advance in centralized cytotoxic preparation units

  14. Technique of application of contrast media in computed tomography of the heart

    International Nuclear Information System (INIS)

    Heuser, L.; Friedmann, G.

    1982-01-01

    Cardiac imaging by means of CT requires administration of intravenous contrast medium which can be applied by infusion or by rapid bolus injection. Contrast infusion is easier in performance and yields opacification of all cardiac cavities. Using bolus technique selective enhancement of cardiac chambers can be obtained which provides increased image quality and better resolution of cardiac structures. Both techniques are described and the results of 221 examinations are analysed with special respect to image quality, technical amount and contrast media side effects. (orig.) [de

  15. 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.

  16. A severe, late reaction to radiological contrast media mimicking a sepsis syndrome

    International Nuclear Information System (INIS)

    Burton, P.R.; Jarmolowski, E.; Raineri, F.; Buist, M.D.; Wriedt, H.R.

    1999-01-01

    An unusual, severe delayed reaction to non-ionic intravenous contrast media was observed. A 44-year-old man underwent a computed tomography scan with non-ionic contrast media. Four hours later the patient collapsed with hypotension and cardiovascular shock. Aggressive management (including inotropic support and fluid resuscitation) was instituted in the intensive care unit. Rigorous imaging and biochemical and microbiological investigation failed to identify a source of this man's circulatory collapse. A rapid recovery ensued and at 3 months follow-up the patient was suffering no residual effects from this event. To our knowledge, this is only the second report of a severe delayed reaction to radiological contrast media and the first that manifested as a prolonged hypotensive syndrome. Despite the introduction of non-ionic low osmolar radiological contrast media (NIM), the incidence of adverse reactions to these agents remains at between 3 and 12%. Most of these reactions are acute, self-limiting events (nausea, vomiting, urticaria, diarrhoea) and no treatment is required. The mortality rate of these adverse reactions has been quoted at 0.0020.009% of all procedures. Most of these severe reactions are acute anaphylactoid events manifested by hypotension and bronchospasm. Delayed adverse reactions to NIM have been reported to occur with a frequency of between 8.0 and 27.1%. These reactions are almost uniformly self-limiting and non-life threatening, requiring minimal intervention. We report an unusual late adverse reaction to NIM, which presented with many of the features of a severe sepsis syndrome. Non-ionic low osmolar radiological contrast media has the capacity to cause severe delayed reactions in rare instances, but the pathophysiological mechanisms of these reactions are poorly understood and, therefore, diagnosis and management of this clinical situation presented many difficulties. Copyright (1999) Blackwell Science Pty Ltd

  17. Contrast media in computed tomography of the mediastinum and the lung

    International Nuclear Information System (INIS)

    Wegener, O.-H.; Claussen, C.D.

    1981-01-01

    An administration of contrast medium is frequently indicated for problems of mediastinal diagnosis. The reason for this is that previous diagnosis or a clear set of clinical symptoms justifies the suspicion of a space-occupying process. Moreover, CT should lead to diagnoses which are as definite and differentiated as possible. In the majority of examinations, contrast media should be applied to evaluate the mediastinum. Infusion technique is suitable for extensive or disseminated processes, whereby the dose depends on the duration of the examination. An intravasal enhancement exceeding 60 Hounsfield Units (HU) should be achieved for the entire period. For focal lesions bolus injections should be used to clarify the degree of vascularization of the expected process. Besides site and radiodensity, it is the degree of vascularization that narrows down the differential diagnosis in mediastinal disease. At present an indication for application of contrast media in lung diseases does not exist. (Auth.)

  18. Comparison of CO2 DSA and conventional angiography using non-ionic contrast media in lower extremity angiography

    International Nuclear Information System (INIS)

    Kim, Jae Kyu; Park, Sung Jae; Koh, Seok Wan; Seo, Jeong Jin; Kang, Heoung Keun; Chung, Hyon De

    1994-01-01

    The purpose of this study is to compare CO 2 DSA and nonionic contrast media angiography in respect to the quality of the opacification of collaterals and incidence of side-effects in peripheral occlusive arterial disease. Sixteen patients who were suspected to have peripheral occlusive arterial disease were performed angiography with nonionic contrast media and CO 2 at the same location with the same catheter. The causes of the lesions were atherosclerosis(n=7) and Buerger's disease(n=9). CO 2 DSA was compared with nonionic contrast media angiography in respect to the quality of image in the diagnosis of the lesions, opacifications of collaterals and side-effects. In atherosclerosis; quality of the images of CO 2 DSA was same as that of nonionic contrast media angiography in 6 patients and was poor in 1 patient; opacifications of collaterals of CO 2 DSA were same as that of nonionic contrast media angiography in 5 patients and was poor in 2 patients. In Buerger's disease; quality of the images of CO 2 DSA was same as that of nonionic contrast media angiography in 2 patients and was poor in 7 patients; opacifications of collaterals of CO 2 DSA were same as that of nonionic contrast media angiography in 1 patient and was poor in 8 patients. Leg pain was the only side-effect after CO 2 injection occurring in 4 out of 16 patients. CO 2 could be used as safe contrast media in patient with risk factors for nonionic contrast media and for diagnosis of the atherosclerosis in lower extremity. For the procedures such as vascular intervention requiring large amount of contrast media CO 2 could effectively replace nonionic contrast media

  19. 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

  20. 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.

  1. 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.

  2. 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.

  3. 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.

  4. 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

  5. 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

  6. 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.

  7. Lumbar myelography with water-soluble contrast media including comparison with computed tomography

    International Nuclear Information System (INIS)

    Langlotz, M.

    1986-01-01

    The heart of this book lies in the bringing together of clinical data, CT, myelography (at full one to one scale), and early follow-up of individual cases. In order to achieve better visual understanding of the examples, as well as an overview of them, line drawings summarizing the most important pathologic and radiologic changes introduce each section. (orig./MG) With 373 figs

  8. Development and implementation of a critical pathway for prevention of adverse reactions to contrast media for computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Keun Jo [Presbyterian Medical Center, Seoul (Korea, Republic of); Kweon, Dae Cheol; Kim, Myeong Goo [Seoul National University Hospital, Seoul (Korea, Republic of); Yoo, Beong Gyu [Wonkwang Health Science College, Iksan (Korea, Republic of)

    2007-03-15

    The purpose of this study is to develop a critical pathway (CP) for the prevention of adverse reactions to contrast media for computed tomography. The CP was developed and implemented by a multidisciplinary group is Seoul National University Hospital. The CP was applied to CT patients. Patients who underwent CT scanning were included in the CP group from March in 2004. The satisfaction of the patients with CP was compared with non-CP groups. We also investigated the degree of satisfaction among the radiological technologists and nurses. The degree of patient satisfaction with the care process increased patient information (24%), prevention of adverse reactions to contrast media (19%), pre-cognitive effect of adverse reactions to contrast media (39%) and information degree of adverse reactions to contrast media (19%). This CP 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.

  9. Development and implementation of a critical pathway for prevention of adverse reactions to contrast media for computed tomography

    International Nuclear Information System (INIS)

    Jang, Keun Jo; Kweon, Dae Cheol; Kim, Myeong Goo; Yoo, Beong Gyu

    2007-01-01

    The purpose of this study is to develop a critical pathway (CP) for the prevention of adverse reactions to contrast media for computed tomography. The CP was developed and implemented by a multidisciplinary group is Seoul National University Hospital. The CP was applied to CT patients. Patients who underwent CT scanning were included in the CP group from March in 2004. The satisfaction of the patients with CP was compared with non-CP groups. We also investigated the degree of satisfaction among the radiological technologists and nurses. The degree of patient satisfaction with the care process increased patient information (24%), prevention of adverse reactions to contrast media (19%), pre-cognitive effect of adverse reactions to contrast media (39%) and information degree of adverse reactions to contrast media (19%). This CP 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

  10. Usefulness of low dose oral contrast media in FDG PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    An, Y. S.; Yun, J. G.; Lee, M. H.; Cho, C. W.; Yun, S. N [Ajou University Medical Center, Suwon (Korea, Republic of)

    2004-07-01

    Oral contrast media might help in interpreting PET/CT images, allowing better discrimination between physiologic and pathologic abdominal uptake. The aim of this study was to evaluate the usefulness of low dose oral contrast on FDG PET/CT. A total of 435 cancer patients received 200mL of oral Barium with water(200mL) immediately before FDG injection. PET images were reconstructed using attenuation correction and iterative reconstruction. The FDG uptake in gastrointestinal(GI) tract were analyzed by visual and semiquantitative method in transaxial, coronal and sagittal planes. Seventy patients(16%, 113 sites) of 435 images showed high FDG uptake(pSUV>4.0) : 50(74%, 84 sites) with diffuse uptake and 20(26%, 29sites) with focal uptake. The most common distribution site of oral contrast media was small bowel (n=27, 39%) and others were small bowel with transverse colon(n=6, 8%), small bowel with ascending and sigmoid colon(n=6, 8%) and etc. In PET/CT images, FDG uptake coexisted with oral contrast was showed in 26 patients(54%) with diffuse pattern and 9(45%) with focal pattern, and by sites, those were 38(45%) and 9(31%), respectively. In small bowel regions, the most common distribution site, the proportion of coexistence reached as high as 61% (29 in the total 47 sites). Application of low dose contrast agent can be helpful in the evaluation of intestinal uptake in FDG PET/CT image.

  11. Usefulness of low dose oral contrast media in FDG PET/CT

    International Nuclear Information System (INIS)

    An, Y. S.; Yun, J. G.; Lee, M. H.; Cho, C. W.; Yun, S. N

    2004-01-01

    Oral contrast media might help in interpreting PET/CT images, allowing better discrimination between physiologic and pathologic abdominal uptake. The aim of this study was to evaluate the usefulness of low dose oral contrast on FDG PET/CT. A total of 435 cancer patients received 200mL of oral Barium with water(200mL) immediately before FDG injection. PET images were reconstructed using attenuation correction and iterative reconstruction. The FDG uptake in gastrointestinal(GI) tract were analyzed by visual and semiquantitative method in transaxial, coronal and sagittal planes. Seventy patients(16%, 113 sites) of 435 images showed high FDG uptake(pSUV>4.0) : 50(74%, 84 sites) with diffuse uptake and 20(26%, 29sites) with focal uptake. The most common distribution site of oral contrast media was small bowel (n=27, 39%) and others were small bowel with transverse colon(n=6, 8%), small bowel with ascending and sigmoid colon(n=6, 8%) and etc. In PET/CT images, FDG uptake coexisted with oral contrast was showed in 26 patients(54%) with diffuse pattern and 9(45%) with focal pattern, and by sites, those were 38(45%) and 9(31%), respectively. In small bowel regions, the most common distribution site, the proportion of coexistence reached as high as 61% (29 in the total 47 sites). Application of low dose contrast agent can be helpful in the evaluation of intestinal uptake in FDG PET/CT image

  12. 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

  13. Tissue specific MR contrast media role in the differential diagnosis of cirrhotic liver nodules.

    Science.gov (United States)

    Lupescu, Ioana Gabriela; Capsa, Razvan A; Gheorghe, Liana; Herlea, Vlad; Georgescu, Serban A

    2008-09-01

    State-of-the-art magnetic resonance (MR) imaging using tissue specific contrast media facilitates detection and characterization in most cases of hepatic nodules. According to the currently used nomenclature, in liver cirrhosis there are only two major types of hepatocellular nodular lesions: regenerative lesions and dysplastic or neoplastic lesions. The purpose of this clinical imaging review is to provide information on the properties of tissue-specific MR contrast agents and on their usefulness in the demonstration of the pathologic changes that take place at the level of the hepatobiliary and reticuloendothelial systems during the carcinogenesis in liver cirrhosis.

  14. 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)

  15. Mode decomposition methods for flows in high-contrast porous media. A global approach

    KAUST Repository

    Ghommem, Mehdi; Calo, Victor M.; Efendiev, Yalchin R.

    2014-01-01

    We apply dynamic mode decomposition (DMD) and proper orthogonal decomposition (POD) methods to flows in highly-heterogeneous porous media to extract the dominant coherent structures and derive reduced-order models via Galerkin projection. Permeability fields with high contrast are considered to investigate the capability of these techniques to capture the main flow features and forecast the flow evolution within a certain accuracy. A DMD-based approach shows a better predictive capability due to its ability to accurately extract the information relevant to long-time dynamics, in particular, the slowly-decaying eigenmodes corresponding to largest eigenvalues. Our study enables a better understanding of the strengths and weaknesses of the applicability of these techniques for flows in high-contrast porous media. Furthermore, we discuss the robustness of DMD- and POD-based reduced-order models with respect to variations in initial conditions, permeability fields, and forcing terms. © 2013 Elsevier Inc.

  16. Propagation stability of self-reconstructing Bessel beams enables contrast-enhanced imaging in thick media.

    Science.gov (United States)

    Fahrbach, Florian O; Rohrbach, Alexander

    2012-01-17

    Laser beams that can self-reconstruct their initial beam profile even in the presence of massive phase perturbations are able to propagate deeper into inhomogeneous media. This ability has crucial advantages for light sheet-based microscopy in thick media, such as cell clusters, embryos, skin or brain tissue or plants, as well as scattering synthetic materials. A ring system around the central intensity maximum of a Bessel beam enables its self-reconstruction, but at the same time illuminates out-of-focus regions and deteriorates image contrast. Here we present a detection method that minimizes the negative effect of the ring system. The beam's propagation stability along one straight line enables the use of a confocal line principle, resulting in a significant increase in image contrast. The axial resolution could be improved by nearly 100% relative to the standard light-sheet techniques using scanned Gaussian beams, while demonstrating self-reconstruction also for high propagation depths.

  17. Dry preparation for virtual CT colonography with fecal tagging using water-soluble contrast medium: initial results

    International Nuclear Information System (INIS)

    Bielen, Didier; Thomeer, Maarten; Vanbeckevoort, Dirk; Marchal, Guy; Kiss, Gabriel; Maes, Frederik; Rutgeerts, Paul

    2003-01-01

    The purpose of this study was to evaluate the feasibility of a dry bowel preparation, i.e. without laxative fluids, for virtual CT colonography (VCTC), and its impact on patient acceptance compared with conventional colonoscopy (CC). A randomly chosen patient population scheduled for CC (n=11) was first submitted to VCTC after a dry preparation, consisting of low-residue meals combined with a small amount of a iodinated water-soluble contrast medium during each meal 3 days before VCTC. In different colon segments and between different persons, the degree of tagging in VCTC was evaluated and graded. Patient acceptance and future preference were assessed for both preparations as well as for both investigations. The mixing of the contrast with the intestinal content results in contrast impregnated stool, the tagged feces. The degree of fecal tagging was good in the majority of the patients and the colonic segments, especially in the descending colon and sigmoid. Furthermore, patient acceptance and preference were clearly in favour of VCTC compared with CC merely because of the non-invasiveness of the dry preparation. Dry bowel preparation and VCTC is a promising approach towards a patient-friendly colon cancer-screening setup. (orig.)

  18. Growth responses and accumulation of soluble sugars in Inga marginata Wild. (Fabaceae) subjected to flooding under contrasting light conditions.

    Science.gov (United States)

    Bender, B; Capellesso, E S; Lottici, M E; Sentkovski, J; Mielniczki-Pereira, A A; Rosa, L M G; Sausen, T L

    2017-01-01

    Flood events in riparian forests of southern Brazil, can be characterized as unpredictable and of low magnitude with an average duration of less than 15 days. Inga marginata is an evergreen tree which grows in Southeast South America on a wide range of environments, including riparian forests. In this paper, the interactive effects of the light environment and soil flooding on morphological parameters of I. marginata were examined. Seedlings were acclimated in two contrasting light conditions: sun or shade for 30 days. Sun and shade plants were subjected to soil flooding for two periods; five or 15 days. After 5 days, the interaction between flooding and light did not affect growth, chlorophyll content and dry mass or the root-shoot ratio. After 15 days, flooded plants from the sunny treatment had a lower shoot dry mass compared to control sun plants and flooded plants from the shaded treatment. Moreover, the higher dry mass observed for shade plants compared to sun plants, following flooding, can also be directly associated with a higher content of soluble sugars. Shade plants of I. marginata showed a greater acclimation to soil waterlogging. This acclimation appears to be associated with a larger accumulation of soluble sugars compared to non-flooded plants. The responses observed on the shade plants appear to be decisive to indicate the use of I. marginata in degraded areas.

  19. Computed tomography contrast media extravasation: treatment algorithm and immediate treatment by squeezing with multiple slit incisions.

    Science.gov (United States)

    Kim, Sue Min; Cook, Kyung Hoon; Lee, Il Jae; Park, Dong Ha; Park, Myong Chul

    2017-04-01

    In our hospital, an adverse event reporting system was initiated that alerts the plastic surgery department immediately after suspecting contrast media extravasation injury. This system is particularly important for a large volume of extravasation during power injector use. Between March 2011 and May 2015, a retrospective chart review was performed on all patients experiencing contrast media extravasation while being treated at our hospital. Immediate treatment by squeezing with multiple slit incisions was conducted for a portion of these patients. Eighty cases of extravasation were reported from approximately 218 000 computed tomography scans. The expected extravasation volume was larger than 50 ml, or severe pressure was felt on the affected limb in 23 patients. They were treated with multiple slit incisions followed by squeezing. Oedema of the affected limb disappeared after 1-2 hours after treatment, and the skin incisions healed within a week. We propose a set of guidelines for the initial management of contrast media extravasation injuries for a timely intervention. For large-volume extravasation cases, immediate management with multiple slit incisions is safe and effective in reducing the swelling quickly, preventing patient discomfort and decreasing skin and soft tissue problems. © 2016 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

  20. 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

  1. Domain Decomposition Preconditioners for Multiscale Flows in High-Contrast Media

    KAUST Repository

    Galvis, Juan; Efendiev, Yalchin

    2010-01-01

    In this paper, we study domain decomposition preconditioners for multiscale flows in high-contrast media. We consider flow equations governed by elliptic equations in heterogeneous media with a large contrast in the coefficients. Our main goal is to develop domain decomposition preconditioners with the condition number that is independent of the contrast when there are variations within coarse regions. This is accomplished by designing coarse-scale spaces and interpolators that represent important features of the solution within each coarse region. The important features are characterized by the connectivities of high-conductivity regions. To detect these connectivities, we introduce an eigenvalue problem that automatically detects high-conductivity regions via a large gap in the spectrum. A main observation is that this eigenvalue problem has a few small, asymptotically vanishing eigenvalues. The number of these small eigenvalues is the same as the number of connected high-conductivity regions. The coarse spaces are constructed such that they span eigenfunctions corresponding to these small eigenvalues. These spaces are used within two-level additive Schwarz preconditioners as well as overlapping methods for the Schur complement to design preconditioners. We show that the condition number of the preconditioned systems is independent of the contrast. More detailed studies are performed for the case when the high-conductivity region is connected within coarse block neighborhoods. Our numerical experiments confirm the theoretical results presented in this paper. © 2010 Society for Industrial and Applied Mathematics.

  2. 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.

  3. The strategy of performing non-prophylactic hemodialysis therapy after administration of contrast media in renal insufficiency patients

    International Nuclear Information System (INIS)

    Hokama, Sanehiro; Oda, Masami; Kadekawa, Katsumi

    2007-01-01

    Acute renal failure induced by contrast media is an important problem in renal insufficiency patients. Prophylactic hemodialysis is usually undertaken after the administration of radiocontrast media. However, we decided to cease giving prophylactic hemodialysis from February, 2002 in line with the guidelines regarding dialysis and contrast media administration provided by the European Society of Urogenital Radiology. We reported our policy at the doctor's meeting of hemodialysis therapy and at the meeting of clinical engineering technologists which were held in Okinawa. After the presentation, a questionnaire survey in 28 hospitals was undertaken by telephone. In all the hospitals, prophylactic hemodialysis after the administration of radiocontrast media was still being continued, with the exception of one hospital. We need to enlighten medical staff that the strategy of performing hemodialysis immediately after the administration of contrast media in patients with reduced renal function does not diminish the rate of radiocontrast media-induced nephropathy. (author)

  4. Measurement of single kidney contrast media clearance by multiphasic spiral computed tomography: preliminary results

    International Nuclear Information System (INIS)

    Hackstein, N.; Puille, M.F.; Bak, Benjamin H.; Scharwat, Oliver; Rau, W.S.

    2001-01-01

    Objective. We present preliminary results of a new method (hereinafter called 'CT-clearance') to measure single kidney contrast media clearance by performing multiphasic helical CT of the kidneys. CT-clearance was calculated according to an extension of the Patlak-Plot. In contrast to prior investigators, who repeatedly measured a single slice, this method makes it possible to calculate single kidney clearance from at least three spiral CTs, utilizing the whole kidney volume. Methods. Spiral CT of the kidneys was performed unenhanced and about 30 and 100 s after administration of about 120 ml iopromide. Sum-density of the whole kidneys and aortic density was calculated from this data. Using this data, renal clearance of contrast media was calculated by CT-clearance in 29 patients. As reference, Serum-clearance was calculated in 24 patients by application of a modified one-exponential slope model. Information on the relative kidney function was gained by renal scintigraphy with Tc99m-MAG-3 or Tc99m-DMSA in 29 patients. Results. Linear regression analysis revealed a correlation coefficient of CT-clearance with Serum-clearance of r=0.78 with Cl (CT) [ml/min]=22.2+1.03 * Cl (serum), n=24. Linear regression of the relative kidney function (rkf) of the right kidney calculated by CT-clearance compared to scintigraphy results provided a correlation coefficient r=0.89 with rkf(CT)[%]=18.6+0.58 * rkf(scintigraphy), n=29. Conclusion. The obtained results of contrast media clearance measured by CT-clearance are in the physiological range of the parameter. Future studies should be performed to improve the methodology with the aim of higher accuracy. More specifically, better determination of the aortic density curve might improve the accuracy

  5. 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.

  6. Mode decomposition methods for flows in high-contrast porous media. Global-local approach

    KAUST Repository

    Ghommem, Mehdi; Presho, Michael; Calo, Victor M.; Efendiev, Yalchin R.

    2013-01-01

    In this paper, we combine concepts of the generalized multiscale finite element method (GMsFEM) and mode decomposition methods to construct a robust global-local approach for model reduction of flows in high-contrast porous media. This is achieved by implementing Proper Orthogonal Decomposition (POD) and Dynamic Mode Decomposition (DMD) techniques on a coarse grid computed using GMsFEM. The resulting reduced-order approach enables a significant reduction in the flow problem size while accurately capturing the behavior of fully-resolved solutions. We consider a variety of high-contrast coefficients and present the corresponding numerical results to illustrate the effectiveness of the proposed technique. This paper is a continuation of our work presented in Ghommem et al. (2013) [1] where we examine the applicability of POD and DMD to derive simplified and reliable representations of flows in high-contrast porous media on fully resolved models. In the current paper, we discuss how these global model reduction approaches can be combined with local techniques to speed-up the simulations. The speed-up is due to inexpensive, while sufficiently accurate, computations of global snapshots. © 2013 Elsevier Inc.

  7. Mode decomposition methods for flows in high-contrast porous media. Global-local approach

    KAUST Repository

    Ghommem, Mehdi

    2013-11-01

    In this paper, we combine concepts of the generalized multiscale finite element method (GMsFEM) and mode decomposition methods to construct a robust global-local approach for model reduction of flows in high-contrast porous media. This is achieved by implementing Proper Orthogonal Decomposition (POD) and Dynamic Mode Decomposition (DMD) techniques on a coarse grid computed using GMsFEM. The resulting reduced-order approach enables a significant reduction in the flow problem size while accurately capturing the behavior of fully-resolved solutions. We consider a variety of high-contrast coefficients and present the corresponding numerical results to illustrate the effectiveness of the proposed technique. This paper is a continuation of our work presented in Ghommem et al. (2013) [1] where we examine the applicability of POD and DMD to derive simplified and reliable representations of flows in high-contrast porous media on fully resolved models. In the current paper, we discuss how these global model reduction approaches can be combined with local techniques to speed-up the simulations. The speed-up is due to inexpensive, while sufficiently accurate, computations of global snapshots. © 2013 Elsevier Inc.

  8. 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.

  9. 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

  10. The pharmaco-kinetics of angiographic contrast media with special reference to the extravascular spaces. Fundamental studies on dogs for the characterization of angiographic media. Pt. 1

    International Nuclear Information System (INIS)

    Lagemann, K.

    1975-01-01

    The pharmaco-kinetics of angiographic contrast media in the extra-vascular space, which are largely unknown, were investigated experimentally in dogs. As part of a basic study, using radio-active contrast media, it was possible to determine the concentration and rate of elimination in practically all organs and tissues. Measurements were carried out first after prolonged infusion of contrast under conditions of balanced flow, and secondly six hours after the end of the infusion. It was therefore possible to determine the inflow and loss of contrast medium in various organs, or organs systems. The most commonly used angiographic contrast media in Germany were investigated. Their kinetic behaviour is largely identical, their pattern of distribution and elimination depended principally on the organ or tissue. (orig.) [de

  11. Differences between Drug-Induced and Contrast Media-Induced Adverse Reactions Based on Spontaneously Reported Adverse Drug Reactions.

    Science.gov (United States)

    Ryu, JiHyeon; Lee, HeeYoung; Suh, JinUk; Yang, MyungSuk; Kang, WonKu; Kim, EunYoung

    2015-01-01

    We analyzed differences between spontaneously reported drug-induced (not including contrast media) and contrast media-induced adverse reactions. Adverse drug reactions reported by an in-hospital pharmacovigilance center (St. Mary's teaching hospital, Daejeon, Korea) from 2010-2012 were classified as drug-induced or contrast media-induced. Clinical patterns, frequency, causality, severity, Schumock and Thornton's preventability, and type A/B reactions were recorded. The trends among causality tools measuring drug and contrast-induced adverse reactions were analyzed. Of 1,335 reports, 636 drug-induced and contrast media-induced adverse reactions were identified. The prevalence of spontaneously reported adverse drug reaction-related admissions revealed a suspected adverse drug reaction-reporting rate of 20.9/100,000 (inpatient, 0.021%) and 3.9/100,000 (outpatients, 0.004%). The most common adverse drug reaction-associated drug classes included nervous system agents and anti-infectives. Dermatological and gastrointestinal adverse drug reactions were most frequently and similarly reported between drug and contrast media-induced adverse reactions. Compared to contrast media-induced adverse reactions, drug-induced adverse reactions were milder, more likely to be preventable (9.8% vs. 1.1%, p contrast media-induced adverse reactions (56.6%, p = 0.066). Causality patterns differed between the two adverse reaction classes. The World Health Organization-Uppsala Monitoring Centre causality evaluation and Naranjo algorithm results significantly differed from those of the Korean algorithm version II (p contrast media-induced adverse reactions. The World Health Organization-Uppsala Monitoring Centre and Naranjo algorithm causality evaluation afforded similar results.

  12. 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)

  13. 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.

  14. Exposure to radiologic contrast media and an increased risk of treated end-stage renal disease.

    Science.gov (United States)

    Muntner, Paul; Coresh, Josef; Klag, Michael J; Whelton, Paul K; Perneger, Thomas V

    2003-12-01

    Radiologic contrast media can cause acute renal failure, but whether their repeated use is associated with end-stage renal disease (ESRD) is unknown. We compared 716 incident case subjects of treated ESRD with 361 control subjects, frequency matched on age, drawn from the general population (age, 20-65 years). Participants were interviewed by telephone regarding their previous exposure (before initiation of dialysis for case subjects and the study interview for control subject) to various imaging procedures. As expected, the case subjects reported having more imaging procedures of the kidneys than did control subjects. Excluding persons who had been subjected to examinations of their kidney from the analysis and adjusting for ultrasound examinations and several possible confounders, persons who had a history of one [odds ratio (OR), 2.0; 95% confidence interval (CI), 1.0, 4.0], 2 or 3 (OR, 2.6; 95% CI, 1.2,5.9), or 4 or more (OR, 3.6; 95% CI, 1.0, 12.5) radiocontrast examinations were at higher risk of treated ESRD than persons who reported not having had such procedures. Ultrasound examinations and a history of barium enema were not associated with an increased risk of treated ESRD. In the current study, a graded association was present between increasing exposure to radiologic contrast media and higher risk of treated ESRD. Whether exposure to contrast media accelerates progression to ESRD or is merely a noncausal accompaniment to multiple disease processes occurring concurrently cannot be determined from our observational data. However, if these results are confirmed in future prospective studies, they will have important clinical implications.

  15. 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

  16. [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.

  17. 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.

  18. Paraplegia after contrast media application: a transient or devastating rare complication? Case report.

    Science.gov (United States)

    Mielke, Dorothee; Kallenberg, Kai; Hartmann, Marius; Rohde, Veit

    2016-05-01

    The authors report the case of a 76-year-old man with a spinal dural arteriovenous fistula. The patient suffered from sudden repeated reversible paraplegia after spinal digital subtraction angiography as well as CT angiography. Neurotoxicity of contrast media (CM) is the most probable cause for this repeated short-lasting paraplegia. Intolerance to toxicity of CM to the vulnerable spinal cord is rare, and probably depends on the individual patient. This phenomenon is transient and can occur after both intraarterial and intravenous CM application.

  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. Adverse reactions to contrast media: an analysis of spontaneous reports in the database of the pharmacovigilance programme of India.

    Science.gov (United States)

    Kalaiselvan, Vivekanandan; Sharma, Surbhi; Singh, Gyanendra Nath

    2014-09-01

    Contrast media are used widely to improve medical imaging. Like all other pharmaceuticals, these agents are not completely devoid of risk, and continuous monitoring of adverse reactions with these agents is important. Spontaneous reporting is the simplest method for understanding the safety profile of pharmaceutical products after their approval. Our objective was to identify the pattern and characteristics of adverse reactions attributed to contrast media in the Indian population reported to the National Coordination Centre for the Pharmacovigilance Programme of India (NCC-PvPI). Individual case safety reports (ICSRs) attributed to contrast media submitted spontaneously to the NCC-PvPI were extracted from the database for July 2010 to September 2013. We analysed these reports for information related to reporter's professional category, patient's age and sex, reporter's diagnosis of the reaction, seriousness of the reaction, type of contrast media exposure, system organ class (SOC) affected (as described in World Health Organization Adverse Reaction Terminology [WHO-ART]) and outcome. Of the total 59,915 ICSRs in the database, 415 (0.7%) were suspected adverse reactions to contrast media; 44 reports were serious, including three fatal cases. The most affected SOCs were skin and appendage disorders, body as a whole-general disorders, gastrointestinal system disorders and respiratory system disorders. Hypersensitivity reactions were reported in the majority of ICSRs. The contrast media with the highest number of reports were iohexol (40.7%), iomeprol (17.8%), iopamidol (12%) and diatrizoate (12%). Most of the reactions to contrast media were allergic-like, and no previously unrecognised adverse reactions were observed in the Indian population. Further data and increased awareness among healthcare professionals is required to signal and prevent the consequences of adverse reactions attributed to contrast media.

  1. Water soluble contrast enema examination of the integrity of the rectal anastomosis prior to loop ileostomy reversal may be superfluous.

    Science.gov (United States)

    Larsson, Anna; Lindmark, Gudrun; Syk, Ingvar; Buchwald, Pamela

    2015-03-01

    Defunctioning loop ileostomy in low anterior resection (LAR) is routinely used to reduce consequences of anastomotic leakage. The purpose of this study was to analyze which examination technique is optimal for evaluating the integrity of the anastomosis prior to loop ileostomy reversal. Retrospective analysis of 95 patients who had been subjected to LAR at Helsingborg Hospital and Skåne University Hospital, Sweden, was undertaken between January 2007 and June 2009. The examination techniques of the rectal anastomosis prior to reversal and the clinical outcome after reversal were studied. Radiologic anastomosis control using water soluble contrast enema, digital rectal examination (DRE), and rectoscopy were performed in 53 % (50/95), 98 % (93/95), and 69 % (66/95), respectively. In two patients, no control of the anastomosis was performed before reversal. Fifty-two percent (49/95) of the patients were examined using all techniques. Six patients demonstrated leakage detected before reversal of which two were only radiological leakages. These two patients underwent loop ileostomy reversal after delay without complications. They were the only ones where the three examination techniques did not prove coherence. Four patients had symptomatic leakage; these were detected with rectoscopy and DRE and verified with enema. Three patients developed anastomotic leakage after loop ileostomy reversal despite normal preoperative examinations. Two of these patients had rectovaginal fistulas (AVFs). This retrospective study indicates that contrast enema does not provide additional information if rectoscopy and DRE are normal. Despite negative examinations, three of nine leakages were diagnosed after loop ileostomy reversal. Especially, AVFs seem difficult to diagnose.

  2. Delayed allergy-like reactions to X-ray contrast media administration focusing on clinical aspects. First expert meeting

    International Nuclear Information System (INIS)

    Sviridov, N.K.

    1998-01-01

    Materials presented at the first expert meeting of leading specialists in medical radiology are briefly described. The include 14 reports of the scientists of Germany, England, Japan, USA, Finland, Austria. The reports concert delayed allergy-like response to X-ray contrast media accepting on clinical aspects and analysis of nonionic dimeric isotonic media application

  3. Bioavailability of seocalcitol I: Relating solubility in biorelevant media with oral bioavailability in rats--effect of medium and long chain triglycerides

    DEFF Research Database (Denmark)

    Grove, Mette; Pedersen, Gitte P; Nielsen, Jeanet L

    2005-01-01

    Simulated intestinal media (SIM) containing bile salt (BS) and phospholipids (PL) with and without medium chain lipolytic products (MC-LP) or long chain lipolytic products (LC-LP) were developed to study the solubility of seocalcitol. Both MC-LP and LC-LP were studied in order to investigate...... the influence of fatty acid chain length on the in vitro solubility of seocalcitol. The same solubility of seocalcitol was found in media containing either MC-LP or LC-LP. The bioavailability after oral administration of seocalcitol dissolved in medium chain triglyceride (MCT), long chain triglyceride (LCT...

  4. Bounds and Estimates for Transport Coefficients of Random and Porous Media with High Contrasts

    International Nuclear Information System (INIS)

    Berryman, J G

    2004-01-01

    Bounds on transport coefficients of random polycrystals of laminates are presented, including the well-known Hashin-Shtrikman bounds and some newly formulated bounds involving two formation factors for a two-component porous medium. Some new types of self-consistent estimates are then formulated based on the observed analytical structure both of these bounds and also of earlier self-consistent estimates (of the CPA or coherent potential approximation type). A numerical study is made, assuming first that the internal structure (i.e., the laminated grain structure) is not known, and then that it is known. The purpose of this aspect of the study is to attempt to quantify the differences in the predictions of properties of a system being modeled when such organized internal structure is present in the medium but detailed spatial correlation information may or (more commonly) may not be available. Some methods of estimating formation factors from data are also presented and then applied to a high-contrast fluid-permeability data set. Hashin-Shtrikman bounds are found to be very accurate estimates for low contrast heterogeneous media. But formation factor lower bounds are superior estimates for high contrast situations. The new self-consistent estimators also tend to agree better with data than either the bounds or the CPA estimates, which themselves tend to overestimate values for high contrast conducting composites

  5. A study of contrast media on X-rays of upper GI examinations

    International Nuclear Information System (INIS)

    Beck, A.; Rupp, H.G.; Reinhold, W.D.; Grosser, G.

    1989-01-01

    700 gastro intestinal x-ray pictures were controlled by four independent radiologists. Three different baryum applications in patients examination were performed. The three baryum contrast-medium were Top-Contral, Mikropaque, (H-D Barium) and Titanate de Baryum. The examination technique in all patients was the same. In different sessions every radiologist was asked for his opinion about the regularity and thickness of the emulsion of contrast-medium, of the graph of the Areae gastricae, the sharpness of the stomach-contour and the production of bubbles. Finally to every picture it had to be done a qualification concerning to its presentation from 'insignificant' to 'excellent' in four degrees. The results: Excellent pictures could be done in the Esophagus with Titanate de Baryum. Best presentation of the stomach specially in double contrast could be done with Mikropaque, a quiet similar result was the examination with Top-Contral. There is no significant differentiation between contrasts-media in the small intestine. (orig.) [de

  6. 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

  7. The Royal Australian College of Radiologists (RACR) survey of reactions to intravenous ionic and non-ionic contrast media

    International Nuclear Information System (INIS)

    Palmer, J.F.

    1989-01-01

    The Royal Australian College of Radiologists (RACR) expressed concern as to medico-legal implications of the continued use of conventional ionic contrast media in view of the availability of the new low-osmolar media. The new agents had demonstrated significant advantages and it was anticipated that their use would be associated with a lower incidence of undesirable reactions and deaths. However, these new media are significantly more expensive than conventional ionic media and complete changes to these agents has considerable implications for health budgets. Since it was the view of the RACR that there was insufficient information available of the incidence of reactions in clinical use to justify a complete change, a prospective survey of reations to intravenous contrast media injections was initiated. Particpants were issued a simple form, which required for each patient a record of the presence or absence of risk factors, wether ionic or non-ionic contrast media were used, and of the severity of eventual reactions. The results of about 170.000 patients were reported. The survey demonstrated the relative safety of non-ionic media for intravenous use. Despite the relative high cost of these media the continued use of conventional ionic media will become increasingly difficult to justify. (H.W.). 9 refs.; 4 tabs

  8. The Use of Enteric Contrast Media for Diagnostic CT, MRI, and Ultrasound in Infants and Children: A Practical Approach.

    Science.gov (United States)

    Callahan, Michael J; Talmadge, Jennifer M; MacDougall, Robert; Buonomo, Carlo; Taylor, George A

    2016-05-01

    Enteric contrast media are commonly administered for diagnostic cross-sectional imaging studies in the pediatric population. The purpose of this manuscript is to review the use of enteric contrast media for CT, MRI, and ultrasound in infants, children, and adolescents and to share our experiences at a large tertiary care pediatric teaching hospital. The use of enteric contrast material for diagnostic imaging in infants and children continues to evolve with advances in imaging technology and available enteric contrast media. Many principles of enteric contrast use in pediatric imaging are similar to those in adult imaging, but important differences must be kept in mind when imaging the gastrointestinal tract in infants and children, and practical ways to optimize the imaging examination and the patient experience should be employed where possible.

  9. Effect of ionic and non-ionic contrast media on whole blood viscosity, plasma viscosity and hematocrit in vitro

    International Nuclear Information System (INIS)

    Aspelin, P.

    1978-01-01

    The effect of the ionic contrast media diatrizoate, iocarmate and metrizoate and the non-ionic metrizamide on whole blood viscosity, plasma viscosity and hematocrit was investigated. All the contrast media increased whole blood and plasma viscosity and reduced the hematocrit. The whole blood viscosity increased with increasing osmolality of the contrast medium solutions, whereas the plasma viscosity increased with increasing viscosity of the contrast medium solutions. The higher the osmolality of the contrast media, the lower the hematocrit became. The normal shear-thinning (decreasing viscosity with increasing shear rate) property of blood was reduced when contrast medium was added to the blood. At 50 per cent volume ratio (contrast medium to blood), the ionic contrast media converted the blood into a shear-thickening (increasing viscosity with increasing shear rate) suspension, indicating a marked rigidification of the single red cell, while the non-ionic contrast medium still produced shear-thinning, indicating less rigidification of the red cell (p<0.01). (Auth.)

  10. Classification of structurally related commercial contrast media by near infrared spectroscopy.

    Science.gov (United States)

    Yip, Wai Lam; Soosainather, Tom Collin; Dyrstad, Knut; Sande, Sverre Arne

    2014-03-01

    Near infrared spectroscopy (NIRS) is a non-destructive measurement technique with broad application in pharmaceutical industry. Correct identification of pharmaceutical ingredients is an important task for quality control. Failure in this step can result in several adverse consequences, varied from economic loss to negative impact on patient safety. We have compared different methods in classification of a set of commercially available structurally related contrast media, Iodixanol (Visipaque(®)), Iohexol (Omnipaque(®)), Caldiamide Sodium and Gadodiamide (Omniscan(®)), by using NIR spectroscopy. The performance of classification models developed by soft independent modelling of class analogy (SIMCA), partial least squares discriminant analysis (PLS-DA) and Main and Interactions of Individual Principal Components Regression (MIPCR) were compared. Different variable selection methods were applied to optimize the classification models. Models developed by backward variable elimination partial least squares regression (BVE-PLS) and MIPCR were found to be most effective for classification of the set of contrast media. Below 1.5% of samples from the independent test set were not recognized by the BVE-PLS and MIPCR models, compared to up to 15% when models developed by other techniques were applied. Copyright © 2013 Elsevier B.V. All rights reserved.

  11. 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.

  12. 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

  13. The influence of contrast media on kidney function in patients with stable coronary artery disease.

    Science.gov (United States)

    Reuter, Simon Bertram; Harutyunyan, Marina; Mygind, Naja Dam; Jørgensen, Erik; Kastrup, Jens

    2014-08-01

    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. A total of 447 patients referred for elective coronary intervention due to suspected CAD were included. Blood samples were collected before and 24 h after intervention and medical records were obtained. Patients had no drinking fluid restrictions and were routinely treated with a 1000 ml saline infusion. All patients were invited to a 6-month examination and collection of blood samples. A total of 19 patients (4.3%) developed CIN. CIN patients had a pre-investigation higher estimated glomerular filtration rate (eGRF), lower level of kidney failure and lower creatinine level than non-CIN patients. Kidney function was not normalized in CIN patients 6 months after the intervention. Two patients still met the definition of CIN. With no restriction in fluid intake and supplementary infusion of saline, only a few patients with stable CAD developed early indications of CIN during elective 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.

  14. Slow clearance gadolinium-based extracellular and intravascular contrast media for three-dimensional MR angiography.

    Science.gov (United States)

    Bremerich, J; Colet, J M; Giovenzana, G B; Aime, S; Scheffler, K; Laurent, S; Bongartz, G; Muller, R N

    2001-04-01

    The objective of this study was to assess two new slow-clearance contrast media with extracellular and intravascular distribution for magnetic resonance angiography (MRA). Extracellular Gd-DTPA-BC(2)glucA and intravascular Gd(DO3A)(3)-lys(16) were developed within the European Biomed2 MACE Program and compared with two reference compounds, intravascular CMD-A2-Gd-DOTA and extracellular GdDOTA, in 12 rats. Pre- and post-contrast three-dimensional MR (TR/TE = 5 msec/2.2 msec; isotropic voxel size 0.86 mm(3)) was acquired for 2 hours. Signal-to-noise enhancement (DeltaSNR) was calculated. Two minutes after injection, all contrast media provided strong vascular signal enhancement. The DeltaSNR for Gd-DTPA-BC(2)glucA, Gd(DO3A)(3)-lys(16), CMD-A2-Gd-DOTA, and GdDOTA were 13.0 +/- 1.8, 25.0 +/- 3.2, 25.0 +/- 4.0, and 18.0 +/- 3.4, respectively. Gd-DTPA-BC(2)glucA, Gd(DO3A)(3)-lys(16), and CMD-A2-Gd-DOTA cleared slowly from the circulation, whereas GdDOTA cleared rapidly. Vascular DeltaSNR at 2 hours were 2.9 +/- 0.6, 25.0 +/- 3.2, 25.0 +/- 4.0, and 0.4 +/- 1.0. Gd(DO3A)(3)-lys(16) provided strong vascular and minor background enhancement, and thus may be useful for MRA or perfusion imaging. Gd-DTPA-BC(2)glucA produces persistent enhancement of extracellular water, and thus may allow quantification of extracellular distribution volume and assessment of myocardial viability.

  15. 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.)

  16. One-step enzymatic synthesis of nucleosides from low water-soluble purine bases in non-conventional media.

    Science.gov (United States)

    Fernández-Lucas, Jesús; Fresco-Taboada, Alba; de la Mata, Isabel; Arroyo, Miguel

    2012-07-01

    The effect of several water-miscible cosolvents on activity and stability of soluble and immobilized 2'-deoxyribosyltransferase from Lactobacillus reuteri on Sepabeads® has been studied in order to establish optimal conditions for enzymatic synthesis of nucleosides using purine bases with low solubility in aqueous buffer. As a rule of thumb, there was a general reduction of soluble enzyme activity when cosolvent content was gradually increased in reaction medium. In contrast, immobilized enzyme activity was enhanced 1.2-1.4-fold at 20% of methanol, ethanol, 2-propanol, diethylene glycol, and acetone; and at 10% and 30% acetonitrile. Likewise, highest increased activity (1.8-fold) was also obtained in presence of 20% acetonitrile. Immobilized enzyme was successfully used in the synthesis of 2'-deoxyxanthosine and 2'-deoxyguanosine using 2'-deoxyuridine as sugar donor and the corresponding poor water-soluble base in the presence of 30% of methanol, ethanol, 2-propanol, ethylene glycol, acetonitrile, and DMSO, giving high nucleoside yields at 4h. Copyright © 2011 Elsevier Ltd. All rights reserved.

  17. 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

  18. Experimental investigations on the weakening of pulsed X-radiation by contrast media

    Energy Technology Data Exchange (ETDEWEB)

    Moldenhauer, K

    1973-07-25

    In order to be able to carry out a videodensitometry simultaneously with the cineangiocardiography with pulsed X-rays, the weakening of the X-radiation by contrast media is more closely examined and a calibration of the amplitudes is carried out. The determination of the extinction curves for different parts of the X-ray pulses show that under unfavourable conditions (high voltage, low tube current, no Cu filtration) the spectrum is displaced to larger wavelengths, white an influence on the weakness coefficient only occurs after the intensity has fallen to 10% of the impulse maximum. On the other hand, the quantity depedence of the extinction coefficient is significant. The densitometry simulations performed with a digital computer using empirically gained calibration curves show that a quantitative densitometry is possible even if the Lambert-Beer law is not valid.

  19. Experimental investigations on the weakening of pulsed X-radiation by contrast media

    International Nuclear Information System (INIS)

    Moldenhauer, K.

    1973-01-01

    In order to be able to carry out a videodensitometry simultaneously with the cineangiocardiography with pulsed X-rays, the weakening of the X-radiation by contrast media is more closely examined and a calibration of the amplitudes is carried out. The determination of the extinction curves for different parts of the X-ray pulses show that under unfavourable conditions (high voltage, low tube current, no Cu filtration) the spectrum is displaced to larger wavelengths, white an influence on the weakness coefficient only occurs after the intensity has fallen to 10% of the impulse maximum. On the other hand, the quantity depedence of the extinction coefficient is significant. The densitometry simulations performed with a digital computer using empirically gained calibration curves show that a quantitative densitometry is possible even if the Lambert-Beer law is not valid. (ORU/LH) [de

  20. Cardiovascular responses to the intracarotid injections of ionic contrast media and iohexol in the dog

    International Nuclear Information System (INIS)

    Hayakawa, K.; Morris, T.W.; Katzberg, R.W.; Fischer, H.W.

    1986-01-01

    Hypotension and bradycardia are the most significant cardiovascular responses resulting from intracarotid injections of hypertonic contrast media (CM). We have assessed both local and systemic vascular responses to the selective intracarotid injections of ionic and non-ionic CM in twelve pentobarbital anesthetized dogs. Alterations in blood pressure, heart rate, and femoral, renal and carotid blood flows were monitored following right common carotid artery injections of ionic contrast media (282-288 mg I/ml), isotonic saline, and iohexol (300 mg I/ml). Ionic CM led to early (0 to 10 s) decreases in blood pressure, heart rate and femoral vascular resistance. Isotonic saline induced no significant early changes in these same parameters while iohexol caused a decrease in heart rate. Our observations suggest that the early (0 to 10 s) decreases in femoral vascular resistance, heart rate and pressure that occur with the intracarotid injection of hypertonic CM are mediated via the autonomic nervous system and initiated from a site in the carotid circulation. During the 15 to 40 s period when the CM has reached the systemic circulation, iohexol produced smaller effects on systemic blood pressure and peripheral vascular resistances than did the ionic CM. During this 15 to 40 s period there were decreased vascular resistances in the carotid and renal vascular beds that probably result from local effects of the CM, however, the femoral resistance was actually increased. This later increase in femoral resistance probably represents the results of increased symphathetic nervous system activity working to offset the decrease in renal and carotid resistances and thus maintain pressure at baseline values. The vascular resistance changes observed demonstrate a complexity of responses to CM not previously appreciated. (orig.)

  1. 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.

  2. Side Effects of Radiographic Contrast Media: Pathogenesis, Risk Factors, and Prevention

    Directory of Open Access Journals (Sweden)

    Michele Andreucci

    2014-01-01

    Full Text Available Radiocontrast media (RCM are medical drugs used to improve the visibility of internal organs and structures in X-ray based imaging techniques. They may have side effects ranging from itching to a life-threatening emergency, known as contrast-induced nephropathy (CIN. We define CIN as acute renal failure occurring within 24–72 hrs of exposure to RCM that cannot be attributed to other causes. It usually occurs in patients with preexisting renal impairment and diabetes. The mechanisms underlying CIN include reduction in medullary blood flow leading to hypoxia and direct tubule cell damage and the formation of reactive oxygen species. Identification of patients at high risk for CIN is important. We have reviewed the risk factors and procedures for prevention, providing a long list of references enabling readers a deep evaluation of them both. The first rule to follow in patients at risk of CIN undergoing radiographic procedure is monitoring renal function by measuring serum creatinine and calculating the eGFR before and once daily for 5 days after the procedure. It is advised to discontinue potentially nephrotoxic medications, to choose radiocontrast media at lowest dosage, and to encourage oral or intravenous hydration. In high-risk patients N-acetylcysteine may also be given.

  3. Side Effects of Radiographic Contrast Media: Pathogenesis, Risk Factors, and Prevention

    Science.gov (United States)

    Tasanarong, Adis

    2014-01-01

    Radiocontrast media (RCM) are medical drugs used to improve the visibility of internal organs and structures in X-ray based imaging techniques. They may have side effects ranging from itching to a life-threatening emergency, known as contrast-induced nephropathy (CIN). We define CIN as acute renal failure occurring within 24–72 hrs of exposure to RCM that cannot be attributed to other causes. It usually occurs in patients with preexisting renal impairment and diabetes. The mechanisms underlying CIN include reduction in medullary blood flow leading to hypoxia and direct tubule cell damage and the formation of reactive oxygen species. Identification of patients at high risk for CIN is important. We have reviewed the risk factors and procedures for prevention, providing a long list of references enabling readers a deep evaluation of them both. The first rule to follow in patients at risk of CIN undergoing radiographic procedure is monitoring renal function by measuring serum creatinine and calculating the eGFR before and once daily for 5 days after the procedure. It is advised to discontinue potentially nephrotoxic medications, to choose radiocontrast media at lowest dosage, and to encourage oral or intravenous hydration. In high-risk patients N-acetylcysteine may also be given. PMID:24895606

  4. Early safety outcome following transcatheter aortic valve implantation: is the amount of contrast media used a matter of concern?

    Science.gov (United States)

    Vontobel, Jan; Possner, Mathias; Schütz, Philipp; Müller, Beat; Taramasso, Maurizio; Binder, Roland K; Haueis, Sabine; Attinger-Toller, Adrian; Maisano, Francesco; Nietlispach, Fabian

    2015-01-01

    The study objective was to evaluate the impact of the amount of contrast medium used for transcatheter aortic valve implantation (TAVI) on short-term outcome. Patients undergoing TAVI are exposed to repeat contrast medium application both for preprocedural screening and during the TAVI procedure itself. Whether the amount of contrast media is associated with worse outcome is unclear. A total of 257 patients were included (median age 82.7 years) and divided into two groups with preserved and reduced kidney function (glomerular filtration rate contrast media administered during and within 5 days prior to TAVI was analysed. A combined early safety endpoint at 30 days was evaluated. The early safety endpoint was reached by 31 patients and acute kidney injury occurred in 22 patients. The median total volume of contrast media administered was 144 ml (interquartile range 81-225 ml). The amount of contrast did not independently predict the early safety endpoint in the overall population (odds ratio [OR] 0.93, 95% confidence interval [CI] 0.56 to 1.53, p = 0.774) and in subgroups with preserved and reduced kidney function. Change in creatinine was an independent strong predictor of the early safety endpoint in the overall population (OR 18.13, 95% CI 4.70 to 69.99, p contrast did not predict a change in creatinine within 72 hours following TAVI (r = 0.02, 95% CI -0.02 to 0.07, p = 0.368). Decreased kidney function after TAVI influences outcome. When rather small amounts of contrast media are used for screening and the TAVI procedure itself, the amount of contrast media seems not to be an independent predictor of outcome, further suggesting that decreased kidney function after TAVI is multifactorial.

  5. 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

  6. 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.)

  7. 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.)

  8. 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

  9. The comparative study of various oral contrast media in 3D display of gastric lesions in spiral CT

    International Nuclear Information System (INIS)

    Wu Dong; Zhou Kangrong; Peng Weijun

    2001-01-01

    Objective: To optimize the oral contrast media in three-dimensional display of gastric lesions. Methods: 41 cases were randomly divided into 3 groups according to different oral contrast media administered: No. 1 air contrast group (n = 17), No. 2 fat emulsion group (n = 7) and No. 3 positive contrast group (n = 25). The 3D CT images were reconstructed using MPR, SSD, RaySum display and virtual endoscopic techniques, and compared with gastric endoscopy and/or conventional barium study. Results: The detectability of gastric lesions using fat emulsion and air contrast was 42.8%(3/7) and 80.0%(20/25), respectively, both were significantly lower than that using positive contrast (100%, 30/30) (x 2 = 19.22, P 2 = 6.60, P 2 = 17.04, P < 0.01). Conclusion: It is very important to choose the appropriate oral contrast media for 3D display of gastric lesions in spiral CT, the positive contrast agent is the optimal choice

  10. Occupational doses during the injection of contrast media in paediatric CT procedures

    International Nuclear Information System (INIS)

    Al-Haj, A.N.; Lobriguito, A.M.; Lagarde, C.S.

    2003-01-01

    The administration of intravenous contrast media by hand or power injection in paediatric computed tomography (CT) procedures is carried out at King Faisal Specialist Hospital and Research Centre for chest, abdomen and torso diagnostic examinations. Some procedures require the CT unit to commence patient scanning during the injection of the last volume of the contrast medium. During the injection, even if the nurse is wearing a 0.5 mm lead equivalent protective apron, the head region and the hand are likely to receive high doses. This study was therefore made to assess the head and extremity doses to the nurses during CT procedures where typical exposure parameters of 200 to 220 mA s and 120 kV p were used. Thermoluminescence dosemeters were deployed for three consecutive months in two CT rooms. A total of 96 procedures were performed during this period and they were included in this study. Scattered radiation measurements were done at different locations where the nurse may be positioned. Results showed that the average dose to the head region and the hands per paediatric case were 50 μSv and 80 μSv respectively. This study investigated the factors that affect the dose and found them to be the length of stay inside the room, type of CT examination, exposure parameters and location of the nurse. (author)

  11. Valsartan protects HK-2 cells from contrast media-induced apoptosis by inhibiting endoplasmic reticulum stress.

    Science.gov (United States)

    Peng, Ping-An; Wang, Le; Ma, Qian; Xin, Yi; Zhang, Ou; Han, Hong-Ya; Liu, Xiao-Li; Ji, Qing-Wei; Zhou, Yu-Jie; Zhao, Ying-Xin

    2015-12-01

    Contrast-induced acute kidney injury (CI-AKI) is associated with increasing in-hospital and long-term adverse clinical outcomes in high-risk patients undergoing percutaneous coronary intervention (PCI). Contrast media (CM)-induced renal tubular cell apoptosis is reported to participate in this process by activating endoplasmic reticulum (ER) stress. An angiotensin II type 1 receptor (AT1R) antagonist can alleviate ER stress-induced renal apoptosis in streptozotocin (STZ)-induced diabetic mice and can reduce CM-induced renal apoptosis by reducing oxidative stress and reversing the enhancement of bax mRNA and the reduction of bcl-2 mRNA, but the effect of the AT1R blocker on ER stress in the pathogenesis of CI-AKI is still unknown. In this study, we explored the effect of valsartan on meglumine diatrizoate-induced human renal tubular cell apoptosis by measuring changes in ER stress-related biomarkers. The results showed that meglumine diatrizoate caused significant cell apoptosis by up-regulating the expression of ER stress markers, including glucose-regulated protein 78 (GRP78), activating transcription factor 4 (ATF4), CCAAT/enhancer-binding protein-homologous protein (CHOP) and caspase 12, in a time- and dose-dependent manner, which could be alleviated by preincubation with valsartan. In conclusion, valsartan had a potential nephroprotective effect on meglumine diatrizoate-induced renal cell apoptosis by inhibiting ER stress. © 2015 International Federation for Cell Biology.

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

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    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.

  13. Induction of mitotic micronuclei by X-ray contrast media in human peripheral lymphocytes

    International Nuclear Information System (INIS)

    Parvez, Z.; Moncada, R.; Kormano, M.; Satokari, K.; Eklund, R.

    1987-01-01

    In vitro and in vivo cytogenetic effects of X-ray contrast media (CM) were determined by scoring micronuclei (MN) in 72-h cultures of human peripheral lymphocytes. Both ionic (sodium meglumine diatrizoate, methylglucamine diatrizoate, and sodium meglumine ioxaglate and nonionic CM (iosimide, iopromide, iohexol and iotrolan) were able to induce MN in lymphocytes. Based upon their calculated percent probabilities for MN induction, these agents could be ranked in their decreasing order of probability, as iosimide > sodium meglumine ioxaglate > iohexol > sodium meglumine diatrizoate > iopromide > methylglucamine diatrizoate > iotrolan. Stepwise logistic regression analysis of the data indicated that the frequency of MN in CM-exposed lymphocyte cultures was significantly higher than the frequency of MN in control cultures (P < 0.001). In clinical studies where 14 patients were injected with an ionic CM methylglucamine diatrizoate, lymphocyte cultures from 10 patients showed higher frequencies of MN. The differences between pre- and post-CM counts of MN were significant in a Mann-Whitney U test (P < 0.05). The effect of X-irradiation on MN formation in lymphocytes was separately determined and was found to be insignificant. These results indicate that irrespective of ionic and osmolality differences, X-ray contrast agents are capable of producing chromosomal damage in peripheral lymphocytes. Further studies are required to establish molecular mechanisms in the observed cytogenetic effects of CM in cell cultures. (Auth.)

  14. Contrast media and glomerular filtration: dose dependence of clearance for three agents

    International Nuclear Information System (INIS)

    Baeck, S.E.K.; Krutzen, E.; Nilsson-Ehle, P.

    1988-01-01

    Determination of plasma clearance of contrast agents has been advocated as a means to assess glomerular filtration rate. To evaluate the feasibility of different agents for this purpose, we have compared, in healthy volunteers, the dose dependence of plasma clearance for three contrast media (iohexol, a nonionic agent, and iothalamate and metrizoate, which are ionic substances), with special emphasis on the lower dose range (2-20 mL corresponding to 0.9-12.9 g, depending on dose and agent). Iohexol and iothalamate were cleared at constant rates, irrespective of given dose, whereas metrizoate clearance increased significantly at lower doses. In general, the clearances or iothalamate and metrizoate were, respectively, moderately and markedly higher than that of iohexol. The clearance of different doses of metrizoate (2 mL versus a radiographic dose of 40 mL or more) was also compared with the clearance of [ 51 Cr]EDTA in two groups of patients with reduced renal function. When compared with [ 51 Cr]EDTA in patients with renal dysfunction, metrizoate was cleared significantly faster after a 2-mL dose, whereas clearances were identical when the metrizoate dose was 40 mL or more. These findings indicate that tubular secretion plays an active role in the elimination of metrizoate. The pharmacokinetic properties of iohexol, in combination with its low toxicity, make it a suitable agent for determination of glomerular filtration rate in clinical practice

  15. 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.

  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. 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.)

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

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    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.

  20. 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.

  1. Effect of ionic and non-ionic contrast media on aggregation of red blood cells in vitro

    International Nuclear Information System (INIS)

    Raininko, R.; Ylinen, S.L.

    1987-01-01

    Fresh human blood without additives, and contrast medium were mixed and examined immediately by light microscopy in a non-flowing state. Sodium meglumine diatrizoate, meglumine diatrizoate, meglumine iodamide, sodium meglumine ioxaglate, iopromide, iopamidol, iohexol, and metrizamide were tested in concentrations of 300 mgI/ml. Physiologic saline and 5% glucose were used as controls. All media were tested in a randomized order with blood samples from 23 volunteers. No aggregation was detected in physiologic saline, and few rouleaux were found in ionic contrast media. Irregular red cell aggregates were found in all low-osmolal contrast media: in 17% of the specimens in ioxaglate, in 52% in metrizamide, and in 78 to 100% in other non-ionic media. Irregular aggregates were seen in all specimens with glucose. It remains to be domonstrated whether or not the irregular aggregation of human red cells in non-ionic contrast media has clinical significance. Iohexol was also tested with blood samples from several laboratory animals, but in nearly every case no aggregates were found. Results of animal experiments or tests with animal blood seem to be poorly applicable to man. (orig.)

  2. [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.

  3. Solubility of La, Pr, Eu, Er and Lu in a media of 1M ionic force of NaCl by 303 K

    International Nuclear Information System (INIS)

    Ramirez G, J.J.; Solache R, M.J.; Jimenez R, M.; Rojas H, A.

    2002-01-01

    The solubility and the solubility product of La, Pr, Eu, Er and Lu in media of 1M ionic force of NaCl by 303 K was determined, by means of a radiochemical method and the pLn - pCH diagrams in free conditions of CO 2 were constructed. Moreover, the non saturation and the saturated zones and with them the pCH precipitation bound were determined. Finally a comparison among the obtained data in this work and those reported in the literature in several media was realized. (Author)

  4. 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.

  5. Polysorbate 80 and low-osmolality water-soluble contrast medium enema in diagnosis and treatment of faecal obstruction in malignant phaeochromocytoma

    International Nuclear Information System (INIS)

    Ratcliffe, J.F.

    1986-01-01

    Stercoral obstruction in a young woman with disseminated phaeochromocytoma was diagnosed and treated successfully using an enema of isosmolar iohexol (Omnipaque) and 1% polysorbate 80 (Tween 80) without complication. Surgical intervention was thus avoided. A low osmolality water-soluble contrast medium (iohexol 150 mg I/ml) with a wetting agent (1% Tween 80) was used because a barium suspension would have inspissated, exacerbating the constipation and a hyperosmolar contrast medium might have precipitated a hypertensive crisis and destablished her critical salt and water balance. (orig.)

  6. Application of low dose radiation and low concentration contrast media in enhanced CT scans in children with congenital heart disease.

    Science.gov (United States)

    Liu, Zhimin; Song, Lei; Yu, Tong; Gao, Jun; Zhang, Qifeng; Jiang, Ling; Liu, Yong; Peng, Yun

    2016-09-01

    The aim of this study was to explore the feasibility of using low dose radiation and low concentration contrast media in enhanced CT examinations in children with congenital heart disease. Ninety patients with congenital heart disease were randomly divided into three groups of 30 patients each who underwent contrast-enhanced cardiac scans on a Discovery CT750 HD scanner. Group A received 270 mg I/mL iodixanol, and group B received 320 mg I/mL iodixanol contrast media and was scanned with prospective ECG triggering mode. Group C received 320 mg I/mL iodixanol and was scanned with conventional retrospective ECG gating mode. The same weight-based contrast injection protocol was used for all three groups. Images were reconstructed using a 30% adaptive statistical iterative reconstruction (ASIR) algorithm and a 50% ASIR in groups A and B and a 30% ASIR in group C. The subjective and objective image quality evaluations, diagnostic accuracies, radiation doses and amounts of contrast media in the three groups were measured and compared. All images in the three groups met the diagnostic requirements, with the same diagnostic accuracy and image quality scores greater than 3 in a 4-point scoring system. However, ventricular enhancement and the objective noise, signal-to-noise ratio, contrast-to-noise ratio and subjective image quality scores in group C were better than those in groups A and B (all Pcontrast dose (14% lower than that of groups B and C). Enhanced CT scan images with low dose radiation and low concentration contrast media can meet the diagnostic requirements for examining children with congenital heart disease while reducing the potential risk of radiation damage and contrast-induced nephropathy. © 2016 John Wiley & Sons Ltd.

  7. 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.

  8. 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.

  9. 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

  10. 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.)

  11. 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.

  12. Effects of Contrast Media on Blood Rheology: Comparison in Humans, Pigs, and Sheep

    International Nuclear Information System (INIS)

    Laurent, Alexandre; Durussel, Jean Jacques; Dufaux, Jacques; Penhouet, Laurence; Bailly, Anne Laure; Bonneau, Michel; Merland, Jean Jacques

    1999-01-01

    Purpose: To compare whole blood viscosity and erythrocyte aggregation in humans, pigs, and sheep, before and after adding water-soluble iodinated contrast medium (CM). Methods: Two CMs were studied: iopromide (nonionic) and ioxaglate (ionic). The blood-CM viscosity was measured with a Couette viscometer. Erythrocyte aggregation was measured with an erythroaggregometer. Results: The blood-CM viscosity was increased up to +20% (relative to pure blood) with a CM concentration of 0%-10%. At CM concentrations from 10% to 50%, the viscosity decreased. The disaggregation shear stress was increased (relative to pure blood) at low CM concentration (0%-10%). When the CM concentration increased from 10% to 20%, the disaggregation shear stress was decreased, except with the pig blood-ioxaglate mixture. Conclusion: At low CM concentration the blood viscosity was increased in pig, sheep, and humans and the disaggregation shear stress was increased in pig and humans. The aggregation of sheep blood was too low to be detected by the erythroaggregometer. This rise can be explained by the formation of poorly deformable echinocytes. At higher CM concentration, the viscosity and the disaggregation shear stress decreased in relation to the blood dilution. We conclude that pig blood and sheep blood can both be used to study the effect of CM injection on blood viscosity. Nevertheless, the rheologic behavior of pig blood in terms of erythrocyte aggregation is closer to that of human blood than is sheep blood when mixed with CM. Pigs could thus be more suitable than sheep for in vivo studies of CM miscibility with blood during selective cannulation procedures

  13. 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

  14. Should patients with risk factors be tested for hypersensitivity to contrast media: a prospective study.

    Science.gov (United States)

    Tepetam, Fatma Merve; Çiftaslan, Nezihe; Oruç, Özlem; Duman, Dildar; Ağca, Meltem; Bulut, İsmet; Çolakoğlu, Bahattin

    2016-08-01

    Previous hypersensitivity reactions to contrast media (CM), atopy, atopic disease, drug allergy, and age (20-29 or >55) are risk factors for CM hypersensitivity reactions. Our aim was to evaluate whether these risk factors should prompt skin testing for diagnosing CM allergy. The study was conducted among patients referred for allergy testing with CM. Skin tests were performed with non ionic or gadolinium CM, recommended by a radiologist. After completion of tests patients were telephonically queried on their symptoms of reactions. 151 risk patients (53 men, 98 women; mean age 55.2) were included in the study. Only 13 (9 %) had a history of hypersensitivity reaction to CM. Compared with the other patients, atopy was significantly more common in patients with a history of CM hypersensitivity reactions. Female gender and mean age were also higher, but not significant. All of the tests with CMs were negative. Only one patient reported urticaria within 1-2 min after administration of CM (telephonically). Atopy can increase the risk of CM allergy. However, skin tests with CMs may be inefficient, unnecessary, and time-consuming, except in cases with a history of CM allergy. Premedication protocols appear to be beneficial in patients with a history of CM allergy and cannot be recommended for patients with well-controlled asthma, rhinitis, atopic dermatitis or history of drug allergy.

  15. 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

  16. An evaluation of the use of oral contrast media in abdominopelvic CT

    Energy Technology Data Exchange (ETDEWEB)

    Buttigieg, Erica Lauren; Cortis, Kelvin; Galea Soler, Sandro [Mater Dei Hospital, Medical Imaging Department, Msida (Malta); Borg Grima, Karen; Zarb, Francis [Mater Dei Hospital, Faculty of Health Sciences, Msida (Malta)

    2014-11-15

    To evaluate the diagnostic efficacy of different oral contrast media (OCM) for abdominopelvic CT examinations performed for follow-up general oncological indications. The objectives were to establish anatomical image quality criteria for abdominopelvic CT; use these criteria to evaluate and compare image quality using positive OCM, neutral OCM and no OCM; and evaluate possible benefits for the medical imaging department. Forty-six adult patients attending a follow-up abdominopelvic CT for general oncological indications and who had a previous abdominopelvic CT with positive OCM (n = 46) were recruited and prospectively placed into either the water (n = 25) or no OCM (n = 21) group. Three radiologists performed absolute visual grading analysis (VGA) to assess image quality by grading the fulfilment of 24 anatomical image quality criteria. Visual grading characteristics (VGC) analysis of the data showed comparable image quality with regards to reproduction of abdominal structures, bowel discrimination, presence of artefacts, and visualization of the amount of intra-abdominal fat for the three OCM protocols. All three OCM protocols provided similar image quality for follow-up abdominopelvic CT for general oncological indications. (orig.)

  17. An evaluation of the use of oral contrast media in abdominopelvic CT

    International Nuclear Information System (INIS)

    Buttigieg, Erica Lauren; Cortis, Kelvin; Galea Soler, Sandro; Borg Grima, Karen; Zarb, Francis

    2014-01-01

    To evaluate the diagnostic efficacy of different oral contrast media (OCM) for abdominopelvic CT examinations performed for follow-up general oncological indications. The objectives were to establish anatomical image quality criteria for abdominopelvic CT; use these criteria to evaluate and compare image quality using positive OCM, neutral OCM and no OCM; and evaluate possible benefits for the medical imaging department. Forty-six adult patients attending a follow-up abdominopelvic CT for general oncological indications and who had a previous abdominopelvic CT with positive OCM (n = 46) were recruited and prospectively placed into either the water (n = 25) or no OCM (n = 21) group. Three radiologists performed absolute visual grading analysis (VGA) to assess image quality by grading the fulfilment of 24 anatomical image quality criteria. Visual grading characteristics (VGC) analysis of the data showed comparable image quality with regards to reproduction of abdominal structures, bowel discrimination, presence of artefacts, and visualization of the amount of intra-abdominal fat for the three OCM protocols. All three OCM protocols provided similar image quality for follow-up abdominopelvic CT for general oncological indications. (orig.)

  18. The present status in the clinical development of MR contrast media

    International Nuclear Information System (INIS)

    Laniado, M.; Kopp, A.F.

    1997-01-01

    The paramagnetic extracellular Gd contrast media (Gd-CM) Magnevist, Dotarem, Omniscan, and ProHance are on the market, whereas Gadovist, Optimark, and MultiHance (also used as a hepatobiliary CM) are undergoing clinical trials (phase III). Among other indications, Gd-CM are applied in tumours, inflammation, vascular pathologies, and MR-angiography. The paramagnetic hepatobiliary CM Teslascan, Eovist and MultiHance are in clinical trials (phase II and III). They improve tumour detection and characterisation. The Mn-CM Teslascan is also suited for pancreatic imaging, the Gd-CM MultiHance for imaging of myocardial infarction and the brain, and the Gd-CM Eovist has been used in liver CT. The superparamagnetic reticuloendothelial CM Endorem is on the market whereas Resovist is undergoing phase-III trials. Both agents have the same indications as the hepatobiliary CM. Sinerem is another superparamagnetic CM. However, it acts as a blood pool agent and accumulates in lymph nodes (MR lymphography). Gastrointestinal CM are divided into paramagnetic, superparamagnetic and diamagnetic agents acting either as positive or negative CM. Some are on the market, but their clinical value is limited. (orig.) [de

  19. Evaluation of individually body weight adapted contrast media injection in coronary CT-angiography.

    Science.gov (United States)

    Mihl, Casper; Kok, Madeleine; Altintas, Sibel; Kietselaer, Bas L J H; Turek, Jakub; Wildberger, Joachim E; Das, Marco

    2016-04-01

    Contrast media (CM) injection protocols should be customized to the individual patient. Aim of this study was to determine if software tailored CM injections result in diagnostic enhancement of the coronary arteries in computed tomography angiography (CTA) and if attenuation values were comparable between different weight categories. 265 consecutive patients referred for routine coronary CTA were scanned on a 2nd generation dual-source CT. Group 1 (n=141) received an individual CM bolus based on weight categories (39-59 kg; 60-74 kg; 75-94 kg; 95-109 kg) and scan duration ('high-pitch: 1s; "dual-step prospective triggering": 7s), as determined by contrast injection software (Certegra™ P3T, Bayer, Berlin, Germany). Group 2 (n=124) received a standard fixed CM bolus; Iopromide 300 mgI/ml; volume: 75 ml; flow rate: 7.2 ml/s. Contrast enhancement was measured in all proximal and distal coronary segments. Subjective and objective image quality was evaluated. Statistical analysis was performed using SPSS (IBM, version 20.0). For group 1, mean attenuation values of all segments were diagnostic (>325 HU) without statistical significant differences between different weight categories (p>0.17), proximal vs. distal: 449 ± 65-373 ± 58 HU (39-59 kg); 443 ± 69-367 ± 81 HU (60-74 kg); 427 ± 59-370 ± 61 HU (75-94 kg); 427 ± 73-347 ± 61 HU (95-109 kg). Mean CM volumes were: 55 ± 6 ml (39-59 kg); 61 ± 7 ml (60-74 kg); 71 ± 8 ml (75-94 kg); 84 ± 9 ml (95-109 kg). For group 2, mean attenuation values were not all diagnostic with differences between weight categories (p<0.01), proximal vs. distal: 611 ± 142-408 ± 69 HU (39-59 kg); 562 ± 135-389 ± 98 HU (60-74 kg); 481 ± 83-329 ± 81 HU (75-94 kg); 420 ± 73-305 ± 35 HU (95-109 kg). Comparable image noise and image quality were found between groups (p ≥ 0.330). Individually tailored CM injection protocols yield diagnostic attenuation and a more homogeneous enhancement pattern between different weight groups. CM

  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. Balancing Radiation and Contrast Media Dose in Single-Pass Abdominal Multidetector CT: Prospective Evaluation of Image Quality.

    Science.gov (United States)

    Camera, Luigi; Romano, Federica; Liccardo, Immacolata; Liuzzi, Raffaele; Imbriaco, Massimo; Mainenti, Pier Paolo; Pizzuti, Laura Micol; Segreto, Sabrina; Maurea, Simone; Brunetti, Arturo

    2015-11-01

    As both contrast and radiation dose affect the quality of CT images, a constant image quality in abdominal contrast-enhanced multidetector computed tomography (CE-MDCT) could be obtained balancing radiation and contrast media dose according to the age of the patients. Seventy-two (38 Men; 34 women; aged 20-83 years) patients underwent a single-pass abdominal CE-MDCT. Patients were divided into three different age groups: A (20-44 years); B (45-65 years); and C (>65 years). For each group, a different noise index (NI) and contrast media dose (370 mgI/mL) was selected as follows: A (NI, 15; 2.5 mL/kg), B (NI, 12.5; 2 mL/kg), and C (NI, 10; 1.5 mL/kg). Radiation exposure was reported as dose-length product (DLP) in mGy × cm. For quantitative analysis, signal-to-noise (SNR) and contrast-to-noise (CNR) ratios were calculated for both the liver (L) and the abdominal aorta (A). Statistical analysis was performed with a one-way analysis of variance. Standard imaging criteria were used for qualitative analysis. Although peak hepatic enhancement was 152 ± 16, 128 ± 12, and 101 ± 14 Hounsfield units (P contrast media dose (mL) administered were 476 ± 147 and 155 ± 27 for group A, 926 ± 291 and 130 ± 16 for group B, and 1981 ± 451 and 106 ± 15 for group C, respectively (P contrast media dose administered to patients of different age. Copyright © 2015 AUR. Published by Elsevier Inc. All rights reserved.

  2. Association Between Contrast Media Volume-Glomerular Filtration Rate Ratio and Contrast-Induced Acute Kidney Injury After Primary Percutaneous Coronary Intervention.

    Science.gov (United States)

    Celik, Omer; Ozturk, Derya; Akin, Fatih; Ayca, Burak; Yalcın, Ahmet Arif; Erturk, Mehmet; Bıyık, Ismail; Ayaz, Ahmet; Akturk, Ibrahim Faruk; Enhos, Asım; Aslan, Serkan

    2015-07-01

    We hypothesized that contrast media volume-estimated glomerular filtration rate (CV-e-GFR) ratio may be a predictor of contrast media-induced acute kidney injury (CI-AKI). We investigated the associations between CV-e-GFR ratio and CI-AKI in 597 patients undergoing primary percutaneous coronary intervention (pPCI). An absolute ≥0.3 mg/dL increase in serum creatinine compared with baseline levels within 48 hours after the procedure was considered as CI-AKI; 78 (13.1%) of the 597 patients experienced CI-AKI. The amount of contrast during procedure was higher in the CI-AKI group than in those without CI-AKI (153 vs 135 mL, P = .003). The CV-e-GFR ratio was significantly higher in patients with CI-AKI than without (2.3 vs 1.5, P 2 (P < .001, OR = 5.917). In conclusion, CV-e-GFR ratio is significantly associated with CI-AKI after pPCI. © The Author(s) 2014.

  3. [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.

  4. Improved X-ray diagnosis of stomach by progress in the development of contrast media and examination techniques

    International Nuclear Information System (INIS)

    Lotz, W.

    1982-01-01

    Three factors have been responsible for the advances during the past few years in X-ray examination of the stomach: Improvement of the contrast media used; introduction of the rare-earth foils; and examination techniques imaging all sections of the stomach and of the duodenal bulb under hypotension in double-contrast technique, in complete filling, and imaging the accessible sections by means of proper compression. An interesting technique employs a combination of two different barium sulphate suspension used at the same time, e.g. Bubbly Barium or some other barium sulphate preparation with a small amount of High-Density Barium yielding excellent image of the gastric mucosa (technique with two contrast media). (orig.) [de

  5. 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.

  6. Effect of prostaglandin inhibition on the renal vascular response to ionic and non-ionic contrast media in the dog

    International Nuclear Information System (INIS)

    Lund, G.; Einzig, S.; Rysavy, J.; Salomonowitz, E.; Castaneda-Zuniga, W.; Amplatz, K.; Minnesota Univ., Minneapolis

    1984-01-01

    In an attempt to study the role of prostaglandins in the renal vascular response to contrast media in mongrel dogs, renal arterial injections of 6 ml of either the non-ionic contrast medium Iopamidol or the ionic medium diatrizoate meglumine/Na + were performed, before and after intravenous injection of a buffered solution of acetyl-salicylic acid (10 mg/kg) (ASA). Renal blood flow was recorded using non-occluding electromagnetic flow probes. The resting renal blood flow was significantly reduced after ASA. The usual biphasic response to contrast injection was observed both before and after ASA, and using either contrast medium. Analysis of the results failed to show any difference in degree of vasodilation or vasoconstriction after ASA. We conclude that prostaglandins may affect the resting level of renal blood flow but are not mediators of the instantaneous changes in response to contrast injection. (orig.)

  7. 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

  8. Nephrogenic systemic fibrosis: UK survey of the use of gadolinium-based contrast media

    International Nuclear Information System (INIS)

    Rees, O.; Agarwal, S.K.

    2010-01-01

    Aim: To identify the current practice of administration of gadolinium-based contrast media (Gd-CM) within the UK with respect to the European Society of Urogenital Radiology (ESUR) guidelines on nephrogenic systemic fibrosis (NSF). Materials and methods: One hundred and fifty-two institutions were contacted to request details regarding the use of Gd-CM at their institution, their awareness of NSF, and of the ESUR guidelines, and their departmental policy on the administration of Gd-CM agents associated with NSF (high-risk agents) in patients with diminished renal function. Results: Of the 100 institutions that replied, 72% used a cyclic agent as a first-line Gd-CM. The majority of institutions used more than one Gd-CM, and 57% used a high-risk Gd-CM. Seventy percent were aware of the ESUR guidelines, and of the 57% that used a high-risk Gd-CM, 9% did not check renal function at all prior to administration. The course of action of the remaining 48% was varied in patients with diminished renal function with some changing to a low-risk Gd-CM and others electing not to use Gd-CM at all. Five percent continued to use a high-risk Gd-CM with an estimated glomerular filtration rate <30 ml/min. Conclusion: The present survey shows that the majority of institutions use a low-risk Gd-CM as a first-line agent; however, a number of institutions do use a high-risk Gd-CM and their course of action for patients with diminished renal function is varied. Given current evidence, it is advisable to use a low-risk Gd-CM, such as a cyclic agent, in patients with diminished renal function.

  9. 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

  10. A possible role for cysteinyl-leukotrienes in non-ionic contrast media induced adverse reactions

    Energy Technology Data Exchange (ETDEWEB)

    Boehm, Ingrid [Department of Radiology, University of Bonn, Sigmund Freud Strasse 25, 53105 Bonn (Germany)]. E-mail: i.boehm@uni-bonn.de; Speck, Ulrich [Department of Radiology, Humboldt University (Charite) of Berlin (Germany); Schild, Hans [Department of Radiology, University of Bonn, Sigmund Freud Strasse 25, 53105 Bonn (Germany)

    2005-09-01

    Purpose: To test whether mono- or dimeric X-ray contrast media (CM) may induce the de novo production of cysteinyl-leukotriens (cys-LT), that could contribute to allergic/allergy-like side effects. Materials and methods: Leukocytes from 39 patients receiving iopromide or iotrolan for routine CT-examination were analyzed for the production of cys-LT. Histamine levels were analyzed in plasma specimens. One patient with a positive history of a previous CM-reaction did not receive CM-injection. Results: Three patients of the iopromide and five of the iotrolan group showed adverse reactions. Reactors had increased cys-LT values in samples obtained before CM-injection induced by the positive control (anti-Fc{epsilon}RI antibodies) (6763.7 pg/ml {+-} 1367.3 versus 2299.8 pg/ml {+-} 399.2; p < 0.007). Patients with versus without CM-reaction did not differ significantly with respect to their histamine values before CM-administeration. In vitro iopromide (p < 0.0002) and iotrolan (p < 0.0008) induced significant cys-LT production as compared to IL-3 stimulation. In vivo both CM induced a significant increase 6 h after CM administration (p < 0.05). Conclusion: Our findings suggest that both CM seem to induce cys-LT production. As to whether the observed increased values in pre-dose samples of patients with as compared to those without reactions could contribute to identify high risk patients should be investigated in larger patient groups in future.

  11. Contrast media administration in coronary computed tomography angiography. A systematic review

    Energy Technology Data Exchange (ETDEWEB)

    Mihl, Casper; Kok, Madeleine; Wildberger, Joachim E.; Das, Marco [Maastricht Univ. Medical Center (Netherlands). CARIM School for Cardiovascular Diseases; Maastricht Univ. Medical Center (Netherlands). Radiology; Maas, Monique; Lobbes, Marc B.I. [Maastricht Univ. Medical Center (Netherlands). Radiology; Turek, Jakub; Seehofnerova, Anna [Maastricht Univ. Medical Center (Netherlands). CARIM School for Cardiovascular Diseases; Leijenaar, Ralph T.H. [GROW School for Oncology and Developmental Biology, Maastricht (Netherlands). Radiation Oncology (MAASTRO)

    2017-04-15

    Various different injection parameters influence enhancement of the coronary arteries. There is no consensus in the literature regarding the optimal contrast media (CM) injection protocol. The aim of this study is to provide an update on the effect of different CM injection parameters on the coronary attenuation in coronary computed tomographic angiography (CCTA). Studies published between January 2001 and May 2014 identified by Pubmed, Embase and MEDLINE were evaluated. Using predefined inclusion criteria and a data extraction form, the content of each eligible study was assessed. Initially, 2551 potential studies were identified. After applying our criteria, 36 studies were found to be eligible. Studies were systematically assessed for quality based on the validated Quality Assessment of Diagnostic Accuracy Studies (QUADAS)-II checklist. Extracted data proved to be heterogeneous and often incomplete. The injection protocol and outcome of the included publications were very diverse and results are difficult to compare. Based on the extracted data, it remains unclear which of the injection parameters is the most important determinant for adequate attenuation. It is likely that one parameter which combines multiple parameters (e.g. IDR) will be the most suitable determinant of coronary attenuation in CCTA protocols. Research should be directed towards determining the influence of different injection parameters and defining individualized optimal IDRs tailored to patient-related factors (ideally in large randomized trials). Key points: This systematic review provides insight into decisive factors on coronary attenuation. Different and contradicting outcomes are reported on coronary attenuation in CCTA. One parameter combining multiple parameters (IDR) is likely decisive in coronary attenuation. Research should aim at defining individualized optimal IDRs tailored to individual factors. Future directions should be tailored towards the influence of different injection

  12. Referring Physicians' Tendency to Collaborate With Radiologists in Managing Contrast Media-Related Risk Factors.

    Science.gov (United States)

    İmamoğlu, Hakan; Doğan, Serap; Erdoğan, Nuri

    2018-02-01

    The aim of this study was to investigate the tendency of referring physicians to collaborate with radiologists in managing contrast media (CM)-related risk factors. The study was conducted at a single academic hospital. Among 150 referring physicians from various specialties, 51 referring physicians (34%) responded to the invitation letter asking for an interview with a radiologist. During the interview, a modified form of the Control Preferences Scale was administered, in which there were five preferences (each displayed on a separate card) that ranged from the fully active to fully passive involvement of referring physicians in managing CM-related risk factors. A descriptive analysis was performed through categorization of the results depending on the respondents' two most preferred roles. Thirty-six referring physicians (70.5%) preferred a collaborative role, and 15 (29.4%) preferred a noncollaborative role (i.e., remained on either the fully active or fully passive side). Among the referring physicians who preferred a collaborative role, the most common response (n = 15 [29.4%]) was collaborative-active. Referring physicians at the authors' institution have basic cognitive and motivational-affective tone toward collaboration in future teamwork aimed at the management of CM-related risk factors. A modified form of the Control Preferences Scale, as in this study, can be used to investigate the tendency of referring physicians to collaborate with radiologists. The results are discussed from ethical and legal perspectives. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  13. A possible role for cysteinyl-leukotrienes in non-ionic contrast media induced adverse reactions

    International Nuclear Information System (INIS)

    Boehm, Ingrid; Speck, Ulrich; Schild, Hans

    2005-01-01

    Purpose: To test whether mono- or dimeric X-ray contrast media (CM) may induce the de novo production of cysteinyl-leukotriens (cys-LT), that could contribute to allergic/allergy-like side effects. Materials and methods: Leukocytes from 39 patients receiving iopromide or iotrolan for routine CT-examination were analyzed for the production of cys-LT. Histamine levels were analyzed in plasma specimens. One patient with a positive history of a previous CM-reaction did not receive CM-injection. Results: Three patients of the iopromide and five of the iotrolan group showed adverse reactions. Reactors had increased cys-LT values in samples obtained before CM-injection induced by the positive control (anti-FcεRI antibodies) (6763.7 pg/ml ± 1367.3 versus 2299.8 pg/ml ± 399.2; p < 0.007). Patients with versus without CM-reaction did not differ significantly with respect to their histamine values before CM-administeration. In vitro iopromide (p < 0.0002) and iotrolan (p < 0.0008) induced significant cys-LT production as compared to IL-3 stimulation. In vivo both CM induced a significant increase 6 h after CM administration (p < 0.05). Conclusion: Our findings suggest that both CM seem to induce cys-LT production. As to whether the observed increased values in pre-dose samples of patients with as compared to those without reactions could contribute to identify high risk patients should be investigated in larger patient groups in future

  14. Contrast media administration in coronary computed tomography angiography. A systematic review

    International Nuclear Information System (INIS)

    Mihl, Casper; Kok, Madeleine; Wildberger, Joachim E.; Das, Marco

    2017-01-01

    Various different injection parameters influence enhancement of the coronary arteries. There is no consensus in the literature regarding the optimal contrast media (CM) injection protocol. The aim of this study is to provide an update on the effect of different CM injection parameters on the coronary attenuation in coronary computed tomographic angiography (CCTA). Studies published between January 2001 and May 2014 identified by Pubmed, Embase and MEDLINE were evaluated. Using predefined inclusion criteria and a data extraction form, the content of each eligible study was assessed. Initially, 2551 potential studies were identified. After applying our criteria, 36 studies were found to be eligible. Studies were systematically assessed for quality based on the validated Quality Assessment of Diagnostic Accuracy Studies (QUADAS)-II checklist. Extracted data proved to be heterogeneous and often incomplete. The injection protocol and outcome of the included publications were very diverse and results are difficult to compare. Based on the extracted data, it remains unclear which of the injection parameters is the most important determinant for adequate attenuation. It is likely that one parameter which combines multiple parameters (e.g. IDR) will be the most suitable determinant of coronary attenuation in CCTA protocols. Research should be directed towards determining the influence of different injection parameters and defining individualized optimal IDRs tailored to patient-related factors (ideally in large randomized trials). Key points: This systematic review provides insight into decisive factors on coronary attenuation. Different and contradicting outcomes are reported on coronary attenuation in CCTA. One parameter combining multiple parameters (IDR) is likely decisive in coronary attenuation. Research should aim at defining individualized optimal IDRs tailored to individual factors. Future directions should be tailored towards the influence of different injection

  15. Outcomes of premedication for non-ionic radio-contrast media hypersensitivity reactions in Korea

    International Nuclear Information System (INIS)

    Kim, Sae-Hoon; Lee, So-Hee; Lee, Sang-Min; Kang, Hye-Ryun; Park, Heung-Woo; Kim, Sun-Sin; Cho, Sang-Heon

    2011-01-01

    Background: Radio-contrast media (CM)-related adverse reactions are important clinical problems that may cause fatal anaphylaxis. Accordingly, it has been common practice to premedicate patients who have had previous reactions to CM with corticosteroids, antihistamines, and H2 blockers to prevent hypersensitive reactions. However, the effectiveness of premedication has not been properly demonstrated, especially in cases related to non-ionic CM. In this study, we evaluated the effectiveness of premedication at preventing of non-ionic CM immediate-type hypersensitivity reactions. Methods: A total of 30 patients who had been pretreated with corticosteroid and H1 antihistamines and/or H2 blockers in a 3-year period were enrolled. The results of premedication were evaluated in terms of clinical characteristics and the features of breakthrough reactions. Results: Hypersensitivity reactions were not prevented in 5 of the 30 patients who had experienced prior CM reactions (overall recurrence rate after premedication 16.7%; 4/17 patients with mild previous reactions, and 1/13 patients with severe previous reactions). The recurrence rate after premedication was significantly higher in patients with mild previous reactions than in those with severe reactions (23.5% vs. 7.7%; p < 0.001). The breakthrough reactions were similar to the prior reactions in terms of severity and clinical manifestations. Conclusion: Premedication with corticosteroid and H1 antihistamines and/or H2 blockers effectively prevent non-ionic CM-related adverse events in most patients who have had severe previous reactions to CM. However, physicians should be aware of the possibility of premedication failing and of breakthrough reactions, even in cases in which the previous reactions were mild.

  16. Contrast media-induced nephropathy: how has Italy contributed in the past 30 years? A systematic review

    Directory of Open Access Journals (Sweden)

    Sessa M

    2017-10-01

    Full Text Available Maurizio Sessa,1,* Claudia Rossi,2,* Annamaria Mascolo,1 Cristina Scavone,1 Gabriella di Mauro,1 Roberto Grassi,2 Liberata Sportiello,1 Salvatore Cappabianca,2 Concetta Rafaniello1 1Section of Pharmacology “L Donatelli”, Department of Experimental Medicine, University of Campania “L Vanvitelli”, Naples, Italy; 2Section of Radiology and Radiotherapy, Department of Clinical and Experimental Medicine “Magrassi-Lanzara”, University of Campania “L Vanvitelli”, Naples, Italy *These authors contributed equally to this work Background and objective: The use of contrast media in Italy has exponentially increased in the past 3 decades. However, it is unknown whether there has been an increase in clinical research evaluating the risks associated with contrast media usage, especially regarding contrast-induced nephropathy. To fill this gap in knowledge, we performed a systematic review.Study eligibility criteria: Meta-analyses, observational studies, and clinical trials assessing contrast media-induced nephropathy as the safety outcome, in which at least one author was affiliated with an Italian university/health care structure, were eligble.Data sources: Ovid MEDLINE, Ovid Embase, Cochrane Methodology Register, and Web of Science were screened.Participants: Men and women exposed to contrast media.Results: In total, 60 original articles were retrieved with an incremental trend between 1990 and 2017. Cohort studies were the most common study design represented. In total, 45 of 60 (75.0% studies were monocenter studies and 41 of 60 (68.3% received no funding. In all, 91.7% of studies disclosed no conflicts of interest and 81.7% had no external collaboration. Most of the studies provided a level of evidence of III-2 (32/60; 53.3% and II (23/60; 38.3%. In total, 50 of 60 studies (83.3% were published in a scientific journal ranked in the first quartile of their subject area.Conclusion: There was an increased number of studies evaluating

  17. New biodegradable organic-soluble chelating agents for simultaneous removal of heavy metals and organic pollutants from contaminated media

    International Nuclear Information System (INIS)

    Ullmann, Amos; Brauner, Neima; Vazana, Shlomi; Katz, Zhanna; Goikhman, Roman; Seemann, Boaz; Marom, Hanit; Gozin, Michael

    2013-01-01

    Highlights: • New soil remediation process using phase transition of partially miscible solvents. • Design and synthesis of new bio-degradable, organic soluble chelating agents. • Feasibility tests of the process on authentically polluted sediments and sludge. • Simultaneous removal of toxic metals and organic pollutants was demonstrated. -- Abstract: Advanced biodegradable and non-toxic organic chelators, which are soluble in organic media, were synthesized on the basis of the S,S-ethylenediamine-disuccinate (S,S-EDDS) ligand. The modifications suggested in this work include attachment of a lipophilic hydrocarbon chain (“tail”) to one or both nitrogen atoms of the S,S-EDDS. The new ligands were designed and evaluated for application in the Sediments Remediation Phase Transition Extraction (SR-PTE) process. This novel process is being developed for the simultaneous removal of both heavy metals and organic pollutants from contaminated soils, sediments or sludge. The new chelators were designed to bind various target metal ions, to promote extraction of these ions into organic solvents. Several variations of attached tails were synthesized and tested. The results for one of them, N,N′-bis-dodecyl-S,S-EDDS (C24-EDDS), showed that the metal-ligand complexes are concentrated in the organic-rich phase in the Phase Transition Extraction process (more than 80%). Preliminary applications of the SR-PTE process with the C24-EDDS ligand were conducted also on actually contaminated sludge (field samples). The extraction of five toxic metals, namely, Cd, Cu, Ni, Pb and Zn was examined. In general, the extraction performance of the new ligand was not less than that of S,S-EDDS when a sufficient ligand-to-extracted ion ratio (about 4:1 was applied

  18. New biodegradable organic-soluble chelating agents for simultaneous removal of heavy metals and organic pollutants from contaminated media

    Energy Technology Data Exchange (ETDEWEB)

    Ullmann, Amos, E-mail: Ullmann@eng.tau.ac.il [Faculty of Engineering, School of Mechanical Engineering, Tel Aviv University, Tel Aviv 69978 (Israel); Brauner, Neima; Vazana, Shlomi; Katz, Zhanna [Faculty of Engineering, School of Mechanical Engineering, Tel Aviv University, Tel Aviv 69978 (Israel); Goikhman, Roman [The Hebrew University of Jerusalem, The Robert H. Smith, Faculty of Agriculture, Food and Environment, Rehovot (Israel); Seemann, Boaz; Marom, Hanit [School of Chemistry, Faculty of Exact Sciences, Tel Aviv University, Tel Aviv 69978 (Israel); Gozin, Michael, E-mail: cogozin@gmail.com [School of Chemistry, Faculty of Exact Sciences, Tel Aviv University, Tel Aviv 69978 (Israel)

    2013-09-15

    Highlights: • New soil remediation process using phase transition of partially miscible solvents. • Design and synthesis of new bio-degradable, organic soluble chelating agents. • Feasibility tests of the process on authentically polluted sediments and sludge. • Simultaneous removal of toxic metals and organic pollutants was demonstrated. -- Abstract: Advanced biodegradable and non-toxic organic chelators, which are soluble in organic media, were synthesized on the basis of the S,S-ethylenediamine-disuccinate (S,S-EDDS) ligand. The modifications suggested in this work include attachment of a lipophilic hydrocarbon chain (“tail”) to one or both nitrogen atoms of the S,S-EDDS. The new ligands were designed and evaluated for application in the Sediments Remediation Phase Transition Extraction (SR-PTE) process. This novel process is being developed for the simultaneous removal of both heavy metals and organic pollutants from contaminated soils, sediments or sludge. The new chelators were designed to bind various target metal ions, to promote extraction of these ions into organic solvents. Several variations of attached tails were synthesized and tested. The results for one of them, N,N′-bis-dodecyl-S,S-EDDS (C24-EDDS), showed that the metal-ligand complexes are concentrated in the organic-rich phase in the Phase Transition Extraction process (more than 80%). Preliminary applications of the SR-PTE process with the C24-EDDS ligand were conducted also on actually contaminated sludge (field samples). The extraction of five toxic metals, namely, Cd, Cu, Ni, Pb and Zn was examined. In general, the extraction performance of the new ligand was not less than that of S,S-EDDS when a sufficient ligand-to-extracted ion ratio (about 4:1 was applied.

  19. Baseline Hemodynamics and Response to Contrast Media During Diagnostic Cardiac Catheterization Predict Adverse Events in Heart Failure Patients.

    Science.gov (United States)

    Denardo, Scott J; Vock, David M; Schmalfuss, Carsten M; Young, Gregory D; Tcheng, James E; O'Connor, Christopher M

    2016-07-01

    Contrast media administered during cardiac catheterization can affect hemodynamic variables. However, little is documented about the effects of contrast on hemodynamics in heart failure patients or the prognostic value of baseline and changes in hemodynamics for predicting subsequent adverse events. In this prospective study of 150 heart failure patients, we measured hemodynamics at baseline and after administration of iodixanol or iopamidol contrast. One-year Kaplan-Meier estimates of adverse event-free survival (death, heart failure hospitalization, and rehospitalization) were generated, grouping patients by baseline measures of pulmonary capillary wedge pressure (PCWP) and cardiac index (CI), and by changes in those measures after contrast administration. We used Cox proportional hazards modeling to assess sequentially adding baseline PCWP and change in CI to 5 validated risk models (Seattle Heart Failure Score, ESCAPE [Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness], CHARM [Candesartan in Heart Failure: Assessment of Reduction in Mortality and Morbidity], CORONA [Controlled Rosuvastatin Multinational Trial in Heart Failure], and MAGGIC [Meta-Analysis Global Group in Chronic Heart Failure]). Median contrast volume was 109 mL. Both contrast media caused similarly small but statistically significant changes in most hemodynamic variables. There were 39 adverse events (26.0%). Adverse event rates increased using the composite metric of baseline PCWP and change in CI (Pcontrast correlated with the poorest prognosis. Adding both baseline PCWP and change in CI to the 5 risk models universally improved their predictive value (P≤0.02). In heart failure patients, the administration of contrast causes small but significant changes in hemodynamics. Calculating baseline PCWP with change in CI after contrast predicts adverse events and increases the predictive value of existing models. Patients with elevated baseline PCWP and

  20. 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.

  1. Myelography in achondroplasia: value of a lateral C1-2 puncture and non-ionic, water-soluble contrast medium

    International Nuclear Information System (INIS)

    Suss, R.A.; Udvarhelyi, G.B.; Wang, H.; Kumar, A.J.; Zinreich, S.J.; Rosenbaum, A.E.

    1983-01-01

    Because of technical difficulties and diagnostic limitations encountered with other myelographic techniques in patients with achondroplasia, the authors employed a lateral C1-2 puncture and non-ionic, water-soluble contrast medium in 18 achondroplastic patients with spinal compression (21 procedures). This technique proved most appropriate for identifying the upper limit of degenerative osteophytes causing exacerbation of congenital spinal stenosis, which is crucial in planning decompressive surgery. A potentially important additional finding was the presence of degenerative lower cervical spine disease in the majority of patients. There were no serious complications. The authors recommend this technique as safe and effective in achondroplastic patients with severe congenital spinal stenosis

  2. Influence of Contrast Media on Bone Mineral Density (BMD) Measurements from Routine Contrast-Enhanced MDCT Datasets using a Phantom-less BMD Measurement Tool.

    Science.gov (United States)

    Toelly, Andrea; Bardach, Constanze; Weber, Michael; Gong, Rui; Lai, Yanbo; Wang, Pei; Guo, Yulin; Kirschke, Jan; Baum, Thomas; Gruber, Michael

    2017-06-01

    Aim  To evaluate the differences in phantom-less bone mineral density (BMD) measurements in contrast-enhanced routine MDCT scans at different contrast phases, and to develop an algorithm for calculating a reliable BMD value. Materials and Methods  112 postmenopausal women from the age of 40 to 77 years (mean age: 57.31 years; SD 9.61) who underwent a clinically indicated MDCT scan, consisting of an unenhanced, an arterial, and a venous phase, were included. A retrospective analysis of the BMD values of the Th12 to L4 vertebrae in each phase was performed using a commercially available phantom-less measurement tool. Results  The mean BMD value in the unenhanced MDCT scans was 79.76 mg/cm³ (SD 31.20), in the arterial phase it was 85.09 mg/cm³ (SD 31.61), and in the venous phase it was 86.18 mg/cm³ (SD 31.30). A significant difference (p Influence of Contrast Media on Bone Mineral Density (BMD) Measurements from Routine Contrast-Enhanced MDCT Datasets using a Phantom-less BMD Measurement Tool. Fortschr Röntgenstr 2017; 189: 537 - 543. © Georg Thieme Verlag KG Stuttgart · New York.

  3. The novel appearance of low rectal anastomosis on contrast enema following laparoscopic anterior resection: discriminating anastomotic leaks from "dog-ears" on water-soluble contrast enema and flexible sigmoidoscopy.

    Science.gov (United States)

    Katory, Mark; McLean, Ross; Osman, Khalid; Ahmad, Mukhtar; Hughes, Tracey; Newby, Mike; Dennison, Christopher; O'Loughlin, Paul

    2017-02-01

    Interpretation of water-soluble contrast enema following laparoscopic low anterior resection can be very challenging for both radiologists and colorectal surgeons. Discriminating the radiological appearances secondary to anastomotic configuration from those caused by actual anastomotic dehiscence is a common problem and may be made worse with the advent of laparoscopic surgery. The aim of this study is to identify potential novel appearances of the water-soluble contrast enema (WSCE) images of rectal anastomosis following laparoscopic low anterior resection to radiologists and surgeons. We enrolled 45 patients who underwent laparoscopic low anterior resection with proximal de-functioning loop ileostomy within a specialized colorectal unit. The water-soluble contrast enema reports were reviewed. Two blinded colorectal radiologists independently reviewed the images of patients suspected of anastomotic leak. All of these patients also underwent a flexible sigmoidoscopy to confirm or exclude anastomotic leak before reversal of loop ileostomy. Inter-observer concordance was calculated. Seven out of eighteen patients (38.9%) were found to have true anastomotic leaks on flexible sigmoidoscopy (15% overall leak rate). In the remaining eleven patients the image appearances were attributed to the appearance of the anastomotic 'dog-ear effect', created by the anastomotic configuration due to multiple firing of the intra-corporeal laparoscopic stapling device. Radiologist inter-observer concordance was 83%. Sensitivity was 100%, specificity 71%, positive-predictive value (38.9%) and negative-predictive value (100%). The novel appearances of laparoscopic-stapled rectal anastomoses in WSCE can be mistaken for anastomotic leak. To avoid delay in reversal of ileostomy, a flexible sigmoidoscopy can be used to confirm or exclude a leak.

  4. Influence of the timing of cardiac catheterization and amount of contrast media on acute renal failure after cardiac surgery.

    Science.gov (United States)

    Sadeghi, Mohsen Mirmohammad; Gharipour, Mojgan; Nilforoush, Peiman; Shamsolkotabi, Hamid; Sadeghi, Hamid Mirmohammad; Kiani, Amjad; Sadeghi, Pouya Mirmohammad; Farahmand, Niloufar

    2011-04-01

    There is limited data about the influence of timing of cardiac surgery in relation to diagnostic angiography and/or the impact of the amount of contrast media used during angiography on the occurance of acute renal failure (ARF). Therefore, in the present study the effect of the time interval between diagnostic angiography and cardiac surgery and also the amount of contrast media used during the diagnostic procedure on the incidence of ARF after cardiac surgery was investigated. Data of 1177 patients who underwent different types of cardiac surgeries after cardiac catheterization were prospectively examined. The influence of time interval between cardiac catheterization and surgery as well as the amount of contrast agent on postoperative ARF were assessed using multivariable logistic regression. The patients who progressed to ARF were more likely to have received a higher dose of contrast agent compared to the mean dose. However, the time interval between cardiac surgery and last catheterization was not significantly different between the patients with and without ARF (p = 0.05). Overall, postoperative peak creatinine was highest on day 0, then decreased and remained significantly unchanged after this period. Overall prevalence of acute renal failure during follow-up period had a changeable trend and had the highest rates in days 1 (53.57%) and 6 (52.17%) after surgery. Combined coronary bypass and valve surgery were the strongest predictor of postoperative ARF (OR: 4.976, CI = 1.613-15.355 and p = 0.002), followed by intra-aortic balloon pump insertion (OR: 6.890, CI = 1.482-32.032 and p = 0.009) and usage of higher doses of contrast media agent (OR: 1.446, CI = 1.033-2.025 and p = 0.031). Minimizing the amount of contrast agent has a potential role in reducing the incidence of postoperative ARF in patients undergoing cardiac surgery, but delaying cardiac surgery after exposure to these agents might not have this protective effect.

  5. Effects of intraarticular contrast media on synovial membrane and cartilage: An electron microscopic evaluation in rabbit knees

    International Nuclear Information System (INIS)

    Kose, N.; Inan, U.; Omeroglu, H.; Seber, S.; Baycu, C.; Omeroglu, H.

    2007-01-01

    To evaluate the histological and ultrastructural alterations in rabbit knee joint cartilage and synovia induced by intraarticular injections of 2 water soluble contrast agents. The study was conducted at the Department of Orthopedics and Traumatology, Medical Faculty, Osmangazi University, Eskisehir, Turkey in January 2002. To examine the effect of contrast agents on articular cartilage and synovial membrane, rabbit model was used. Specimens from 62 knee joints were examined by light microscopy and transmission electron microscopy one hour, one day, one week and 2 weeks after intraarticular administration of gadolinium-diethylenetriamine pentaacetic acid, iopromide or saline. In the knees injected with saline, light microscopic changes of the synovium consisted of edema only. Edema and hyperemia were seen in contrast agent injected knees. Ultrastructurally, numerous and large pinocytotic vesicles in A cells of the synovial membrane were seen in contrast agent injected groups. In the knees injected with saline the cartilage were ultrastructurally normal but contrast agent injected knees showed increased activation of chondrocytes with increase of dense glycogen accumulation, large lipid vacuoles and matrix material. There were very rare pycnotic cells in these samples. The rating scale has been used and the means of the total scores were determined for the groups. The effects of contrast agents reduced gradually on the cartilage and synovium in general but did not become completely normal in the observation period. (author)

  6. Control of asthma for reducing the risk of bronchospasm in asthmatics undergoing general anesthesia and/or intravascular administration of radiographic contrast media.

    Science.gov (United States)

    Liccardi, Gennaro; Salzillo, Antonello; De Blasio, Francesco; D'Amato, Gennaro

    2009-07-01

    It is well known that patients suffering from bronchial asthma undergoing surgical procedures requiring general anesthesia (GA) or the administration of water soluble radiographic contrast media (RCM) have an increased risk of potentially severe bronchospasm. Nevertheless, little attention has been devoted to the possible preventive measures to reduce the occurrence of this potentially life-threatening event. It has been shown that the most important risk factor for bronchospasm during GA induction and/or the use of RCM is represented by a high degree of bronchial hyperreactivity with airway instability not adequately controlled by long-term anti-inflammatory treatment. The aim of this commentary is to underline the need for an accurate clinical and functional evaluation of asthmatics undergoing surgical procedures requiring GA or radiological procedures requiring the administration of RCM, as well as to suggest a stepwise preventive pharmacological approach for reducing the risk of bronchospasm. The authors' suggestions represent clinical experience of the respiratory section of an internal hospital-based working group whose aim is the prevention of asthmatic/anaphylactic/anaphylactoid reactions during the administration of anesthetics and/or RCM. The MEDLINE database was searched with a combination of keywords: general anesthesia, radio contrast media [and] bronchial asthma. The main limitation of this commentary is the scarcity of available literature on this topic. The authors suggest a therapeutic approach before surgical procedures requiring GA and/or RCM administration based on the degree of asthma control as assessed by clinical/functional criteria. In this setting, in addition to the necessity of obtaining the best control of airway reactivity, the authors suggest that an optimal control of asthma symptoms in 'real life' conditions might likely constitute a safety issue in asthmatic patients in the case of emergency procedures.

  7. 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.)

  8. Impact of low-energy CT imaging on selection of positive oral contrast media concentration.

    Science.gov (United States)

    Patino, Manuel; Murcia, Diana J; Iamurri, Andrea Prochowski; Kambadakone, Avinash R; Hahn, Peter F; Sahani, Dushyant V

    2017-05-01

    To determine to what extent low-energy CT imaging affects attenuation of gastrointestinal tract (GIT) opacified with positive oral contrast media (OCM). Second, to establish optimal OCM concentrations for low-energy diagnostic CT exams. One hundred patients (38 men and 62 women; age 62 ± 11 years; BMI 26 ± 5) with positive OCM-enhanced 120-kVp single-energy CT (SECT), and follow-up 100-kVp acquisitions (group A; n = 50), or 40-70-keV reconstructions from rapid kV switching-single-source dual-energy CT (ssDECT) (group B; n = 50) were included. Luminal attenuation from different GIT segments was compared between exams. Standard dose of three OCM and diluted solutions (75%, 50%, and 25% concentrations) were introduced serially in a gastrointestinal phantom and scanned using SECT (120, 100, and 80 kVp) and DECT (80/140 kVp) acquisitions on a ssDECT scanner. Luminal attenuation was obtained on SECT and DECT images (40-70 keV), and compared to 120-kVp scans with standard OCM concentrations. Luminal attenuation was higher on 100-kVp (328 HU) and on 40-60-keV images (410-924 HU) in comparison to 120-kVp scans (298 HU) in groups A and B (p < 0.05). Phantom: There was an inverse correlation between luminal attenuation and X-ray energy, increasing up to 527 HU on low-kVp and 999 HU on low-keV images (p < 0.05). 25% and 50% diluted OCM solutions provided similar or higher attenuation than 120 kVp, at low kVp and keV, respectively. Low-energy CT imaging increases the attenuation of GIT opacified with positive OCM, permitting reduction of 25%-75% OCM concentration.

  9. 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

  10. 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.

  11. 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

  12. A note on variational multiscale methods for high-contrast heterogeneous porous media flows with rough source terms

    KAUST Repository

    Calo, Victor M.

    2011-09-01

    In this short note, we discuss variational multiscale methods for solving porous media flows in high-contrast heterogeneous media with rough source terms. Our objective is to separate, as much as possible, subgrid effects induced by the media properties from those due to heterogeneous source terms. For this reason, enriched coarse spaces designed for high-contrast multiscale problems are used to represent the effects of heterogeneities of the media. Furthermore, rough source terms are captured via auxiliary correction equations that appear in the formulation of variational multiscale methods [23]. These auxiliary equations are localized and one can use additive or multiplicative constructions for the subgrid corrections as discussed in the current paper. Our preliminary numerical results show that one can capture the effects due to both spatial heterogeneities in the coefficients (such as permeability field) and source terms (e.g., due to singular well terms) in one iteration. We test the cases for both smooth source terms and rough source terms and show that with the multiplicative correction, the numerical approximations are more accurate compared to the additive correction. © 2010 Elsevier Ltd.

  13. Biofilm imaging in porous media by laboratory X-Ray tomography: Combining a non-destructive contrast agent with propagation-based phase-contrast imaging tools.

    Science.gov (United States)

    Carrel, Maxence; Beltran, Mario A; Morales, Verónica L; Derlon, Nicolas; Morgenroth, Eberhard; Kaufmann, Rolf; Holzner, Markus

    2017-01-01

    X-ray tomography is a powerful tool giving access to the morphology of biofilms, in 3D porous media, at the mesoscale. Due to the high water content of biofilms, the attenuation coefficient of biofilms and water are very close, hindering the distinction between biofilms and water without the use of contrast agents. Until now, the use of contrast agents such as barium sulfate, silver-coated micro-particles or 1-chloronaphtalene added to the liquid phase allowed imaging the biofilm 3D morphology. However, these contrast agents are not passive and potentially interact with the biofilm when injected into the sample. Here, we use a natural inorganic compound, namely iron sulfate, as a contrast agent progressively bounded in dilute or colloidal form into the EPS matrix during biofilm growth. By combining a very long source-to-detector distance on a X-ray laboratory source with a Lorentzian filter implemented prior to tomographic reconstruction, we substantially increase the contrast between the biofilm and the surrounding liquid, which allows revealing the 3D biofilm morphology. A comparison of this new method with the method proposed by Davit et al (Davit et al., 2011), which uses barium sulfate as a contrast agent to mark the liquid phase was performed. Quantitative evaluations between the methods revealed substantial differences for the volumetric fractions obtained from both methods. Namely, contrast agent-biofilm interactions (e.g. biofilm detachment) occurring during barium sulfate injection caused a reduction of the biofilm volumetric fraction of more than 50% and displacement of biofilm patches elsewhere in the column. Two key advantages of the newly proposed method are that passive addition of iron sulfate maintains the integrity of the biofilm prior to imaging, and that the biofilm itself is marked by the contrast agent, rather than the liquid phase as in other available methods. The iron sulfate method presented can be applied to understand biofilm development

  14. [Me-too pharmaceuticals -- marketing-strategies of drug producers and drug purchasers. Example: non-ionic contrast media].

    Science.gov (United States)

    Wild, C; Puig, S

    2004-11-01

    In the context of increasing economic pressure upon on hospital budgets, it is inevitable that central and standardized purchasing of pharmaceuticals must be considered. It was the aim of this assessment to analyse the many different non-ionic contrast media/CM products on the actual "clinical relevance of the differences" in order to give advice for a more concerted purchasing of CM. The assessment was commissioned by a large scale Austrian hospital cooperation; it can be regarded as the beginning of a broad strategy against the many new, only rarely innovative, but nevertheless patent-protected pharmaceuticals. Eight different non-ionic contrast media - used in routine care - were compared for their physico-chemical characteristics: osmolality, nephrotoxicity, viscosity, hydrophilicity and electric charge. In a systematic review 193 publications were analysed. The examined CM show similar pharmacokinetic and -dynamic attributes, and no differences of clinical relevance. An optimisation of purchasing pharmaceuticals by standardisation of the range of products takes place in the context of common strategies of producers and buying agents in marketing-economies. The strategies of the pharmaceutical industry (patent protection of me-too drugs, high-price-policy, extensive marketing of up to 40 % of revenue) and the counter-strategies of the central hospital purchasers (market concentration, drug commissions, institutional measures to disentangle interests) are presented - exemplified by contrast media - in this article.

  15. 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

  16. Structural signatures of water-soluble organic aerosols in contrasting environments in South America and Western Europe.

    Science.gov (United States)

    Duarte, Regina M B O; Matos, João T V; Paula, Andreia S; Lopes, Sónia P; Pereira, Guilherme; Vasconcellos, Pérola; Gioda, Adriana; Carreira, Renato; Silva, Artur M S; Duarte, Armando C; Smichowski, Patricia; Rojas, Nestor; Sanchez-Ccoyllo, Odon

    2017-08-01

    This study describes and compares the key structural units present in water-soluble organic carbon (WSOC) fraction of atmospheric aerosols collected in different South American (Colombia - Medellín and Bogotá, Peru - Lima, Argentina - Buenos Aires, and Brazil - Rio de Janeiro, São Paulo, and Porto Velho, during moderate (MBB) and intense (IBB) biomass burning) and Western European (Portugal - Aveiro and Lisbon) locations. Proton nuclear magnetic resonance ( 1 H NMR) spectroscopy was employed to assess the relative distribution of non-exchangeable proton functional groups in aerosol WSOC of diverse origin, for the first time to the authors' knowledge in South America. The relative contribution of the proton functional groups was in the order H-C > H-C-C= > H-C-O > Ar-H, except in Porto Velho during MBB, Medellín, Bogotá, and Buenos Aires, for which the relative contribution of H-C-O was higher than that of H-C-C=. The 1 H NMR source attribution confirmed differences in aging processes or regional sources between the two geographic regions, allowing the differentiation between urban combustion-related aerosol and biological particles. The aerosol WSOC in Aveiro, Lisbon, and Rio de Janeiro during summer are more oxidized than those from the remaining locations, indicating the predominance of secondary organic aerosols. Fresh emissions, namely of smoke particles, becomes important during winter in Aveiro and São Paulo, and in Porto Velho during IBB. The biosphere is an important source altering the chemical composition of aerosol WSOC in South America locations. The source attribution in Medellín, Bogotá, Buenos Aires, and Lima confirmed the mixed contributions of biological material, secondary formation, as well as urban and biomass burning emissions. Overall, the information and knowledge acquired in this study provide important diagnostic tools for future studies aiming at understanding the water-soluble organic aerosol problem, their sources and

  17. pH-dependent solubility of indomethacin-saccharin and carbamazepine-saccharin cocrystals in aqueous media.

    Science.gov (United States)

    Alhalaweh, Amjad; Roy, Lilly; Rodríguez-Hornedo, Naír; Velaga, Sitaram P

    2012-09-04

    Cocrystals constitute an important class of pharmaceutical solids for their remarkable ability to modulate solubility and pH dependence of water insoluble drugs. Here we show how cocrystals of indomethacin-saccharin (IND-SAC) and carbamazepine-saccharin (CBZ-SAC) enhance solubility and impart a pH-sensitivity different from that of the drugs. IND-SAC exhibited solubilities 13 to 65 times higher than IND at pH values of 1 to 3, whereas CBZ-SAC exhibited a 2 to 10 times higher solubility than CBZ dihydrate. Cocrystal solubility dependence on pH predicted from mathematical models using cocrystal K(sp), and cocrystal component K(a) values, was in excellent agreement with experimental measurements. The cocrystal solubility increase relative to drug was predicted to reach a limiting value for a cocrystal with two acidic components. This limiting value is determined by the ionization constants of cocrystal components. Eutectic constants are shown to be meaningful indicators of cocrystal solubility and its pH dependence. The two contributions to solubility, cocrystal lattice and solvation, were evaluated by thermal and solubility determinations. The results show that solvation is the main barrier for the aqueous solubility of these drugs and their cocrystals, which are orders of magnitude higher than their lattice barriers. Cocrystal increase in solubility is thus a result of decreasing the solvation barrier compared to that of the drug. This work demonstrates the favorable properties of cocrystals and strategies that facilitate their meaningful characterization.

  18. The water soluble composite poly(vinylpyrrolidone–methylaniline: A new class of corrosion inhibitors of mild steel in hydrochloric acid media

    Directory of Open Access Journals (Sweden)

    R. Karthikaiselvi

    2017-02-01

    Full Text Available In recent years poly methyl aniline has been reported as one of the efficient corrosion inhibitors of mild steel in acidic media. In view of the major limitation of the insolubility of polymethyl aniline PMA, we propose to convert PMA into a water soluble composite using supporting polymer polyvinylpyrrolidone to get higher solubility and corrosion inhibition efficiency. The water soluble composite poly(vinylpyrrolidone-methyl aniline was synthesized by chemical oxidative polymerization and its inhibitive effect on mild steel in 1 M HCl has been investigated using weight loss and electrochemical techniques (potentiodynamic polarization studies and impedance spectroscopy. SEM and EDX analyses are carried out to establish a protective film formation on the metal surface.

  19. Soluble carbohydrate content variation in Sanionia uncinata and Polytrichastrum alpinum, two Antarctic mosses with contrasting desiccation capacities

    Directory of Open Access Journals (Sweden)

    Paz Zúñiga-González

    Full Text Available BACKGROUND: Cryptogamic vegetation dominates the ice-free areas along the Antarctic Peninsula. The two mosses Sanionia uncinata and Polytrichastrum alpinum inhabit soils with contrasting water availability. Sanionia uncinata grows in soil with continuous water supply, while P. alpinum grows in sandy, non-flooded soils. Desiccation and rehydration experiments were carried out to test for differences in the rate of water loss and uptake, with non-structural carbohydrates analysed to test their role in these processes. RESULTS: Individual plants of S. uncinata lost water 60 % faster than P. alpinum; however, clumps of S. uncinata took longer to dry than those of P. alpinum (11 vs. 5 h, respectively. In contrast, rehydration took less than 10 min for both mosses. Total non-structural carbohydrate content was higher in P. alpinum than in S. uncinata, but sugar levels changed more in P. alpinum during desiccation and rehydration (60-50 % when compared to S. uncinata. We report the presence of galactinol (a precursor of the raffinose family for the first time in P. alpinum. Galactinol was present at higher amounts than all other non-structural sugars. CONCLUSIONS: Individual plants of S. uncinata were not able to retain water for long periods but by growing and forming carpets, this species can retain water the longest. In contrast individual P. alpinum plants required more time to lose water than S. uncinata, but as moss cushions they suffered desiccation faster than the later. On the other hand, both species rehydrated very quickly. We found that when both mosses lost 50 % of their water, carbohydrates content remained stable and the plants did not accumulate non-structural carbohydrates during the desiccation prosses as usually occurs in vascular plants. The raffinose family oligosaccarides decreased during desiccation, and increased during rehydration, suggesting they function as osmoprotectors.

  20. 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.)

  1. 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.

  2. Use of high concentration contrast media: principles and rationale--vascular district

    International Nuclear Information System (INIS)

    Fleischmann, Dominik.

    2003-01-01

    Optimal contrast medium delivery remains a crucial issue in CT angiography and it will become even more critical with continuously evolving, faster CT scanner technology. This review article first explains the fundamentals of arterial enhancement using mathematical models of early contrast medium dynamics. The relationship of contrast medium volume, injection flow rates and injection duration are explicitly illustrated. Next, current techniques of contrast medium application are reviewed, with particular attention to methods of accurate timing of the scanning delay (test-bolus and automated bolus triggering), tools for automated saline-flushing of the veins (double-syringe power injectors) and the use of high-concentration contrast medium. From there, rational CT angiographic injection protocols for a wide range of selectable acquisition times for 4-, 8- and 16-channel MDCT are proposed

  3. Usage of CO2 microbubbles as flow-tracing contrast media in X-ray dynamic imaging of blood flows.

    Science.gov (United States)

    Lee, Sang Joon; Park, Han Wook; Jung, Sung Yong

    2014-09-01

    X-ray imaging techniques have been employed to visualize various biofluid flow phenomena in a non-destructive manner. X-ray particle image velocimetry (PIV) was developed to measure velocity fields of blood flows to obtain hemodynamic information. A time-resolved X-ray PIV technique that is capable of measuring the velocity fields of blood flows under real physiological conditions was recently developed. However, technical limitations still remained in the measurement of blood flows with high image contrast and sufficient biocapability. In this study, CO2 microbubbles as flow-tracing contrast media for X-ray PIV measurements of biofluid flows was developed. Human serum albumin and CO2 gas were mechanically agitated to fabricate CO2 microbubbles. The optimal fabricating conditions of CO2 microbubbles were found by comparing the size and amount of microbubbles fabricated under various operating conditions. The average size and quantity of CO2 microbubbles were measured by using a synchrotron X-ray imaging technique with a high spatial resolution. The quantity and size of the fabricated microbubbles decrease with increasing speed and operation time of the mechanical agitation. The feasibility of CO2 microbubbles as a flow-tracing contrast media was checked for a 40% hematocrit blood flow. Particle images of the blood flow were consecutively captured by the time-resolved X-ray PIV system to obtain velocity field information of the flow. The experimental results were compared with a theoretically amassed velocity profile. Results show that the CO2 microbubbles can be used as effective flow-tracing contrast media in X-ray PIV experiments.

  4. Cine Magnetic Resonance Imaging of the Small Bowel: Comparison of Different Oral Contrast Media

    International Nuclear Information System (INIS)

    Asbach, P.; Breitwieser, C.; Diederichs, G.; Eisele, S.; Kivelitz, D.; Taupitz, M.; Zeitz, M.; Hamm, B.; Klessen, C.

    2006-01-01

    Purpose: To evaluate several substances regarding small bowel distension and contrast on balanced steady-state free precession (bSSFP) cine magnetic resonance (MR) images. Material and Methods: Luminal contrast was evaluated in 24 volunteers after oral application of two different contrast agent groups leading to either bright lumen (pineapple, blueberry juice) or dark lumen (tap water, orange juice) on T1-weighted images. Bowel distension was evaluated in 30 patients ingesting either methylcellulose or mannitol solution for limiting intestinal absorption. Fifteen patients with duodeno-jejunal intubation served as the control. Quantitative evaluation included measurement of luminal signal intensities and diameters of four bowel segments, qualitative evaluation assessed luminal contrast and distension on a five-point scale. Results: Quantitative and qualitative evaluation of the four contrast agents revealed no significant differences regarding luminal contrast on bSSFP images. Quantitative evaluation revealed significantly lower (P<0.05) small bowel distension for three out of four segments (qualitative evaluation: two out of four segments) for methylcellulose in comparison to the control. Mannitol was found to be equal to the control. Conclusion: Oral ingestion of tap water or orange juice in combination with mannitol is recommended for cine MR imaging of the small bowel regarding luminal contrast and small bowel distension on bSSFP sequences

  5. Cine Magnetic Resonance Imaging of the Small Bowel: Comparison of Different Oral Contrast Media

    Energy Technology Data Exchange (ETDEWEB)

    Asbach, P.; Breitwieser, C.; Diederichs, G.; Eisele, S.; Kivelitz, D.; Taupitz, M.; Zeitz, M.; Hamm, B.; Klessen, C. [Charite - Universitatsmedizin Berlin, Charite Campus Mitte, Berlin (Germany). Dept. of Radiology

    2006-11-15

    Purpose: To evaluate several substances regarding small bowel distension and contrast on balanced steady-state free precession (bSSFP) cine magnetic resonance (MR) images. Material and Methods: Luminal contrast was evaluated in 24 volunteers after oral application of two different contrast agent groups leading to either bright lumen (pineapple, blueberry juice) or dark lumen (tap water, orange juice) on T1-weighted images. Bowel distension was evaluated in 30 patients ingesting either methylcellulose or mannitol solution for limiting intestinal absorption. Fifteen patients with duodeno-jejunal intubation served as the control. Quantitative evaluation included measurement of luminal signal intensities and diameters of four bowel segments, qualitative evaluation assessed luminal contrast and distension on a five-point scale. Results: Quantitative and qualitative evaluation of the four contrast agents revealed no significant differences regarding luminal contrast on bSSFP images. Quantitative evaluation revealed significantly lower (P<0.05) small bowel distension for three out of four segments (qualitative evaluation: two out of four segments) for methylcellulose in comparison to the control. Mannitol was found to be equal to the control. Conclusion: Oral ingestion of tap water or orange juice in combination with mannitol is recommended for cine MR imaging of the small bowel regarding luminal contrast and small bowel distension on bSSFP sequences.

  6. MR angiography of stenosis and aneurysm models in the pulsatile flow: variation with imaging parameters and concentration of contrast media

    International Nuclear Information System (INIS)

    Park, Kyung Joo; Park, Jae Hyung; Lee, Hak Jong; Won, Hyung Jin; Lee, Dong Hyuk; Min, Byung Goo; Chang, Kee Hyun

    1997-01-01

    The image quality of magnetic resonance angiography (MRA) varies according to the imaging techniques applied and the parameters affected by blood flow patterns, as well as by the shape of the blood vessels. This study was designed to assess the influence on signal intensity and its distribution of the geometry of these vessels, the imaging parameters, and the concentration of contrast media in MRA of stenosis and aneurysm models. MRA was performed in stenosis and aneurysm models made of glass tubes, using pulsatile flow with viscosity and flow profile similar to those of blood. Slice and maximum intensity projection (MIP) images were obtained using various imaging techniques and parameters;there was variation in repetition time, flip angle, imaging planes, and concentrations of contrast media. On slice images of three-dimensional (3D) time-of-flight (TOF) techniques, flow signal intensity was measured at five locations in the models, and contrast ratio was calculated as the difference between flow signal intensity (SI) and background signal intensity (SIb) divided by background signal intensity or (SI-SIb)/SIb. MIP images obtained by various techniques and using various parameters were also analyzed, with emphasis in the stenosis model on demonstrated degree of stenosis, severity of signal void and image distortion, and in the aneurysm model, on degree of visualization, distortion of contour and distribution of signals. In 3D TOF, the shortest TR (36 msec) and the largest FA (50 deg ) resulted in the highest contrast ratio, but larger flip angles did not effectively demonstrate the demonstration of the peripheral part of the aneurysm. Loss of signal was most prominent in images of the stenosis model obtained with parallel or oblique planes to the flow direction. The two-dimensional TOF technique also caused signal void in stenosis, but precisely demonstrated the aneurysm, with dense opacification of the peripheral part. The phase contrast technique showed some

  7. Low molecular weight dextran provides similar optical coherence tomography coronary imaging compared to radiographic contrast media.

    Science.gov (United States)

    Frick, Kyle; Michael, Tesfaldet T; Alomar, Mohammed; Mohammed, Atif; Rangan, Bavana V; Abdullah, Shuaib; Grodin, Jerrold; Hastings, Jeffrey L; Banerjee, Subhash; Brilakis, Emmanouil S

    2014-11-01

    Optical coherence tomography (OCT) coronary imaging requires displacement of red blood cells from the vessel lumen. This is usually accomplished using radiographic contrast. Low molecular weight dextran has low cost and is safe in low volumes. In the present study, we compared dextran with contrast for coronary OCT imaging. Fifty-one vessels in 26 patients were sequentially imaged using manual injection of radiographic contrast (iodixanol) and dextran. OCT images were analyzed at 1 mm intervals to determine the image clarity (defined as a visible lumen border > 270°) and to measure the lumen area and lumen diameter. To correct for the refractive index of dextran, the dextran area measurements were multiplied by 1.117 and the dextran length measurements were multiplied by 1.057. A total of 3,418 cross-sections (1,709 with contrast and 1,709 with dextran) were analyzed. There were no complications related to OCT imaging or to contrast or dextran administration. Clear image segments were observed in 97.0% vs. 96.7% of the cross-sections obtained with contrast and dextran, respectively (P = 0.45). The mean lumen areas were also similar: 6.69 ± 1.95 mm(2) with iodixanol vs. 7.06 ± 2.06 mm(2) with dextran (correlation coefficient 0.984). The image quality and measurements during OCT image acquisition are similar for dextran and contrast. Dextran could be used instead of contrast for OCT imaging, especially in patients in whom contrast load minimization is desired. © 2013 Wiley Periodicals, Inc.

  8. Properties of weak contrast PP reflection/transmission coefficients for weakly anisotropic elastic media

    Czech Academy of Sciences Publication Activity Database

    Pšenčík, Ivan; Martins, J. L.

    2001-01-01

    Roč. 45, č. 2 (2001), s. 176-199 ISSN 0039-3169. [ICTCA'99. Trieste, 10.05.1999-14.05.1999] Institutional research plan: CEZ:AV0Z3012916 Keywords : elastic media * anisotropy * seismic reflection Subject RIV: DC - Siesmology, Volcanology, Earth Structure Impact factor: 0.680, year: 2001

  9. Computed tomography versus water-soluble contrast swallow in the detection of intrathoracic anastomotic leak complicating esophagogastrectomy (Ivor Lewis): a prospective study in 97 patients.

    Science.gov (United States)

    Strauss, Christiane; Mal, Frederic; Perniceni, Thierry; Bouzar, Nadia; Lenoir, Stephane; Gayet, Brice; Palau, Robert

    2010-04-01

    Water-soluble contrast swallow (CS) is usually performed before refeeding for anastomosis assessment after esophagectomy with intrathoracic anastomosis but the sensitivity of CS is low. Another diagnostic approach is based on analysis of computed tomography (CT) scan with oral contrast and of CT mediastinal air images. We undertook to compare them prospectively. Ninety-seven patients with an esophageal carcinoma operated by intrathoracic anastomosis were included prospectively in a study based on a CT scan at postoperative day 3 (without oral and intravenous contrast) and CT scan and CS at day 7. CT scan analysis consisted of assessing contrast and air leakage. In case of doubt, an endoscopy was done. A diagnosis of anastomotic leak was made in 13 patients (13.4%), in 2 cases before day 7 and in 3 beyond day 7. At day 3, 94 CT scans were performed, but the diagnostic value was poor. In 95 patients with both CS and CT scan at day 7, CS disclosed a leak in 5 of 11, and CT scan was abnormal in 8 of 11. Leakage of contrast and/or presence of mediastinal gas had the best negative predictive value (95.8%). Endoscopy was done in 16 patients with only mediastinal gas at day 7 CT scan. It disclosed a normal anastomosis in 11, fibrin deposits in 4, and a leak in 1. In comparison with CS only, CT at day 7 improves the sensitivity and negative predictive value for diagnosing an anastomotic leak. In case of doubt endoscopy is advisable. This approach provides an accurate assessment of the anastomosis before refeeding.

  10. Tantalum X-ray contrast media, by M.G. Zuev and L.P. Larionov (Ekaterinburg: UrO RAN, 2002. 155 p.)

    International Nuclear Information System (INIS)

    Zhuravleva, E.Yu.

    2004-01-01

    The monograph of M.G. Zuev and L.P. Larionov Tantalum X-ray contrast media (Solid state chemistry for medicine series) is discussed. The monograph includes information on physical and chemical properties of tantalum, rare earths, and their oxides, phase compositions and phase diagrams of M 2 O 3 -Ta 2 O 5 (M - rare earths) systems is performed. Data on preclinical tests of yttrium orthotantalate and lanthanum orthotantalate as X-ray contrast media are given. Procedures for the production of X-ray contrast media involving tantalum oxide, rare earth tantalate and tantalum powder are described [ru

  11. 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.

  12. Impact of minimum contrast media volumes during elective percutaneous coronary intervention for prevention of contrast-induced nephropathy in patients with stable coronary artery disease.

    Science.gov (United States)

    Ebisawa, Soichiro; Kurita, Tairo; Tanaka, Nobuyoshi; Nasu, Kenya; Kimura, Masashi; Ito, Tatsuya; Kinoshita, Yoshihisa; Tsuchikane, Etsuo; Terashima, Mitsuyasu; Suzuki, Takahiko

    2016-01-01

    Contrast-induced nephropathy (CIN) is an important complication following percutaneous coronary intervention (PCI). The clinical importance of a minimum contrast media volume (CMV) for PCI to prevent CIN has not been well evaluated. The purpose of this study was to evaluate the impact of minimum CMV to prevent CIN after PCI. In this study, 2052 consecutive patients who underwent elective PCI in our institute were analyzed. We divided patients into two groups according to CMV: a minimum CMV PCI group [CMV ≤50 ml (n = 94)] and a non-minimum CMV PCI group [CMV >50 ml (n = 1958)]. CIN occurred in 160 (7.8 %) patients. The incidence of CIN was significantly lower in the minimum CMV PCI group than in the non-minimum CMV PCI group (2.1 vs. 8.1 %; P = 0.03). According to multivariate analysis, elderly patients and diabetes mellitus patients were at high risk of developing CIN in this study population. When analyzing only high-risk patients, the incidence of CIN was also significantly lower in the minimum CMV group than in the non-minimum CMV group (2.6 vs. 10.3 %; P = 0.03). Minimum CMV PCI could reduce the incidence of CIN, particularly in high-risk patients; as such, defining the minimum CMV clinical cut-off values may be useful for the prevention of CIN.

  13. Evaluation of time lapse for establishing distal tubal occlusion diagnosis during hysterosalpingography procedure performed by using water soluble contrast media

    Directory of Open Access Journals (Sweden)

    Serkan Kahyaoglu

    2017-05-01

    Conclusion: Although a trend exists towards shorter time period intervals between the first uterine visualization and distal tubal filling graphy among patients with tubal patency, rather than patients with distal tubal occlusion confirmed by diagnostic laparoscopy, clinically reliable objective time period intervals for finalizing the HSG procedure and proceeding with diagnostic laparoscopy due to distal tubal occlusion diagnosis on HSG could not be detected.

  14. Intravenous contrast media application using cone-beam computed tomography in a rabbit model

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Min Sung; Kim, Bok Yeol; Choi, Hwa Young [Dept. of Oral and Maxillofacial Radiology, School of Dentistry, Kyung Hee University, Seoul (Korea, Republic of); and others

    2015-03-15

    This study was performed to evaluate the feasibility of visualizing soft tissue lesions and vascular structures using contrast-enhanced cone-beam computed tomography (CE-CBCT) after the intravenous administration of a contrast medium in an animal model. CBCT was performed on six rabbits after a contrast medium was administered using an injection dose of 2 mL/kg body weight and an injection rate of 1 mL/s via the ear vein or femoral vein under general anesthesia. Artificial soft tissue lesions were created through the transplantation of autologous fatty tissue into the salivary gland. Volume rendering reconstruction, maximum intensity projection, and multiplanar reconstruction images were reconstructed and evaluated in order to visualize soft tissue contrast and vascular structures. The contrast enhancement of soft tissue was possible using all contrast medium injection parameters. An adequate contrast medium injection parameter for facilitating effective CE-CBCT was a 5-mL injection before exposure combined with a continuous 5-mL injection during scanning. Artificial soft tissue lesions were successfully created in the animals. The CE-CBCT images demonstrated adequate opacification of the soft tissues and vascular structures. Despite limited soft tissue resolution, the opacification of vascular structures was observed and artificial soft tissue lesions were visualized with sufficient contrast to the surrounding structures. The vascular structures and soft tissue lesions appeared well delineated in the CE-CBCT images, which was probably due to the superior spatial resolution of CE-CBCT compared to other techniques, such as multislice computed tomography.

  15. Intravenous contrast media application using cone-beam computed tomography in a rabbit model

    International Nuclear Information System (INIS)

    Kim, Min Sung; Kim, Bok Yeol; Choi, Hwa Young

    2015-01-01

    This study was performed to evaluate the feasibility of visualizing soft tissue lesions and vascular structures using contrast-enhanced cone-beam computed tomography (CE-CBCT) after the intravenous administration of a contrast medium in an animal model. CBCT was performed on six rabbits after a contrast medium was administered using an injection dose of 2 mL/kg body weight and an injection rate of 1 mL/s via the ear vein or femoral vein under general anesthesia. Artificial soft tissue lesions were created through the transplantation of autologous fatty tissue into the salivary gland. Volume rendering reconstruction, maximum intensity projection, and multiplanar reconstruction images were reconstructed and evaluated in order to visualize soft tissue contrast and vascular structures. The contrast enhancement of soft tissue was possible using all contrast medium injection parameters. An adequate contrast medium injection parameter for facilitating effective CE-CBCT was a 5-mL injection before exposure combined with a continuous 5-mL injection during scanning. Artificial soft tissue lesions were successfully created in the animals. The CE-CBCT images demonstrated adequate opacification of the soft tissues and vascular structures. Despite limited soft tissue resolution, the opacification of vascular structures was observed and artificial soft tissue lesions were visualized with sufficient contrast to the surrounding structures. The vascular structures and soft tissue lesions appeared well delineated in the CE-CBCT images, which was probably due to the superior spatial resolution of CE-CBCT compared to other techniques, such as multislice computed tomography.

  16. 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

  17. Extravasation of the contrast media during voiding cystourethrography in a long-term spinal cord injury patient.

    Science.gov (United States)

    Kovindha, A; Sivasomboon, C; Ovatakanont, P

    2005-07-01

    To present complications and pitfalls in voiding cystourethrography (VCUG) and introduce a guideline for performing VCUG in a long-term spinal cord injury (SCI) patient with neurogenic bladder dysfunction (NBD) and contracted bladder. A case report. Maharaj Nakorn Chiang Mai Hospital, Chiang Mai, Thailand. We describe a chronic C(5) tetraplegic man with NBD and contracted bladder, who developed autonomic dysreflexia (AD), gross hematuria and extravasation of contrast median during VCUG. A foley catheter was retained after VCUG. AD was resolved and urine cleared after a week of continuous bladder irrigation. VCUG should be performed with caution in a long-term SCI patient with NBD and contracted bladder. Forceful pushing of the contrast media by the hand-injection method caused abrupt distention of the contracted bladder, damaged bladder mucosa and aggrevated AD. We suggest a guideline as follows: report bladder capacity and AD, if present, in an X-ray requisition form; use the gravity-drip method, stop the drip and drain the contrast media if a sudden headache and rising of blood pressure (BP) develop; observe urine colour, and report if bleeding or AD occurs.

  18. Depiction of normal gastrointestinal anatomy with MDCT: comparison of low- and high-attenuation oral contrast media.

    Science.gov (United States)

    Erturk, Sukru Mehmet; Mortelé, Koenraad J; Oliva, Maria-Raquel; Ichikawa, Tomoaki; Silverman, Stuart G; Cantisani, Vito; Pagliara, Elisa; Ros, Pablo R

    2008-04-01

    To compare low- and high-attenuation oral contrast media for depiction of normal gastrointestinal anatomy with multidetector-row computed tomography (MDCT). A prospective, randomized study of 90 consecutive patients without known or suspected gastrointestinal disease was conducted after the approval of our Institutional Review Board. All patients underwent IV contrast-enhanced abdominal and pelvic CT scans after oral administration of 900 ml of either low- or high-attenuation barium sulphate suspension. Using a five-point scale, two radiologists independently graded distention and wall visualization of stomach, duodenum, jejunum, and ileum. The degree of distention and wall visualization was compared using Mann-Whitney U-test. Duodenal, jejunal and ileal distention (pcontrast medium were significantly higher than those with high-attenuation barium sulphate preparation, for reader 1. Duodenal and jejunal wall visualization scores with low-attenuation contrast medium (pcontrast medium, for reader 2. Interobserver agreement was fair to good for both distention (kappa-range: 0.41-0.74) and wall visualization (kappa-range: 0.48-0.71). MDCT with low-attenuation contrast medium provides distention and wall visualization of the GI tract that is equal or better than high-attenuation contrast medium.

  19. Influence of the timing of cardiac catheterization and amount of contrast media on acute renal failure after cardiac surgery

    Directory of Open Access Journals (Sweden)

    Mohsen Mirmohammad Sadeghi

    2011-01-01

    Full Text Available Background: There is limited data about the influence of timing of cardiac surgery in relation to diagnostic angiography and/or the impact of the amount of contrast media used during angiography on the occurance of acute renal failure (ARF. Therefore, in the present study the effect of the time interval between diagnostic angiography and cardiac surgery and also the amount of contrast media used during the diagnostic procedure on the incidence of ARF after cardiac surgery was investigated. Methods: Data of 1177 patients who underwent different types of cardiac surgeries after cardiac catheterization were prospectively examined. The influence of time interval between cardiac catheterization and surgery as well as the amount of contrast agent on postoperative ARF were assessed using multivariable logistic regression. Results: The patients who progressed to ARF were more likely to have received a higher dose of contrast agent compared to the mean dose. However, the time interval between cardiac surgery and last catheterization was not significantly different between the patients with and without ARF (p = 0.05. Overall, postoperative peak creatinine was highest on day 0, then decreased and remained significantly unchanged after this period. Overall prevalence of acute renal failure during follow-up period had a changeable trend and had the highest rates in days 1 (53.57% and 6 (52.17% after surgery. Combined coronary bypass and valve surgery were the strongest predictor of postoperative ARF (OR: 4.976, CI = 1.613-15.355 and p = 0.002, followed by intra-aortic balloon pump insertion (OR: 6.890, CI = 1.482-32.032 and p = 0.009 and usage of higher doses of contrast media agent (OR: 1.446, CI = 1.033-2.025 and p = 0.031. Conclusions: Minimizing the amount of contrast agent has a potential role in reducing the incidence of postoperative ARF in patients undergoing cardiac surgery, but delaying cardiac surgery after exposure to these agents might not have

  20. Depiction of normal gastrointestinal anatomy with MDCT: Comparison of low- and high-attenuation oral contrast media

    International Nuclear Information System (INIS)

    Erturk, Sukru Mehmet; Mortele, Koenraad J.; Oliva, Maria-Raquel; Ichikawa, Tomoaki; Silverman, Stuart G.; Cantisani, Vito; Pagliara, Elisa; Ros, Pablo R.

    2008-01-01

    Purpose: To compare low- and high-attenuation oral contrast media for depiction of normal gastrointestinal anatomy with multidetector-row computed tomography (MDCT). Materials and methods: A prospective, randomized study of 90 consecutive patients without known or suspected gastrointestinal disease was conducted after the approval of our Institutional Review Board. All patients underwent IV contrast-enhanced abdominal and pelvic CT scans after oral administration of 900 ml of either low- or high-attenuation barium sulphate suspension. Using a five-point scale, two radiologists independently graded distention and wall visualization of stomach, duodenum, jejunum, and ileum. The degree of distention and wall visualization was compared using Mann-Whitney U-test. Results: Duodenal, jejunal and ileal distention (p < 0.05, <0.001, <0.001, respectively) and wall visualization (p < 0.05, <0.01, <0.05, respectively) scores with low-attenuation contrast medium were significantly higher than those with high-attenuation barium sulphate preparation, for reader 1. Duodenal and jejunal wall visualization scores with low-attenuation contrast medium (p < 0.05, <0.01, respectively) were significantly higher than those with high-attenuation contrast medium, for reader 2. Interobserver agreement was fair to good for both distention (κ-range: 0.41-0.74) and wall visualization (κ-range: 0.48-0.71). Conclusion: MDCT with low-attenuation contrast medium provides distention and wall visualization of the GI tract that is equal or better than high-attenuation contrast medium

  1. Iron oxide contrast media improve MR-imaging of the portal venous system -an experimental study

    International Nuclear Information System (INIS)

    Boeck, J.C.; Knollmann, F.D.; Teltenkoetter, S.; Wlodarcyk, W.; Muehler, A.; Felix, R.

    1997-01-01

    Purpose: The aim was to demonstrate that intravenous superparamagnetic iron oxide contrast agents improve the delineation of the portal venous system. Material and methods: The portal venous system of 8 minipigs was demonstrated by a FLASH 2-D MRA-sequence. Scans were acquired before and after intravenous administration of 10 and 20 μmol/kg of a superparamagnetic iron oxide contrast agent (SHU 555 A). Signal intensities were measured in the portal vein and hepatic parenchym and contrast-to-noise ratios were calculated. Results: Following a cumulative dose of 10 μmol iron oxide, hepatic parenchymal signal intensity decreased to 67±6%, following 20 μmol to 29±4%, and following 40 μmol to 13±2% of control (p [de

  2. 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.

  3. Catheter-Malposition-Induced Cardiac Tamponade via Contrast Media Leakage During Computed Tomography Study

    International Nuclear Information System (INIS)

    Liang, C.-D.; Ko, S.-F.; Huang, C.-F.; Chien, S.J.; Tiao, M.M.

    2005-01-01

    We present a rare case of a central venous catheter-malposition-induced life-threatening cardiac tamponade as a result of computed tomography (CT) with contrast enhancement in an infant with a ventricular septal defect and pulmonary atresia after a modified Blalock-Taussig shunt. The diagnosis was confirmed by chest radiographs and CT study with catheter perforation through the right atrial wall and extravasation of the contrast medium into the pericardium, leading to cardiac tamponade and subsequent circulatory collapse. Two hours after successful cardiopulmonary resuscitation, the patient gradually resumed normal hemodynamic status

  4. A clinical study concerning hepatic arterial dominant phase and arrival time of contrast media on helical dynamic CT

    International Nuclear Information System (INIS)

    Matsubara, Susumu; Uchida, Chiharu; Sato, Sei; Ishida, Junichi; Masuya, Ryozo; Makiguchi, Mako; Kanamori, Isao

    2001-01-01

    Hepatic arterial dominant phase in helical dynamic CT was optimized by measuring the arrival time of contrast media (ATCM) with time-density curve (TDC). Subjects were 1005 patients (577 males and 428 females) and 98 nodules diagnosed as advanced hepatocellular carcinoma (HCC). The CT was done with Toshiba 4MHU X-vision SP, ultrasonography with Toshiba SSH-160A and automatic infusion of the contrast medium, iopamidol or iohexol, with Nemotokyorindo Autoenhance A-50. ATCM was found correlated with pulse rate and with arterial diameter, and significantly different between the sex. Elevation slope of TDC was suggested to be made constant by a defined infusion time of the dose corrected by body weight. Fluctuation of TDC among patients , when normalized by ATCM, was found smaller and the TDC was suggested to be useful for better imaging of HCC of less than 10 mm diameter. (K.H.)

  5. 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

  6. In vivo and in vitro assessment of pathways involved in contrast media-induced renal cells apoptosis

    Science.gov (United States)

    Quintavalle, C; Brenca, M; De Micco, F; Fiore, D; Romano, S; Romano, M F; Apone, F; Bianco, A; Zabatta, M A; Troncone, G; Briguori, C; Condorelli, G

    2011-01-01

    Contrast-induced nephropathy accounts for >10% of all causes of hospital-acquired renal failure, causes a prolonged in-hospital stay and represents a powerful predictor of poor early and late outcome. Mechanisms of contrast-induced nephropathy are not completely understood. In vitro data suggests that contrast media (CM) induces a direct toxic effect on renal tubular cells through the activation of the intrinsic apoptotic pathway. It is unclear whether this effect has a role in the clinical setting. In this work, we evaluated the effects of CM both in vivo and in vitro. By analyzing urine samples obtained from patients who experienced contrast-induced acute kidney injury (CI-AKI), we verified, by western blot and immunohistochemistry, that CM induces tubular renal cells apoptosis. Furthermore, in cultured cells, CM caused a dose–response increase in reactive oxygen species (ROS) production, which triggered Jun N-terminal kinases (JNK1/2) and p38 stress kinases marked activation and thus apoptosis. Inhibition of JNK1/2 and p38 by different approaches (i.e. pharmacological antagonists and transfection of kinase-death mutants of the upstream p38 and JNK kinases) prevented CM-induced apoptosis. Interestingly, N-acetylcysteine inhibited ROS production, and thus stress kinases and apoptosis activation. Therefore, we conclude that CM-induced tubular renal cells apoptosis represents a key mechanism of CI-AKI. PMID:21562587

  7. 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.

  8. 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.

  9. 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.

  10. Utility of intravenous nonionic contrast media for abdominal CT in patients with renal dysfunction

    International Nuclear Information System (INIS)

    Craig, B.M.; Alpern, M.B.; Sandler, M.A.; Pearlberg, J.L.; Swanson, D.P.

    1987-01-01

    The safety and efficacy of a nonionic contrast medium (NICM) for CT enhancements in patients with renal dysfunction were evaluated. Thirty consecutive patients referred for abdominal CT with a serum creatinine (SCr) level over 5 mg/dL or a SCr level of 2-5 mg/dL and another risk factor (e.g., diabetes, single kidney) received NICM. Each was matched with a control who received the same 150-mL bolus of a conventional medium. No adverse reactions or significant alterations in SCr values were found in the NICM patients. No significant differences between the patient groups were found in blinded subjective image quality ratings or measured attenuation values of a parenchymal organs and vascular structures (with the exception of less renal enhancement in the NICM patients, reflecting their renal dysfunction). Use of an NICM is a safe and effective method for contrast medium-enhanced CT in patients with renal dysfunction

  11. [Extravasation of contrast media at the puncture site: Strategies for managment].

    Science.gov (United States)

    Pacheco Compaña, F J; Gago Vidal, B; Méndez Díaz, C

    2014-01-01

    The incidence of contrast medium extravasation at the venipuncture site has increased with the generalized use of automatic injectors. Most extravasations only cause slight edema and erythema. Nevertheless, in some cases extravasation can result in severe skin lesions or even in compartment syndrome. Lesions caused by extravasation usually resolve spontaneously with conservative treatment. Although the complications of extravasation are well known, institutional protocols are normally lacking and the criteria for taking action and the type of treatment, whether based on the literature or personal preferences, tend to vary. In this article, we review the incidence, risk factors, clinical manifestations, and options for preventing and treating contrast medium extravasation in soft tissues. Finally, we present the protocol we use to manage extravasation at our hospital. Copyright © 2013 SERAM. Published by Elsevier Espana. All rights reserved.

  12. Macromolecular contrast media. A new approach for characterising breast tumors with MR-mammography

    International Nuclear Information System (INIS)

    Daldrup, H.E.; Gossmann, A.; Koeln Univ.; Wendland, M.; Brasch, R.C.; Rosenau, W.

    1997-01-01

    The value of macromolecular contrast agents (MMCM) for the characterization of benign and malignant breast tumors will be demonstrated in this review. Animal studies suggest a high potential of MMCM to increase the specificity of MR-mammography. The concept of tumor differentiation is based on the pathological hyperpermeability of microvessels in malignant tumors. MMCM show a leak into the interstitium of carcinomas, whereas they are confined to the intravascular space in benign tumors. Capabilities and limitations of the MMCM-prototype. Albumin-Gd-DTPA, for breast tumor characterization will be summarized and compared to the standard low molecular weight contrast agent Gd-DTPA. Initial experience with new MMCM, such as Dendrimers, Gd-DTPA-Polylysine and MS-325 will be outlined. The potential of 'blood-pool'-iron oxides, such as AMI-227 for the evaluation of tumor microvascular permeabilities will be discussed. (orig.) [de

  13. 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.

  14. Contrast media for left ventricular angiography. A comparison between Cardio-Conray and iopamidol.

    OpenAIRE

    Gwilt, D J; Nagle, R E

    1984-01-01

    Forty consecutive patients with coronary artery disease undergoing left ventricular angiography took part in a randomised double blind trial comparing a conventional contrast medium sodium meglumine iothalamate (Cardio-Conray) with the low osmolar agent iopamidol. Iopamidol produced a smaller rise in heart rate and a smaller fall in left ventricular systolic pressure, but the changes in left ventricular and diastolic pressure and maximum rate of change of pressure (dP/dt max) were not differe...

  15. Interactive neonatal gastrointestinal magnetic resonance imaging using fruit juice as an oral contrast media

    International Nuclear Information System (INIS)

    Arthurs, Owen J; Graves, Martin J; Edwards, Andrea D; Joubert, Ilse; Set, Pat AK; Lomas, David J

    2014-01-01

    The objective was to evaluate the use of fruit juice with an interactive inversion recovery (IR) MR pulse sequence to visualise the gastrointestinal tract. We investigated the relaxation properties of 12 different natural fruit juices in vitro, to identify which could be used as oral contrast. We then describe our initial experience using an interactive MR pulse sequence to allow optimal visualisation after administering pineapple juice orally, and suppressing pre-existing bowel fluid contents, with variable TI in three adult and one child volunteer. Pineapple juice (PJ) had both the shortest T 1 (243 ms) and shortest T 2 (48 ms) of the fruit juices tested. Optimal signal differentiation between pre-existing bowel contents and oral PJ administration was obtained with TIs of between 900 and 1100 ms. The use of an inversion recovery preparation allowed long T 1 pre-existing bowel contents to be suppressed whilst the short T 1 of fruit juice acts as a positive contrast medium. Pineapple juice could be used as oral contrast agent for neonatal gastrointestinal magnetic resonance imaging

  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. 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.

  18. 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.

  19. 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

  20. Pre-Interventional Kynurenine Predicts Medium-Term Outcome after Contrast Media Exposure Due to Coronary Angiography.

    Science.gov (United States)

    Reichetzeder, Christoph; Heunisch, Fabian; Einem, Gina von; Tsuprykov, Oleg; Kellner, Karl-Heinz; Dschietzig, Thomas; Kretschmer, Axel; Hocher, Berthold

    2017-01-01

    Contrast induced acute kidney injury (CI-AKI) remains a serious complication of contrast media enhanced procedures like coronary angiography. There is still a lack of established biomarkers that help to identify patients at high risk for short and long-term complications. The aim of the current study was to evaluate plasma kynurenine as a predictive biomarker for CI-AKI and long-term complications, measured by the combined endpoint "major adverse kidney events" (MAKE) up to 120 days after CM application. In this prospective cohort study 245 patients undergoing coronary angiography were analyzed. Blood samples were obtained at baseline, 24h and 48h after contrast media (CM) application to diagnose CI-AKI. Patients were followed for 120 days for adverse clinical events including death, the need for dialysis, and a doubling of plasma creatinine. Occurrence of any of these events was summarized in the combined endpoint MAKE. Preinterventional plasma kynurenine was not associated with CI-AKI. Patients who later developed MAKE displayed significantly increased preinterventional plasma kynurenine levels (p<0.0001). ROC analysis revealed that preinterventional kynurenine is highly predictive for MAKE (AUC=0.838; p<0.0001). The optimal cutoff was found at ≥3.5 µmol/L Using this cutoff, the Kaplan-Meier estimator demonstrated that concentrations of plasma kynurenine ≥3.5 µmol/L were significantly associated with a higher prevalence of MAKE until follow up (p<0.0001). This association remained significant in multivariate Cox regression models adjusted for relevant factors of long-term renal outcome. Preinterventional plasma kynurenine might serve as a highly predictive biomarker for MAKE up to 120 days after coronary angiography. © 2017 The Author(s). Published by S. Karger AG, Basel.

  1. Pre-Interventional Kynurenine Predicts Medium-Term Outcome after Contrast Media Exposure Due to Coronary Angiography

    Directory of Open Access Journals (Sweden)

    Christoph Reichetzeder

    2017-05-01

    Full Text Available Background/Aims: Contrast induced acute kidney injury (CI-AKI remains a serious complication of contrast media enhanced procedures like coronary angiography. There is still a lack of established biomarkers that help to identify patients at high risk for short and long-term complications. The aim of the current study was to evaluate plasma kynurenine as a predictive biomarker for CI-AKI and long-term complications, measured by the combined endpoint "major adverse kidney events" (MAKE up to 120 days after CM application. Methods: In this prospective cohort study 245 patients undergoing coronary angiography were analyzed. Blood samples were obtained at baseline, 24h and 48h after contrast media (CM application to diagnose CI-AKI. Patients were followed for 120 days for adverse clinical events including death, the need for dialysis, and a doubling of plasma creatinine. Occurrence of any of these events was summarized in the combined endpoint MAKE. Results: Preinterventional plasma kynurenine was not associated with CI-AKI. Patients who later developed MAKE displayed significantly increased preinterventional plasma kynurenine levels (p<0.0001. ROC analysis revealed that preinterventional kynurenine is highly predictive for MAKE (AUC=0.838; p<0.0001. The optimal cutoff was found at ≥3.5 µmol/L Using this cutoff, the Kaplan-Meier estimator demonstrated that concentrations of plasma kynurenine ≥3.5 µmol/L were significantly associated with a higher prevalence of MAKE until follow up (p<0.0001. This association remained significant in multivariate Cox regression models adjusted for relevant factors of long-term renal outcome. Conclusion: Preinterventional plasma kynurenine might serve as a highly predictive biomarker for MAKE up to 120 days after coronary angiography.

  2. Studies to compare radioactivity of bone cements and their ingredient X-ray contrast media

    International Nuclear Information System (INIS)

    Hopf, C.; Gloebel, B.; Hopf, T.; Universitaet des Saarlandes, Homburg/Saar; Universitaet des Saarlandes, Homburg/Saar

    1990-01-01

    Various PMMA bone cements/containing zirconium oxide (ZrO 2 ) as an X-ray contrast medium and zirconium oxides of several manufacturers were tested for their radioactivity by means of a gamma spectrometer. All the bone cements tested (Implast, Palacos R, and Sulfix-6) showed a certain degree of radioactivity. The radiation source in the bone cement is the added zirconium oxide, which is polluted by radioactive elements. The examination of various zirconium oxides showed some high radioactive emissions. (orig./GDG) [de

  3. 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

  4. The use of dilute calogen[reg] as a fat density oral contrast medium in upper abdominal computed tomography, compared with the use of water and positive oral contrast media

    International Nuclear Information System (INIS)

    Ramsay, Duncan W.; Markham, Derrian H.; Morgan, Bruno; Rodgers, Peter M.; Liddicoat, Amanda J.

    2001-01-01

    AIM: Oral contrast media are commonly given prior to computed tomography (CT) examination of the upper abdomen. Although positive oral contrast media are normally used, there is increasing interest in using negative agents such as water and less commonly fat density products. The aim of this study was to compare a positive oral contrast medium, water, and a diluted emulsion of arachis oil (Calogen[reg], a fat density food supplement) for assessment of the upper abdomen. MATERIALS AND METHODS: Seventy-one patients referred for upper abdominal CT were randomized to receive either 500 ml water, 2% sodium diatrizoate or a dilute suspension of Calogen[reg]. The CT images were scored independently by three radiologists. Distension and anatomical identification was assessed for the stomach, duodenum and jejunum; with anatomical identification recorded for the pancreas, retroperitoneum, liver, gallbladder and spleen. RESULTS: Dilute Calogen[reg] produced a significant improvement (P < 0.01) in distension and anatomical visualization of the stomach and proximal duodenum. Only minimal differences were demonstrated between the three contrast media for visualization of more distal small bowel or identification of the other upper abdominal viscera. Significantly more artifacts were caused by positive contrast media than with the Calogen[reg] mixture. CONCLUSION: A dilute suspension of Calogen[reg] as an oral contrast medium is recommended when disease is suspected within the stomach or proximal duodenum. Ramsay, D.W. et al. (2001)

  5. 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.

  6. Paramagnetic contrast media for magnetic resonance imaging of the central nervous system

    International Nuclear Information System (INIS)

    McNamara, M.T.

    1987-01-01

    Presently, a variety of radiofrequency (RF) and magnetic field gradient pulse sequences is used to manipulate magnetic resonance (MR) image contrast. Such manipulation may be performed by altering the RF pulse sequence repetition time (TR), the spin-echo delay time (TE), the inversion-delay time (TI), and the flip angle. The detection and characterization of a lesion or structure may thus be optimized. Although such contrast manipulation is noninvasive, magnetic resonance imaging (MRI) still suffers somewhat from lack of specificity. Also, the use of multiple imaging sequences to locate and characterize a lesion may prolong the imaging time and, thus, might place an economic burden on the system. Paramagnetic pharmaceuticals offer promise in this regard. They shorten tissue relaxation times, thus permitting the use of shorter imaging parameters, and in some circumstances, may obviate additional and more time-consuming pulse sequences. Paramagnetics could expand the sensitivity and specificity of MRI and provide functional information with regard to tissue perfusion, tissue viability, and blood-brain barrier integrity

  7. The effects of contrast media volume on acute kidney injury after transcatheter aortic valve replacement: a systematic review and meta-analysis.

    Science.gov (United States)

    Thongprayoon, Charat; Cheungpasitporn, Wisit; Podboy, Alexander J; Gillaspie, Erin A; Greason, Kevin L; Kashani, Kianoush B

    2016-11-01

    The goal of this systematic review was to assess the effects of contrast media volume on transcatheter aortic valve replacement-related acute kidney injury. A literature search was performed using Medline, EMbase, the Cochrane Database of Systematic Reviews, and clinicaltrials.gov from the inception of these databases through December 2015. Studies that reported relative risk, odds ratio, or hazard ratio comparing the risks of acute kidney injury following transcatheter aortic valve replacement in patients who received high contrast media volume were included. Pooled risk ratio (RR) and 95% confidence intervals (95% CI) were calculated using a random-effect, generic inverse variance method. Four cohort studies composed of 891 patients were included in the analyses to assess the risk of acute kidney injury after transcatheter aortic valve replacement in patients who received high contrast media volume. The pooled RR of acute kidney injury after transcatheter aortic valve replacement in patients who received a large volume of contrast media was 1.41 (95% CI, 0.87 to 2.28) compared with low contrast media volume. The meta-analysis was limited to studies using standard acute kidney injury definitions, and the pooled RR of acute kidney injury in patients who received high contrast media volume is 1.12 (95% CI, 0.78 to 1.62). Our meta-analysis shows no significant association between cont