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PubMedDate not supplied

Water-soluble contrast media in radiography of small bowel obstruction. Comparison of ionic and non-ionic contrast media.

Fifty patients with possible gastrointestinal obstruction, referred for enteric follow-through examination, were randomized for a double-blind, parallel comparison of the hyperosmolar contrast medium Gastrografin and the low-osmolar Omnipaque. The result was that Omnipaque retained its radiographic density in the small bowel better than Gastrografin. Omnipaque was thus a better alternative than Gastrografin in follow-through examinations of intestinal obstruction. Also, 23 patients out of 28 with small bowel obstruction due to peritoneal adhesions, had spontaneous relief of symptoms during the observation period following contrast medium ingestion with no significant difference between the two media. This indicated that enteric follow-through procedures may have a therapeutic efficacy similar to the treatment of small bowel obstruction using nasogastric suction and gastrointestinal rest. Possible mechanisms for this action of the contrast media are discussed.

Aged↗
PubMed1984

[Systemic and local reactions in leg phlebography with special reference to iodine-containing contrast media. Randomized, prospective, intraindividual double-blind study using iodine-containing contrast media of different osmolarity and iodine concentration. I].

Iopamidol, a non-ionic, tri-iodinated radiographic contrast medium, was superior to the ionic substances ioxaglate, ioglicinate and ioxitalamate in the ascending phlebography. In 180 examinations on 90 patients (report I), which were carried out intraindividually by double blind technique, distinct differences were recorded in particular at pain registration. Since iopamidol was well tolerated in nearly all cases, pain was registered in 10% in ioxaglate, in 22% in ioglicinate and in 37% in ioxitalamate. Anaphylactoid reactions had been observed in one case (1.1%) with iopamidol, in 7% with ioglicinate, in 10% with ioxitalamate and in 17% with ioxaglate. The low incidence of clinically manifest postphlebographic thrombophlebitis and deep venous thrombosis was surprising. In no case was deep venous thrombosis seen after the application of low-osmolar substances, whereas transitory superficial vein irritations could be observed more frequently (10% in iopamidol and 21% in ioxaglate). In ioglicinate as well as in ioxitalamate one deep vein thrombosis and in 10% resp. 30% superficial thrombophlebitis were recorded.

Contrast Media↗
PubMed1976

[The pharmaco-kinetics of angiographic contrast media with special reference to the extravascular space. Experimental studies on dogs. III. Is there an entero-hepatic circulation of angiographic contrast media? A discussion summarising the results of the entire studies (author's transl)].

The presence of an entero hepatic circulation of angiographic contrast media has been demonstrated, but quantitatively it is of little importance. About 1/2% of the contrast reaching the gut in the bile is reabsorbed and after being carried through the portal vein to the liver is re-excreted in the bile. Most of the contrastcontaining bile reaching the small bowel is excreted in the faeces; nearly all of the contrast absorbed from the colon is carried through the portal vein to the liver and after reaching the circulation is excreted by the kidneys.

Angiography↗
PubMed1999

Effect of contrast media on coronary vascular resistance: contrast-induced coronary vasodilation.

STUDY OBJECTIVES: To determine if the vasodilatory response to the intracoronary injection of ionic and nonionic contrast media in intact pigs is dependent on nitric oxide (NO). The mechanisms responsible for inducing the increase in coronary blood flow in response to the intracoronary injection of contrast media during angiography are still not entirely understood. There is evidence to suggest that the response could be partially mediated by NO. PARTICIPANTS: We studied 14 anesthetized, open-chested pigs receiving ventilation. MEASUREMENTS AND RESULTS: Changes in coronary blood flow and coronary vascular resistance were measured in response to the coronary artery injection of saline solution (0.5 mol/L, isosmolar with plasma) and three different contrast agents: meglumine sodium ioxaglate (Hexabrix; Mallinckrodt Medical; Point-Claire, Quebec, Canada), a low osmolar ionic contrast agent; iohexol (Omnipaque 300; Sanofi Winthrop; Markham, Ontario, Canada), a nonionic contrast agent; and diatrizoate meglumine 66%, diatrizoate sodium 10% (MD-76; Mallinckrodt Medical), an ionic contrast agent. Measurements were made during three experimental conditions: the coronary artery infusion of (1) saline solution, control; (2) L-nitro-arginine (LNNA; 10(-3) mol/L and 10(-2) mol/L), a competitive inhibitor of NO synthase; and (3)L-arginine 10(-1) mol/L, a substrate for NO synthase. The infusion of LNNA produced an increase in baseline coronary vascular resistance (p < 0.001), but it did not attenuate the vasodilatory response to the infusion of the contrast agents. Both the high and low osmolar ionic and nonionic contrast media caused a decrease in baseline coronary vascular resistance. For all three conditions, MD-76, which has the highest osmolality, produced the greatest decrease in coronary vascular resistance. CONCLUSION: The vasodilatory response of the coronary vasculature to contrast agents is directly related to osmolality and is not mediated by NO.

Animals↗
PubMed1996

[Risk of hyperthyroidism in examinations with contrast media].

Investigations with contrast media inevitably lead to the patient being exposed to large amounts of iodine. Under certain preconditions this gentails danger for the patient by causing either iodine-induced hyperthyroidism, which is difficult to treat, or even a thyrotoxic crisis. Patients with normal thyroid function and size have only minute changes of thyroid hormones and TSH within the normal range and are not at risk. Patients with unknown hyperthyroidism--independent of the etiological form--and patients with functional autonomy are at risk of exacerbation of pre-existing hyperthyroidism or development of iodine-induced hyperthyroidism. This development depends on two factors: a) the volume of autonomous tissue and b) the quantity of iodine exposure. Besides contrast media, other sources of iodine excess are possible, such as iodine-containing disinfectants, secretolytic agents, antiarrhythmics like amiodarone, eye drops and ointments, geriatrics, skin ointments, toothpaste etc. The development of hyperthyroidism can be prevented by combined treatment with antithyroid drugs and perchlorate in the case of preexisting hyperthyroidism or the urgent clinical suspicion of thyrotoxicosis or with perchlorate alone, when the patients is euthyroid and does not have a large nodular goitre.

Contrast Media↗
PubMed2001

A review of contrast media research in 1999-2000.

Contrast media research published during the years 1999 and 2000 is reviewed in this article, in terms of relevance to developments within the field of diagnostic radiology. The primary focus is on publications from the journal Investigative Radiology, which publishes much of the clinical and laboratory research performed in this field. The journals Radiology and the American Journal of Roentgenology are dominant in the field of diagnostic radiology and together publish more than 10 times the number of articles as appear each year in Investigative Radiology. However, in 1999 for example, these two journals together published fewer articles than did Investigative Radiology alone that concerned basic (animal) research with contrast media. Thirty-six percent of the articles in Investigative Radiology in 1999 had a primary focus on contrast media and 18% on basic (animal) research with contrast media. To make this review more complete, articles from other major journals are cited and discussed, as needed, to provide supplemental information in the few areas not well covered by articles in Investigative Radiology. The safety of contrast media is always an important topic and research continues to be performed in this area, both to explore fundamental issues regarding iodinated contrast media and also to establish the overall safety profile of new magnetic resonance (MR) and ultrasound agents. In regard to preclinical investigations, most of the work performed in the last 2 years has been with MR and ultrasound. In MR, research efforts continue to be focused on the development of targeted agents. In ultrasound, research efforts are split between studies looking at new imaging methods and early studies of targeted agents. In regard to the clinical application of contrast media, the published literature continues to be dominated by MR. Investigations include the study of disease in clinical trials and in animal models. A large number of studies continue to be published in regard to new techniques and applications within the field of contrast-enhanced magnetic resonance angiography. This field represents the single, largest new clinical application of contrast media in MR to emerge in the last decade. New clinical research continues to be published regarding the use of contrast media in computed tomography (CT), ultrasound, and x-ray angiography. The introduction of spiral CT (together with the multidetector scanners) has led to greater utilization of this modality, as well as intravenous iodinated contrast media. The number of publications regarding clinical applications of intravenously injected ultrasound contrast agents remains low, with the high expectations in regard to growth (in terms of number of exams using contrast) of the last decade yet to be fulfilled.

Animals↗
PubMed2002

[MR contrast media for cardiovascular imaging].

MR contrast media improve the diagnostic capability of MRI and MRA. They are used in the discrimination of viable and non-viable myocardium, transmural and non-transmural infarction, occlusive and reperfused infarction and for measurement of myocardial perfusion. Currently, clinical studies are almost completely restricted to the use of extracellular non-specific MR contrast media (i. e., Gd-DTPA, Gd-DTPA,-BMA, Gd-BOPTA, Gd-D03A). However, the feasibility of using intravascular, necrosis specific or intracellular MR contrast media or endogeneous substrates as specific MR contrast media in cardiovascular imaging has been demonstrated in experimental and a few clinical studies. Intravascular contrast media (i. e., MS-325 or NC100150 Injection) allow assessment of microvascular integrity and performance of MR angiography. Necrosis specific contrast media (i. e., Gadophrin-2) have been used for sizing the extent of infarcted myocardium while intracellular contrast media (i. e., Mn-DPDP) delineate viable myocardium. Endogenous contrast media (i. e., Deoxyhemoglobin, Na (+) or K (+)) have been tested for detecting the alterations in concentrations of these ions in infarcted myocardium and for perfusion measurements. Furthermore, intravascular MR contrast media may be useful for MRA and MRI guided cardiovascular interventions.

Contrast Media↗
PubMed1989

Left ventricular after load as a result of levocardiography with contrast media of various osmolality.

Contrast media have been successfully used as a diagnostic aid in radiology for decades. It has, however, been necessary to accept certain, in some cases unexplained, undesirable side effects because of their physicochemical properties. The conventional preparations available have for more than 40 years been iodinated salts or acids, whose major disadvantage has been high osmolality. For some years now, a new generation of contrast media has been available. These contrast media exhibit a far lower osmolality due to the lack of ionicity. As a result of the volume load of the left ventricle by levocardiography, there is usually an increase of the left ventricular end-diastolic pressure in the pathologic range over 12 mmHg. We were able to prove this in 120 consecutive patients whom we examined. The pressure increase with the use of nonionic contrast media was considerably lower. The differentiated observation of various risk groups showed no signs of valid predictive parameters.

Cardiac Output↗
PubMedDate not supplied

Tensile properties of a bone cement containing non-ionic contrast media.

The addition of contrast media such as BaSO4 or ZrO2 to bone cement has adverse effects in joint replacements, including third body wear and particle-induced bone resorption. Ground PMMA containing particles of the non-ionic water-soluble iodine-based X-ray contrast media, iohexol (IHX) and iodixanol (IDX), has, in bone tissue culture, shown less bone resorption than commercial cements. These water-soluble non-ceramic contrast media may change the mechanical properties of acrylic bone cement. The static mechanical properties of bone cement containing either IHX or IDX have been investigated. There was no significant difference in ultimate stress between Palacos R (with 15.0 wt % of ZrO2) and plain cement with 8.0 wt % of IHX or IDX with mass median diameter (MMD) of 15.0 or 16.0 microm, while strain to failure was higher for the latter (p < 0.02). The larger particles (15.0 or 16.0 microm) gave significantly higher (p < 0.001) ultimate tensile strengths and strains to failure than smaller sizes (2.4 or 3.6 microm). Decreasing the amount of IHX from 10.0 wt % to 6.0 wt % gave a higher ultimate tensile strength (p < 0.001) and strain to failure (p < 0.02). Scanning electron microscopy (SEM) showed the smaller contrast media particles attached to the surface of the polymer beads, which may prevent areas of the acrylate bead surface from participating in the polymerization. In conclusion, the mechanical properties of bone cement were influenced by the size and amount of contrast medium particles. By choosing the appropriate amount and size of particles of water-soluble non-ionic contrast media the mechanical properties of the new radio-opaque bone cement can be optimized, thus reaching and surpassing given regulatory standards.

Journal Article↗
PubMed2006

European Society of Urogenital Radiology (ESUR) guidelines on the safe use of iodinated contrast media.

Since 1996 the Contrast Media Safety Committee of the European Society of Urogenital Radiology (ESUR) has released 19 guidelines regarding safety in relation to the use of radiographic, ultrasonographic as well as magnetic resonance contrast media. The committee has covered both renal and non-renal adverse events as well as other aspects of contrast media. The present paper is an overview of the work accomplished over the last 10 years regarding radiographic iodinated contrast media.

Contrast Media↗
PubMed2000

Nephrotoxicity related to contrast media.

The numbers of contrast media (CM)-enhanced examinations are increasing. The annual sale of iodine for CM now represents 60 million CM doses a year world-wide. In spite of improvements in chemical structure, CM are still the third leading cause of hospital-acquired acute renal failure. The definition of contrast nephropathy (CN) is discussed, as well as the mechanisms involved in the pathogenesis. Low osmolar contrast media (LOCM) are less nephrotoxic than high osomolar contrast media (HOCM) and cause fewer osmotoxic side-effects such as pain and heat sensations. The non-ionic dimeric contrast media which are iso-osmolar to plasma (IOCM) cause even fewer haemodynamic side-effects and result in better opacification of the urinary tract than LOCM. The nephrotoxicity of IOCM is low. The risk factors for CN and methods for prevention of CN are discussed.

Contrast Media↗