RESUMO
In deciding to use a new intravascular contrast medium, the considerations should be patient safety, Imaging efficacy, and cost. Balancing these factors, use can be estimated. With the new low-osmolality contrast media, particularly the nonionic media, the expected increased patient safety must be balanced against the much higher cost.
Assuntos
Meios de Contraste/toxicidade , Radiografia/economia , Canadá , Ensaios Clínicos como Assunto , Análise Custo-Benefício , Custos e Análise de Custo , Europa (Continente) , Humanos , Noruega , Concentração Osmolar , Risco , Estados UnidosRESUMO
Urografin 60, iopamidol and Hexabrix were studied in patients undergoing body CT scans to examine the pharmacodynamics of these contrast agents. Immediately following rapid injection, the lower osmolality media, Hexabrix and iopamidol, gave greater aortic concentration of iodine in addition to higher concentrations in the liver and spleen. These two agents also provided significantly better renal enhancement than Urografin 60, with Hexabrix giving higher levels than iopamidol. The higher early vascular concentrations of Hexabrix and iopamidol and the relative absence of side effects due to hyperosmolality and decreased toxicity may have advantages in dynamic CT scanning.
Assuntos
Meios de Contraste/metabolismo , Diatrizoato de Meglumina/metabolismo , Diatrizoato/análogos & derivados , Diatrizoato/metabolismo , Iodobenzoatos/metabolismo , Ácido Iotalâmico/análogos & derivados , Tomografia Computadorizada por Raios X , Ácidos Tri-Iodobenzoicos/metabolismo , Combinação de Medicamentos/metabolismo , Humanos , Iopamidol , Ácido Iotalâmico/metabolismo , Ácido Ioxáglico , Distribuição TecidualRESUMO
The effect of .3 cc of 1:1000 epinephrine on iodine concentration, total iodine content, fluid volume and radiographic quality was evaluated in knee arthrograms in dogs. With the addition of epinephrine the iodine concentration and total iodine content were significantly higher initially and remained significantly higher than in controls over a one hour period. The fluid volume in the knee was significantly lower with epinephrine. Initially both contrast absorption and dilution have major effects in decreasing iodine concentration. With increasing time the effect of contrast absorption becomes the major factor, having a two of three times greater effect on decreasing iodine concentration. With epinephrine radiographs were judged significantly better early and while the quality deteriorated rapidly in the controls the enhanced quality with epinephrine persisted up to one hour. Epinephrine is a very useful adjunct in enhancing the quality of knee arthrography.
Assuntos
Epinefrina/farmacologia , Articulação do Joelho/diagnóstico por imagem , Intensificação de Imagem Radiográfica/métodos , Animais , Cães , Epinefrina/administração & dosagem , Injeções Intra-Articulares , Iodo/análise , Iotalamato de Meglumina/administração & dosagem , Iotalamato de Meglumina/análise , Líquido Sinovial/análise , Líquido Sinovial/efeitos dos fármacosRESUMO
New low-osmolality ratio-3 contrast media have been shown to have less toxicity than currently used contrast media. In intravenous excretory urography, these agents give significantly higher urinary iodine concentrations, produce less diuresis, and are better tolerated by patients because of fewer unpleasant side effects. These newer low-osmolality contrast media have significant advantages in intravenous urography.
Assuntos
Meios de Contraste , Urografia , Animais , Coagulação Sanguínea/efeitos dos fármacos , Criança , Ativação do Complemento/efeitos dos fármacos , Meios de Contraste/efeitos adversos , Diatrizoato , Coração/efeitos dos fármacos , Hemodinâmica/efeitos dos fármacos , Liberação de Histamina/efeitos dos fármacos , Humanos , Ácido Iotalâmico , Ácido Ioxáglico , Rim/efeitos dos fármacos , Pulmão/efeitos dos fármacos , Metrizamida , Camundongos , Tromboflebite/induzido quimicamente , Ácidos Tri-IodobenzoicosRESUMO
Milk-of-calcium renal cysts, which when asymptomatic need no treatment, sometimes pose diagnostic problems by conventional radiography. Two such cases are here reported. The first case was further evaluated by ultrasonography only, the second case also by computed tomography and cyst puncture, because of an irregularity in the cyst wall. Both imaging modalities added valuable information.
Assuntos
Cálcio , Doenças Renais Císticas/diagnóstico , Feminino , Humanos , Rim/diagnóstico por imagem , Pessoa de Meia-Idade , Postura , Tomografia Computadorizada por Raios X , UltrassonografiaRESUMO
In equivalent doses for intravenous urograms conventional ionic contrast agents give iodine concentrations in the urine of approximately 30 mg iodine/ml, nonionic contrast media provide approximately 50 mg iodine/ml, and the ionic dimer Hexabrix approximately 70 mg iodine/mL. These new low osmolality, contrast media provide significantly higher urinary iodine concentrations than conventional ionic contrast media, provide better diagnostic quality excretory urograms, better patient tolerance, and fewer adverse side-effects and serious reactions. These new low osmolality, contrast media have significant advantages in intravenous urography in both safety and efficacy when compared to conventional higher osmolality contrast media.
Assuntos
Meios de Contraste , Urografia , Meios de Contraste/farmacologia , Diatrizoato/farmacologia , Humanos , Concentração Osmolar , Intensificação de Imagem RadiográficaRESUMO
Excretory urography of a patient with an early stage of medullary cystic disease demonstrated an inhomogeneous, streaky nephrogram confined to the medulla, presumably due to accumulation of contrast material in dilated tubules. This was seen best one to two hours after contrast injection and may represent a specific urographic finding which does not appear to have been described previously in this condition.
Assuntos
Doenças Renais Císticas/diagnóstico por imagem , Adolescente , Humanos , Iotalamato de Meglumina , Doenças Renais Císticas/genética , Doenças Renais Císticas/fisiopatologia , Testes de Função Renal , Medula Renal/diagnóstico por imagem , Masculino , Fatores de Tempo , Tomografia por Raios X , UrografiaRESUMO
The authors present an overview of the current status of hysterosalpingography, discussing the advantages and disadvantages of various cannulas, contrast media, and methods of contrast medium introduction. Thirty-two figures illustrate a variety of abnormal findings including among others: intravasation of contrast medium, salpingitis isthmica nodosa, manifestations of pelvic inflammatory disease, the effects of DES exposure, Ascherman's syndrome, adenomyosis, carcinoma, polyps, myomata and developmental uterine abnormalities.
Assuntos
Histerossalpingografia , Doenças das Tubas Uterinas/diagnóstico por imagem , Feminino , Humanos , Histerossalpingografia/instrumentação , Histerossalpingografia/métodos , Doenças Uterinas/diagnóstico por imagem , Útero/anormalidadesRESUMO
Twenty-three cases of polycystic disease were reviewed. All were easily detected by computed tomography. All manifested diffuse, bilateral renal cystic disease, and 74% had demonstrable hepatic cystic disease. Computed tomography is more accurate than other conventional modalities in diagnosing renal cysts, and its simplicity of operation and ease of interpretation are unmatched.
Assuntos
Doenças Renais Policísticas/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Adolescente , Adulto , Idoso , Criança , Cistos/complicações , Cistos/diagnóstico por imagem , Feminino , Humanos , Hepatopatias/complicações , Hepatopatias/diagnóstico por imagem , Masculino , Pessoa de Meia-IdadeRESUMO
Experience with percutaneous drainage in four cases of splenic abscess is presented. Percutaneous drainage and antibiotics were curative in three of four cases. The one case not adequately treated by antibiotics and percutaneous drainage was also complicated by ascites and multilocular collections. Percutaneous drainage in this case did not adversely affect subsequent curative surgery. Percutaneous catheter drainage of splenic abscess under radiologic guidance can be a safe, effective treatment.
Assuntos
Abscesso/cirurgia , Drenagem , Esplenopatias/cirurgia , Abscesso/diagnóstico por imagem , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Radiografia , Esplenopatias/diagnóstico por imagemRESUMO
Two patients are described who presented with complete urinary obstruction secondary to nonopaque uric acid stones. They were treated with percutaneous nephrostomy for urinary diversion and urinary alkalinization by local irrigation and oral sodium bicarbonate therapy with complete dissolution of the stone after 16 and 21 days of therapy. Percutaneous nephrostomy with urinary alkalinization is a reasonable, relatively safe alternative to surgical stone removal for patients with obstructing uric acid stones.
Assuntos
Cálculos Renais/terapia , Ácido Úrico , Idoso , Álcalis/uso terapêutico , Bicarbonatos/uso terapêutico , Feminino , Humanos , Concentração de Íons de Hidrogênio , Rim/cirurgia , Cálculos Renais/cirurgia , Cálculos Renais/urina , Masculino , Métodos , Pessoa de Meia-Idade , Irrigação Terapêutica , Derivação UrináriaRESUMO
The incidence and cause of urinary tract obstruction in 100 consecutive patients with polycystic renal disease are reported. Because of nonspecific symptoms, poor renal function, and calyceal distortion, obstruction may be difficult to detect. A number of patients had infundibular obstruction caused by a calculus, clot, or inflammation and edema of the pelvocalyceal wall.
Assuntos
Cálculos Renais/diagnóstico por imagem , Doenças Renais Policísticas/complicações , Obstrução Ureteral/diagnóstico por imagem , Humanos , Cálculos Renais/complicações , Cálices Renais , Obstrução Ureteral/complicações , UrografiaRESUMO
Herein we review 100 cases of adult polycystic kidney disease. Flank pain was the most common presentation in these cases. In 20% of the patients calculi were noted and 10% had obstruction. The average patient age at death was 57 years. The importance of tomography is emphasized with key radiographic features, such as bilateral large kidneys, inhomogeneous nephrogram, caliceal distortion and poorly defined renal margins. Cystic involvement of the liver and spleen may help to confirm the diagnosis. Differential diagnosis includes bilateral multiple simple cysts, angiomyolipomatosis and bilateral renal carcinomas.
Assuntos
Doenças Renais Policísticas/diagnóstico por imagem , Adolescente , Adulto , Idoso , Humanos , Pessoa de Meia-Idade , Tomografia por Raios XRESUMO
The commonly accepted criteria for colon malignancy were investigated in malignant and benign polyps smaller than 3 cm in diameter. It was found that most small tumors, both benign and malignant, were sessile and smooth in outline. It was only when the polyps increased in size that their outlines became lobulated or irregular. A stalk was not seen in polyps smaller than 1 cm in diameter. Retraction at the base of a cancer was likewise not seen in these small lesions. The typical malignant characteristics became apparent only when the polyp had grown to 2 to 3 cm in diameter.
Assuntos
Neoplasias do Colo/diagnóstico por imagem , Pólipos Intestinais/diagnóstico por imagem , Adenocarcinoma/diagnóstico por imagem , Adenoma/diagnóstico por imagem , Doenças do Colo/diagnóstico por imagem , Humanos , RadiografiaRESUMO
A double-blind clinical trial was performed in 60 patients to compare Hexabrix (ioxaglate meglumine and ioxaglate sodium) and Renografin-60 (diatrizoate meglumine and diatrizoate sodium). Use of Hexabrix produced higher urinary iodine concentrations, lower urine volumes at 30 minutes, and excretory urograms significantly better in diagnostic quality, as rated by four independent observers. There was no difference in nephrogram quality between contrast agents. Patients receiving Hexabrix had less of an increase in heart rate and demonstrated a slight rise in mean arterial blood pressure, rather than the biphasic rise then fall seen with Renografin-60. There was no significant change for up to 96 hours after urography in results of hematology, clinical chemistry, or urinalysis, except for an increase of 0.005 in urine specific gravity with Renografin-60. Patients reported significantly less body heat, heat in the injection arm, and overall discomfort with Hexabrix. There was a similar amount of nausea and vomiting in the two groups. Hexabrix also caused histaminic-type reactions in three patients.
Assuntos
Diatrizoato de Meglumina , Diatrizoato , Ácido Ioxáglico , Urografia , Adulto , Idoso , Idoso de 80 Anos ou mais , Pressão Sanguínea/efeitos dos fármacos , Ensaios Clínicos como Assunto , Diatrizoato/administração & dosagem , Diatrizoato/efeitos adversos , Diatrizoato/farmacologia , Diatrizoato de Meglumina/administração & dosagem , Diatrizoato de Meglumina/efeitos adversos , Diatrizoato de Meglumina/farmacologia , Combinação de Medicamentos/administração & dosagem , Combinação de Medicamentos/efeitos adversos , Combinação de Medicamentos/farmacologia , Feminino , Humanos , Iodo/urina , Ácido Ioxáglico/administração & dosagem , Ácido Ioxáglico/efeitos adversos , Ácido Ioxáglico/farmacologia , Masculino , Pessoa de Meia-Idade , Concentração OsmolarRESUMO
Ninety-seven patients who were undergoing excretory urography for suspected genitourinary tract abnormalities were continuously monitored for systemic blood pressure and pulse rates before (control) and after rapid intravenous injections of contrast material (1.5 ml/kg meglumine iothalamate, 60%) using a Bard pressure monitor. We report the systemic responses observed. Clinically obvious reactions to contrast medium were recorded and compared with the blood pressure and pulse rate responses. The most common response to rapid infusion of contrast medium was a transient hypotension. An increase in systemic pressure had a high association with nausea and vomiting. Significant hypotension (mean blood pressure less than 60 mm Hg) was observed in six patients (6%), but no overt clinical manifestations were present.
Assuntos
Hemodinâmica/efeitos dos fármacos , Iotalamato de Meglumina/efeitos adversos , Urografia/efeitos adversos , Adulto , Idoso , Pressão Sanguínea/efeitos dos fármacos , Frequência Cardíaca/efeitos dos fármacos , Humanos , Hipotensão/induzido quimicamente , Hipotensão/etiologia , Pessoa de Meia-Idade , Náusea/induzido quimicamente , Náusea/etiologiaRESUMO
Computed tomography can aid in the distinction of calculi from both tumors and clots in the urinary tract. Its availability, simplicity of interpretation, and noninvasiveness establish it as an important diagnostic modality in selected cases when calculus is in the differential diagnosis of upper urinary tract filling defects.
Assuntos
Tomografia Computadorizada por Raios X , Cálculos Urinários/diagnóstico por imagem , Adulto , Idoso , Carcinoma de Células de Transição/diagnóstico por imagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cálculos Ureterais/diagnóstico por imagem , Neoplasias Ureterais/diagnóstico por imagem , Neoplasias Urológicas/diagnóstico por imagemRESUMO
A case of a rare acquired form of aqueductal stenosis and hydrocephalus developing as a late sequela of mumps virus infection of the central nervous system is presented. The experimental studies of mumps induced aqueductal stenosis in hamsters and mice and the four previously reported cases in the literature are reviewed.