iothalamate-meglumine and ioversol

To determine the effect of the rate of contrast medium injection on liver enhancement at computed tomography (CT).. Forty-five patients who underwent a follow-up CT examination of the liver were included in five different groups according to the compared rates of contrast material delivery: group A, 2 versus 3 mL/sec; group B, 2 versus 4.5 mL/sec; group C, 3 versus 4.5 mL/sec; group D, 3 versus 6 mL/sec; and group E, 4.5 versus 6 mL/sec.. Time to peak enhancement was shorter for the faster rates of injection. In each group, maximum enhancement was nearly identical for the paired examinations (group A, 57 vs 58 HU; group B, 48 vs 47 HU; group C, 55 vs 58 HU; group D, 55 vs 54 HU; group E, 62 vs 61 HU, respectively). Mean enhancement in each group was similar when calculated at 3-second intervals.. Higher rates of injection shorten the time to peak liver enhancement but have no effect on maximum liver enhancement.

Topics: Contrast Media; Female; Humans; Injections, Intravenous; Iohexol; Iopamidol; Iothalamate Meglumine; Liver; Liver Neoplasms; Male; Middle Aged; Time Factors; Tomography, X-Ray Computed; Triiodobenzoic Acids

To prospectively evaluate a dual-phase helical acquisition in computed tomography (CT) of the liver.. Two helical CT acquisitions were performed in 103 patients: hepatic arterial phase (HAP) 15 seconds after injection of 2 mL/kg contrast material at a rate of 6 mL/sec and the portal venous phase (PVP) 90 seconds after injection. Detection of focal liver lesions, vascular anatomic features, and perfusion abnormalities were assessed by two reviewers. Liver enhancement was also calculated on every section.. Of 119 detected focal liver lesions, nine were seen during HAP only and 40 during PVP only. According to a 0-3 score, visualization of the arterial anatomic landmarks was better during HAP (P < .0001). Five right replaced and two left replaced hepatic arteries were visualized only during HAP. Parenchymal perfusion abnormalities were found in 32 patients during HAP and in four patients during PVP.. A dual-phase acquisition depicted 8% additional focal liver lesions and outlined the entire vasculature of the liver.

Topics: Adult; Aged; Aged, 80 and over; Bile Ducts, Intrahepatic; Contrast Media; Evaluation Studies as Topic; Female; Hepatic Artery; Humans; Iohexol; Iopamidol; Iothalamate Meglumine; Liver; Liver Circulation; Liver Neoplasms; Male; Middle Aged; Portography; Prospective Studies; Radiographic Image Enhancement; Tomography, X-Ray Computed; Triiodobenzoic Acids

Fifty patients undergoing ascending phlebography of a lower limb were evaluated, in a randomized double-blind fashion, to compare the efficacy, patient tolerance, and safety of two different contrast agents. Ioversol-240 (MP-238), a new nonionic agent, and iothalamate-202 (Conray 43), an established ionic agent, were the contrast agents used. Twenty-five patients were injected with iothalamate and 25 with ioversol. The phlebograms were evaluated for diagnostic quality and the patients for symptoms, with special reference to complaints of heat and pain. No significant difference was demonstrated between the two agents in either examination quality or patient tolerance. No major contrast-related reactions were recorded. We conclude that ioversol-240 appears to be a safe and acceptable alternative to iothalamate-202.

Topics: Adult; Aged; Aged, 80 and over; Clinical Trials as Topic; Contrast Media; Double-Blind Method; Drug Tolerance; Female; Humans; Iodobenzoates; Iothalamate Meglumine; Leg; Male; Middle Aged; Phlebography; Radiographic Image Enhancement; Random Allocation; Triiodobenzoic Acids

Ioversol, the new nonionic, low-osmolality contrast agent, has been well characterized chemically and in terms of basic toxicity testing. Ioversol has a formula similar to that of other nonionic agents, and has been used in a variety of clinical studies. These have been reviewed in detail in other papers. This article reviews the worldwide experience to date with the intra-arterial use of this contrast agent. Ioversol has been given to more than 500 patients for studies including intra-arterial digital subtraction angiography, and cerebral, visceral, peripheral, and cardiac angiography. In 23 carefully monitored studies, ioversol was shown to be safe and diagnostically efficacious, as compared with several high- and low-osmolality agents. To date, there have been no deaths or other severe reactions with this new nonionic formulation. Ioversol is likely to provide a useful addition to the current formulary of low-osmolality agents.

Topics: Angiography; Clinical Trials as Topic; Contrast Media; Diatrizoate; Double-Blind Method; Humans; Iodobenzoates; Iopamidol; Iothalamate Meglumine; Subtraction Technique; Triiodobenzoic Acids; Vascular Diseases

To evaluate the impact of the inclusion of computed tomographic colonography (CTC) involving faecal tagging and no laxatives on the computed tomography (CT) study routinely used in staging patients with colorectal cancer.. CTC was performed on 25 patients who had a diagnosis of colorectal carcinoma, with pathological correlation. Researchers recorded the accuracy of the CTC for staging colorectal cancer, as well as any changes to the plans for surgery based on this exam. The patients' tolerance of the preparation required and the quality of the exams was also evaluated.. All exams were well-tolerated, and only one had unsatisfactory quality. CTC identified all the carcinomas and had an overall accuracy of 80%, 60.1% and 100% for the evaluation of tumour depth, lymph nodes and metastases respectively. CTC identified all polyps greater than 9 mm. Following CTC, changes to surgical plans were observed in 20.8% of the cases, all with incomplete optical colonoscopies.. CTC proved useful for the pre-operative evaluation of patients with a diagnosis of colorectal carcinoma, affecting plans for surgery in a expressive number of patients with an incomplete colonoscopy.

Topics: Adult; Aged; Aged, 80 and over; Colonography, Computed Tomographic; Colorectal Neoplasms; Contrast Media; Female; Humans; Iothalamate Meglumine; Lymphatic Metastasis; Male; Middle Aged; Neoplasm Staging; Radiographic Image Interpretation, Computer-Assisted; Sensitivity and Specificity; Triiodobenzoic Acids

The objective of this study was to assess the long-term natural history of focal confluent fibrosis in cirrhotic liver with CT.. Two radiologists retrospectively reviewed in consensus 118 liver CT examinations in 26 patients (19 men, seven women; age range, 32-68 years; mean age, 50 years) performed over approximately 6 years. Helical CT scans were obtained before and 30-35 and 65-70 seconds after injection of 125-150 mL of contrast medium at a rate of 4-5 mL/s. Proof of cirrhosis was based on liver transplantation (n = 6), biopsy (n = 9), or imaging findings (n = 11). The number, location, and attenuation of fibrotic lesions and presence of trapped vessels were evaluated. Variation of hepatic retraction associated with the development of focal confluent fibrosis lesions was assessed using the ellipsoid volume formula and an arbitrary retraction index.. Each radiologist identified 41 focal confluent fibrosis lesions. All lesions were identified by both radiologists. Twelve patients (46%) had a single lesion, 13 (50%) had two lesions, and one (4%) had three lesions. Thirty-four (83%) of 41 lesions were located in segment IV, VII, or VIII. Thirty-two lesions (78%) were hypoattenuating on unenhanced images, 25 lesions (61%) were hypoattenuating on hepatic arterial phase images, and 20 lesions (49%) were isoattenuating on portal venous phase images. Seven lesions (17%) were or became hyperattenuating at follow-up on portal venous phase images. Trapped vessels were found in six lesions (15%). The retraction index showed a significant increase over time (r = 0.423, p < or = 0.0001).. The degree of capsule retraction associated with focal confluent fibrosis evolves with time and relates to the natural evolution of cirrhosis.

Topics: Adult; Aged; Contrast Media; Disease Progression; Female; Humans; Iothalamate Meglumine; Linear Models; Liver Cirrhosis; Male; Middle Aged; Radiographic Image Interpretation, Computer-Assisted; Retrospective Studies; Tomography, Spiral Computed; Triiodobenzoic Acids

In this study the authors tested the osteoinductive potential of recombinant human bone morphogenetic protein-2 (rhBMP-2) when combined with each of three commercially available contrast media (Conray, Omniscan, and Optiray).. Initial in vitro and cadaver tests verified the feasibility of using contrast media to visualize absorbable collagen sponge implants containing rhBMP-2 on fluoroscopic radiographic images. For the feasibility studies, lyophilized rhBMP-2 was prepared for injection by reconstitution with contrast media instead of sterile water. For the in vivo study, samples of an rhBMP-2 stock solution were diluted to 0.1 mg/ml by using three contrast media. In each sample, the final solution consisted of 97% contrast medium by volume. Recombinant human bone morphogenetic protein-2 diluted with sterile water for injection was used as a positive control. The rhBMP-2 solutions were applied to 0.5-cm3 collagen sponges and implanted subcutaneously on the thoracic cavity of athymic rats. At 4 weeks, the rats were killed, and the implants were removed. The explants were graded for degree of bone formation by using manual palpation and radiographic and histological assessments.. By all methods of evaluation used, rhBMP-2 diluted with Omniscan was equivalent to rhBMP-2 diluted with sterile water in inducing bone formation. Both Conray and Optiray were shown to inhibit the osteoinductive potential of rhBMP-2.

Topics: Animals; Bone Morphogenetic Protein 2; Bone Morphogenetic Proteins; Bone Substitutes; Contrast Media; Feasibility Studies; Gadolinium DTPA; Iothalamate Meglumine; Osteogenesis; Prostheses and Implants; Rats; Rats, Nude; Recombinant Proteins; Surgical Sponges; Transforming Growth Factor beta; Triiodobenzoic Acids

Topics: Animals; Blood Pressure; Contrast Media; Enzyme Inhibitors; Histamine; Hypotension; Injections, Intravenous; Iopamidol; Iothalamate Meglumine; NG-Nitroarginine Methyl Ester; Nitric Oxide; Rats; Rats, Sprague-Dawley; Triiodobenzoic Acids

To compare the appearance of small hepatic hemangiomas at nonenhanced and contrast material-enhanced helical computed tomography (CT) with that of small (<3-cm) hypervascular malignant liver tumors and to evaluate the accuracy of multiphase helical CT for differentiating small hemangiomas from small hypervascular malignant tumors.. Radiologists reviewed multiphase helical CT liver images in 86 patients with 37 hemangiomas and 49 malignant liver tumors. They evaluated lesion type and degree of enhancement for change from arterial to portal venous phase. They rated their confidence in the discrimination of hemangiomas from malignant tumors.. At arterial phase CT, enhancement similar to aortic enhancement was observed in 19%-32% of hemangiomas and 0%-2% of malignant tumors; globular enhancement, in 62%-68% and 4%-12%, respectively. At portal venous phase CT, enhancement similar to blood pool enhancement was observed in 43%-54% of hemangiomas and 4%-14% of malignant tumors; globular enhancement, in 46%-49% and 0%-2%, respectively. For all readers and all phases of enhancement, the area under the receiver operating characteristic curves was 0.81-0.87, indicating that inherent accuracy of CT is high and that there was no significant difference (P >.28) in overall accuracy. Readers diagnosed hemangiomas with 47%-53% mean sensitivity with all enhancement phases and diagnosed malignant lesions with 95% mean specificity.. Small hemangiomas frequently show atypical appearances at CT. Two-phase helical CT does not improve sensitivity but does improve specificity for differentiating hemangiomas from hypervascular malignant tumors.

Topics: Carcinoma, Hepatocellular; Contrast Media; Diagnosis, Differential; Female; Hemangioma; Humans; Iothalamate Meglumine; Liver Neoplasms; Male; Middle Aged; Observer Variation; ROC Curve; Sensitivity and Specificity; Tomography, X-Ray Computed; Triiodobenzoic Acids

The purpose of this study was to determine whether the interval change in hepatic colorectal metastases as assessed with serial computed tomographic (CT) scans without contrast material enhancement differs from that as assessed using serial, portal dominant phase, contrast-enhanced CT scans.. Unenhanced and contrast-enhanced abdominal CT scans were obtained in 28 patients. Three radiologists separately reviewed serial unenhanced and contrast-enhanced studies to assess the interval change in liver metastases. These radiologists recorded total number of lesions, bidimensional measurements of the largest lesions (as many as three), and overall impressions regarding the interval change (none, worse, or better).. Among the 84 judgments (28 patients x 3 radiologists), comparisons of unenhanced and contrast-enhanced CT studies were concordant in 60 assessments (71%). Nineteen (23%) showed mild disagreement. Of these, contrast-enhanced CT studies demonstrated disease stability when unenhanced CT studies demonstrated otherwise in 11 judgments, whereas unenhanced CT studies demonstrated stability when contrast-enhanced CT studies demonstrated otherwise in eight assessments. Furthermore, of the five marked disagreements, two resulted from a conclusion of interval improvement on unenhanced CT studies and a conclusion of interval worsening on contrast-enhanced CT studies, whereas three demonstrated the opposite. Neither set of serial CT studies systematically resulted in under- or overestimation of disease progression (McNemar Q test, P < .25).. The authors found no consistent pattern to demonstrate that serial unenhanced or contrast-enhanced CT studies resulted in over- or underestimation of disease progression.

Topics: Adult; Aged; Colorectal Neoplasms; Contrast Media; Disease Progression; Female; Humans; Iothalamate Meglumine; Liver Neoplasms; Male; Middle Aged; Radiographic Image Enhancement; Time Factors; Tomography, X-Ray Computed; Triiodobenzoic Acids

To investigate whether measurements of hepatic metastases from colorectal carcinoma before contrast material administration are significantly different statistically from measurements after contrast material administration.. Twenty-four patients with hepatic metastases from colorectal carcinoma underwent spiral computed tomography (CT) with 7-mm collimation. The liver was imaged before and in the portal-dominant phase after intravenous contrast material administration. For each scan, one to three discrete liver lesions were selected for measurement (n = 49). Three experienced radiologists performed independent measurements of the selected lesions on both pre- and postcontrast images at a computer workstation. A three-way analysis of variance (ANOVA) was performed: subjects by raters (the three independent radiologists) by pre- or postcontrast status. The dependent variable was the product of bidimensional measurements.. Sixty-seven percent (33 of 49) of the lesions were measured as larger on precontrast images; 33% (16 of 49), as smaller. There was high interrater reliability, with an intraclass correlation coefficient greater than 0.9 ANOVA showed significant subject, rater, and contrast material effects (P < .001) for the largest lesions in each liver. Contrast material status was a significant factor for all lesion sizes (P < .003).. On average, hepatic metastases from colorectal carcinoma are significantly smaller after contrast material administration.

Topics: Adult; Aged; Barium Sulfate; Colorectal Neoplasms; Contrast Media; Diatrizoate; Diatrizoate Meglumine; Female; Humans; Iothalamate Meglumine; Liver; Liver Neoplasms; Male; Middle Aged; Sensitivity and Specificity; Tomography, X-Ray Computed; Triiodobenzoic Acids

To determine the frequency and clinical effects of extravasation related to rapid bolus infusion of ionic and nonionic contrast media.. Records of 5,106 computed tomographic studies in adult patients who underwent mechanical bolus injection of contrast medium through a plastic cannula in an upper extremity were retrospectively reviewed.. Mean infusion rate was 2.8 mL/sec (range, 1-5 mL/sec). Extravasation occurred in 48 (0.9%) patients, including in four of 928 patients who received the median injection rate (2.5 mL/sec). Injection rate was not correlated with frequency or amount of extravasation. Average age and use of ionic versus nonionic contrast medium were identical in patients with and in those without extravasation. There was no sex difference. Thirty-one patients had extravasation of ionic contrast medium; nine of these had extravasation of at least 50 mL. Seventeen patients had extravasation of nonionic contrast medium; seven of these had extravasation of at least 50 mL. Hyaluronidase infiltration was often used as treatment for larger extravasations (in 10 patients each with extravasation of ionic or nonionic medium). No patient required surgical intervention, and none had severe or permanent long-term effects.. The frequency of extravasation of contrast medium after mechanical bolus injection is higher than that reported for hand-injection or drip-infusion techniques, but there is no correlation between injection rate and extravasation frequency.

Topics: Adult; Aged; Aged, 80 and over; Contrast Media; Extravasation of Diagnostic and Therapeutic Materials; Female; Humans; Injections, Intravenous; Iothalamate Meglumine; Male; Middle Aged; Osmolar Concentration; Retrospective Studies; Tomography, X-Ray Computed; Triiodobenzoic Acids

Topics: Antigens; Contrast Media; Erythrocytes; Hemagglutination Inhibition Tests; In Vitro Techniques; Iodipamide; Iopamidol; Iothalamate Meglumine; Ioxaglic Acid; Triiodobenzoic Acids

This study was designed to evaluate the effects of ionic and nonionic contrast agents on endothelial cell (EC) and smooth muscle cell (SMC) proliferation, and to determine the role of osmolality as the etiology of these effects.. Cultured bovine aorta EC and SMC were exposed to ionic (iothalamate meglumine) or nonionic (ioversol or iopamidol) contrast, or varying osmolar solutions of mannitol, for periods of 1, 3, 5, 10, or 20 minutes. Cells were then incubated in growth media at 37 degrees C and proliferation and structure were assessed 1, 3, 5, and 7 days later.. Both EC and SMC showed decreased proliferation after brief exposure to both ionic and nonionic contrast. Proliferation was markedly decreased at 24 hours after exposure, and began to recover by day 3 after exposure. EC showed a significant decrease up to 7 days after exposure to ionic contrast (p < 0.03), whereas SMC showed a significant decrease up to 7 days after exposure to nonionic contrast (p < 0.001). The decrease in proliferation was directly dependent on the length of exposure to the contrast and the concentration of the contrast. EC proliferation decreased in proportion to increasing osmolality of the test solution (p < 0.05). SMC proliferation did not show a decrease proportional to osmolality. No change was observed in cell viability as assessed by LDH activity studies. After contrast exposure, bare areas with no cells present were noted in the previously confluent EC and SMC culture wells. Cell structure was altered immediately after exposure to contrast, with normal structure recovered by 24 hours after exposure.. This study demonstrates that brief exposure to contrast agents injures EC and SMC, altering their structure and decreasing proliferation for up to 7 days in vitro. This response is both dose and time dependent. EC are more severely affected by ionic contrast, and SMC are more severely affected by nonionic contrast. EC injury appears to be mediated by the osmolar effect of the contrast, but the effects of contrast on SMC seem to be due to a different mechanism.

Topics: Animals; Cattle; Cell Division; Cells, Cultured; Contrast Media; Dose-Response Relationship, Drug; Endothelium, Vascular; Iopamidol; Iothalamate Meglumine; Muscle, Smooth, Vascular; Osmolar Concentration; Time Factors; Triiodobenzoic Acids

To determine the feasibility and clinical benefit of routine performance of helical computed tomography (CT) with 2.5-mm collimation for the detection of liver lesions.. Twenty patients with small (< or = 10-mm-diameter) liver lesions (total number of lesions, 167) were evaluated with a dual-detector-array CT scanner during the portal venous phase of contrast material enhancement. The acquisition was performed with 2.5-mm collimation during a single breath hold. The identical data set was used to perform reconstructions with 2.5-mm, 5.0-mm, 7.5-mm, and 10.0-mm section thicknesses with 50% section overlap. Each set of images was evaluated by three radiologists to determine lesion detection rates and conspicuity.. Use of 2.5-mm-thick sections resulted in a 46% increase in detection rate versus use of 10.0-mm-thick sections (167 lesions vs 90 lesions), a 33% increase versus use of 7.5-mm-thick sections (167 vs 112), and an 18% increase versus use of 5-mm-thick sections (167 vs 137). Lesion conspicuity and radiologist confidence in lesion detection and characterization of lesion margins increased as section thickness decreased.. CT of the liver can be performed routinely with 2.5-mm collimation with a dual-detector CT system, yielding greater conspicuity of small lesions and improved lesion detection.

Topics: Contrast Media; Feasibility Studies; Female; Humans; Image Processing, Computer-Assisted; Iothalamate Meglumine; Liver Neoplasms; Male; Observer Variation; Tomography Scanners, X-Ray Computed; Tomography, X-Ray Computed; Triiodobenzoic Acids

To evaluate the added value of hepatic arterial-dominant phase (HAP) imaging to portal venous-dominant phase (PVP) imaging in patients with hepatocellular carcinoma (HCC) at computed tomography (CT).. Sixty-six patients with proved HCC underwent biphasic contrast-enhanced CT. HAP and PVP images were obtained at 20-50 and 60-100 seconds, respectively. PVP images were evaluated for the number of HCC foci. Then, HAP images were reviewed to determine whether any additional HCCs were seen.. Three hundred twenty-six tumor foci were seen. HAP images depicted 309 foci (95%) and PVP images 268 (82%). In seven patients (11%), tumor was visible only on HAP images. During the HAP, tumors were hyperattenuating compared with liver in 26 patients, of mixed attenuation in 26, and hypoattenuating in 14 without correlation with histologic appearance. Portal vein thrombosis was identified in 17 of 21 patients on HAP images; in 12 patients, the thrombosis was diagnosed as malignant with neovascularity within the thrombus or diffuse thrombus enhancement.. Use of both HAP and PVP contrast-enhanced CT optimizes the evaluation of patients with or at risk for HCC.

Topics: Carcinoma, Hepatocellular; Contrast Media; Female; Humans; Image Processing, Computer-Assisted; Iothalamate Meglumine; Liver Neoplasms; Male; Middle Aged; Neoplastic Cells, Circulating; Portal Vein; Sensitivity and Specificity; Time Factors; Tomography, X-Ray Computed; Triiodobenzoic Acids

To determine the feasibility of use of a power injector to deliver contrast material through central venous catheters for computed tomographic (CT) examinations.. Ioversol 240 and iothalamate meglumine 43% were separately injected through three 9.6-F Hickman catheters and three 10.0-F Leonard catheters with a power injector in an in vitro study. Flow rates of 1.0, 1.5, 2.0, and 2.5 mL/sec were tested. Peak pressures were mechanically recorded from two sites. A 95% prediction interval was calculated for each peak pressure, and the upper limits at the prediction interval were evaluated to determine if it was less than the recommended limit of 25 psi (175 kPa).. Contrast medium, flow rate, and catheter type each statistically significantly affected the measured peak pressures (P = .0001). For each flow rate tested, the upper limits of the prediction interval for the peak pressure at the connection between the coiled tubing and the catheter were below the manufacturer's specified peak pressure.. In vitro analysis demonstrates that power injection of intravenous contrast medium through central venous catheters does not exceed the pressure limits of these catheters at the flow rates tested. In vivo testing to evaluate the safety and efficacy of power injection through central venous catheters is necessary.

Topics: Analysis of Variance; Catheterization, Central Venous; Catheters, Indwelling; Confidence Intervals; Contrast Media; Feasibility Studies; Humans; In Vitro Techniques; Injections, Intravenous; Iothalamate Meglumine; Tomography, X-Ray Computed; Triiodobenzoic Acids

The electroencephalographic (EEG) effects of intracisternally administered x-ray contrast media were evaluated in rats as a means of assessing neurotoxicity. Rats were ventilated with a mixture of nitrous oxide and oxygen (70/30) sufficient to maintain light anesthesia/analgesia and neuromuscular blockade was induced to prevent movement artifacts. A femoral artery was catheterized for monitoring arterial blood pressure (BP), heart rate, blood gases, and pH. Four 22-gauge stainless steel needle electrodes were inserted underneath the scalp for recording EEG. Approximately 1 hour after the start of EEG recording, test agents were injected via the cisterna magna and rats were placed in a 20 degrees head-down position. EEG and BP were monitored continuously for up to 160 minutes postinjection. Blood gases and pH were monitored periodically. The effects of meglumine iothalamate (IOT), metrizamide (MET), iogulamide (IOG), and ioversol (IOV) were compared at dose levels from 30 to 240 mgI/kg. Normal saline was injected as a control substance and caused no changes in EEG, blood gases, pH, and BP for up to 160 minutes postinjection. IOT (30 mg I/kg) produced profound EEG effects consistent with epileptogenic activity, followed by slowing and subsequent death in 3 of 4 animals. Metrizamide had minimal EEG effects at 30 mg I/kg but at 60 mg I/kg, and 120 mg I/kg produced moderate to severe EEG changes including epileptiform patterns and death in 33% of animals. IOV caused mild EEG abnormalities in 4 of 12 animals at 120 mg I/kg, mild EEG abnormalities in 6 of 11 animals, and moderate EEG abnormalities in 1 of 11 animals at 240 mg I/kg.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Animals; Brain; Contrast Media; Electroencephalography; Female; Iohexol; Iothalamate Meglumine; Metrizamide; Rats; Rats, Inbred Strains; Triiodobenzoic Acids