iothalamate-meglumine and iopromide

Most studies of the adverse effects of x-ray contrast media used in ERCP have focused on post-ERCP pancreatitis. However, the biliary epithelial cells are also exposed to contrast media during ERCP and acute cholangitis is also a serious complication of ERCP. The present study compared the cytotoxicity with gallbladder epithelial cells of ionic and nonionic contrast agents.. A high-osmolar ionic contrast agent (meglumine ioxithalamate) and a low-osmolar nonionic contrast agent (iopromide) were tested. Monolayer cell cultures of dog gallbladder epithelial cells were used. The cells were exposed to the 2 contrast agents with increasing iodine concentration and osmolality for 2 days. Cell number, S-phase fraction, aneuploidy, and supernatant LDH activities were measured each day.. Cell growth was more severely inhibited by ioxithalamate than iopromide (p < 0.05) and strongly dependent on the osmolality of contrast agent. The cytostatic effect estimated by S-phase fraction was more pronounced for ioxithalamate. Chromosomal damage determined by aneuploidy was more frequently detected with ioxithalamate.. High-osmolar ionic contrast media are more cytotoxic than low-osmolar nonionic contrast media to gallbladder epithelial cells. Animal and clinical studies are needed to estimate the clinical implications of these findings.

Topics: Aneuploidy; Animals; Cell Count; Cell Cycle; Cholangiopancreatography, Endoscopic Retrograde; Cholangitis; Contrast Media; Dogs; Epithelial Cells; Gallbladder; Iohexol; Iothalamate Meglumine; Pancreatitis

To compare the accuracy of spiral computed tomography (CT) with that of ventilation-perfusion (V-P) scintigraphy in the diagnosis of pulmonary embolism (PE).. Fifty-four patients in whom indeterminate V-P scans or discordant clinical and scintigraphic results were obtained underwent both V-P scanning and contrast material-enhanced spiral CT. The reference standard was pulmonary angiographic results in 26 patients (group I) or clinical outcome in 28 (group II).. Six (25%) of 24 group I patients had proved PE. The prospective sensitivity and specificity for segmental or subsegmental PE were 67% and 100%, respectively, and the positive and negative predictive values were 100% and 90%, respectively. In two group II patients, V-P scans had high probability for acute embolism, but spiral CT scans showed only chronic PE; in one patients, the V-P scan had low probability and the CT scan was positive for acute PE. An alternative CT diagnosis was established in four (31%) of 13 patients in whom a normal or low-probability V-P scan was obtained. Clinical outcome was consistent with spiral CT results in all cases.. Spiral CT has greater accuracy and specificity than V-P scanning in patients with an unresolved diagnosis and may be useful as the primary screening technique for PE.

Topics: Acute Disease; Adult; Aged; Aged, 80 and over; Angiography; Angiography, Digital Subtraction; Chronic Disease; Contrast Media; Female; Follow-Up Studies; Humans; Image Processing, Computer-Assisted; Iohexol; Iothalamate Meglumine; Male; Middle Aged; Predictive Value of Tests; Probability; Prospective Studies; Pulmonary Embolism; Radionuclide Imaging; Radiopharmaceuticals; Reference Standards; Sensitivity and Specificity; Technetium Tc 99m Aggregated Albumin; Tomography, X-Ray Computed; Treatment Outcome; Ventilation-Perfusion Ratio

Mechanical contrast media application is used to improve image quality and allow better quantitative assessment of the contrast media kinetics for CT as well as MRI. The pressure within the i.v. line system must be known to enable safe and quantitatively exact application.. Experimental setup to analyse the inline pressure, the storage volume as well as the exactness of delivery within the i.v. line system was prepared. Representative contrast media Ultravist 300, Ultravist 370, Magnevist and Conray 60 as well as 0.9% NaCl were measured with ten different flow rates from 0.1 ml/sec to 5.0 ml/sec using the six most common i.v. cannula sizes (22G-14G).. System pressures between 38-60 psi (maximum allowed system pressure = 60 psi) are commonly obtained with standard sizes of i.v. cannulas, such as an 18 G cannula and flow rates > or = 2.5 ml/sec using Ultravist 300 (viscosity 13 mPa.s at 20 degrees C). Higher system pressures (> 25 psi) produce an exponential increase of the storage volume within the i.v. line system. The additional storage volume within the i.v. line tubing (d = 2.9 mm, 76 shore) is at 60 psi and 20 degrees C 5 ml/m, and at 37 degrees C 11 ml/m in addition to the volume of the tubing of 7 ml/m.. Based on the measured data, both the minimum and the recommended sizes of the i.v. cannulas in respect of flow rate and viscosity of the used contrast media were compiled for system pressures at < or = 60 psi as well as < or = 38 psi.

Topics: Catheterization; Contrast Media; Gadolinium; Gadolinium DTPA; Humans; Iohexol; Iothalamate Meglumine; Magnetic Resonance Imaging; Organometallic Compounds; Pentetic Acid; Pressure; Temperature; Tomography, X-Ray Computed; Viscosity

SHU 454 (Schering AG, Berlin, Federal Republic of Germany) is a new contrast agent that releases microbubbles with a median diameter of 3 microns into the circulation. During echocardiography, it permits visualization of myocardial blood flow (MBF) when given by intracoronary or aortic root injections. Its hemodynamic effects were investigated in anesthetized dogs with a view to application in humans. Cardiac effects were studied after intracoronary injections of 1 mL of SHU 454 (100 mg/mL). Twenty seconds after injection, MBF increased 35% and coronary vascular resistance decreased accordingly. The increase in MBF was not seen when the coronary bed was maximally dilated with intravenous dipyridamole. Peripheral effects were evaluated after 5 mL of SHU 454 (200 mg/mL) was injected into the aortic root, which gave the same myocardial echo contrast. Aortic pressure decreased 5%, and heart rate and dP/dt increased. To evaluate the effects of hypertonicity, SHU 454 was compared with five radiocontrast media and glucose. Its effects on MBF were similar to those of radiologic contrast media on an equal volume basis. Only 1 mL of intracoronary SHU 454, however, was required for myocardial contrast enhancement. The results suggest that visualization of the myocardium using SHU 454 or similar compounds for contrast echocardiography is a viable prospect.

Topics: Animals; Blood Pressure; Cardiac Output; Central Venous Pressure; Contrast Media; Coronary Circulation; Diatrizoate Meglumine; Dogs; Echocardiography; Female; Glucose; Heart; Heart Rate; Hypertonic Solutions; Iohexol; Iothalamate Meglumine; Male; Osmolar Concentration; Polysaccharides; Vascular Resistance; Ventricular Function, Left

Topics: Animals; Brain; Carotid Arteries; Contrast Media; Infusions, Intra-Arterial; Iohexol; Iothalamate Meglumine; Muscles; Osmolar Concentration; Rabbits; Triiodobenzoic Acids

The authors investigated the effect on the brain of red blood cells that had been modified by contrast media. Rat blood was mixed with an equivolume of contrast media, and up to 200 microL of the mixture was infused to the internal carotid artery of the rat. Evans blue was administered intravenously to assess the integrity of the blood-brain barrier (BBB). Immediately after the death of the animal, or 2.5 hours after the infusion, the brain was removed for evaluation of the degree of BBB destruction and edema. Extensive destruction of the BBB, cerebral edema, and death of the animals were induced by infusion of blood mixed with an ionic contrast medium, such as diatrizoate and iothalamate, which deformed red blood cells. Microscopic observation showed atrophy and necrosis of nerve cells and decomposition of nerve fibers in the affected area of the brain. Cerebral damage was not observed in rats injected with blood mixed with a nonionic contrast medium such as iopamidol, iopromide, or metrizamide, which had less effect on red blood cells. Cerebral damage also was observed in the rats injected with blood mixed with a hyperosmotic solution of mannitol, as well as washed red blood cells mixed with an ionic contrast medium. This study's results indicate that hyperosmotic ionic contrast media affect red blood cells and cause disturbance in cerebral circulation.

Topics: Animals; Blood-Brain Barrier; Brain Edema; Cerebral Angiography; Contrast Media; Diatrizoate Meglumine; Erythrocyte Deformability; Iohexol; Iopamidol; Iothalamate Meglumine; Male; Metrizamide; Osmolar Concentration; Rats; Rats, Inbred Strains

A rabbit model was used to assess the effects of intracarotid injections of ionic monomer (meglumine iothalamate), non-ionic monomer (iohexol, iopromide), and non-ionic dimer (iotrol) contrast materials on the blood-brain barrier. The degree of blood-brain barrier damage was assessed qualitatively using Evans' blue dye, and quantitatively by calculating the difference in pertechnetate uptake between injected and non-injected hemispheres. The results showed that the non-ionic dimer, iotrol, had the least effect on the blood-brain barrier, and that although iopromide and iohexol produced greater damage than iotrol, the ionic compound, meglumine iothalamate, caused the greatest disruption to the blood-brain barrier. The implications of these findings are discussed.

Topics: Animals; Blood-Brain Barrier; Carotid Arteries; Contrast Media; Evans Blue; Female; Injections, Intra-Arterial; Iohexol; Iothalamate Meglumine; Male; Rabbits; Sodium Pertechnetate Tc 99m; Triiodobenzoic Acids