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Sun YX, Shang J, Cui Y, Zhang KJ, Li XT, Li DN, Gu XL, Tian XY, Sun N, Zhang L, You MN, Zhang XY, Sun YS. Impact of different concentration iodinated contrast media on pain and comfort in abdominal computed tomography. Eur J Radiol 2024; 179:111664. [PMID: 39121745 DOI: 10.1016/j.ejrad.2024.111664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Revised: 07/04/2024] [Accepted: 08/02/2024] [Indexed: 08/12/2024]
Abstract
OBJECTIVES To investigate whether high concentration iodinated contrast media (CM), compared with low concentration CM, could reduce pain and discomfort levels in patients who had level II and III venous conditions. METHODS This prospective, single-center study enrolled patients who had level II and III venous conditions and underwent abdominal contrast-enhanced CT scan between July 2021 and February 2022. The venous condition to establish peripheral venous access for CM injection was graded using the Intravenous Access Scoring system, of which level II and III indicated poor venous condition and difficult venous access. Patients received iomeprol 400 in high concentration group and ioversol 320 in low group at an identical iodine delivery rate of 1.12 gI/s. The primary outcomes were pain and comfort levels. The secondary outcomes included adverse events and image quality. Patients rated pain intensity via Numerical Rating Scale and comfort level via Visual Analogue Scale with higher scores indicating higher levels of pain and discomfort. Quantitative and qualitative image assessment were compared between two groups. Continuous variables were compared using Student's t test or Mann-Whitney U test. Categorical variables were compared using χ2 test, χ2 test for trend or Fisher's exact test. RESULTS A total of 206 patients (mean age, 60.13 ± 12.14 years; 81 males) were included with 99 in the high concentration group and 107 in the low concentration group. The high group had significantly lower pain scores (median 1 [IQR: 0-2] vs 2 (IQR 2-4), p < 0.001) and comfort scores (1 [IQR: 0-3] vs 3 [IQR: 2-5], p < 0.001) than the low group. Incidence of CM extravasation did not significantly differ (1.0 % vs 4.5 %, p = 0.214). No hypersensitivity reaction was observed. Qualitative assessment showed higher clarity scores of intrahepatic hepatic artery and portal vein in the high group. Quantitative assessment results were comparable between two groups. CONCLUSION High concentration iodinated CM could lower pain intensity and improve comfort levels without comprising image quality of CT scan. High concentration CM is a preferable choice in patients with poor venous conditions during contrast-enhanced CT scan.
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Affiliation(s)
- Yan-Xia Sun
- Department of Radiology, Peking University Cancer Hospital and Institute, Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Beijing 100142, China
| | - Jing Shang
- Department of Radiology, Peking University Cancer Hospital and Institute, Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Beijing 100142, China
| | - Yong Cui
- Department of Radiology, Peking University Cancer Hospital and Institute, Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Beijing 100142, China
| | - Ke-Jin Zhang
- Department of Radiology, Peking University Cancer Hospital and Institute, Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Beijing 100142, China
| | - Xiao-Ting Li
- Department of Radiology, Peking University Cancer Hospital and Institute, Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Beijing 100142, China
| | - Dan-Ni Li
- Department of Radiology, Peking University Cancer Hospital and Institute, Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Beijing 100142, China
| | - Xiao-Lei Gu
- Department of Radiology, Peking University Cancer Hospital and Institute, Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Beijing 100142, China
| | - Xiao-Yu Tian
- School of Health Policy & Management, Nanjing Medical University, Nanjing 211166, China
| | - Nan Sun
- Department of Radiology, Peking University Cancer Hospital and Institute, Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Beijing 100142, China
| | - Lan Zhang
- MRI Department, The 1st Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou 450046, China
| | - Miao-Ning You
- Department of Breast Oncology, Peking University Cancer Hospital and Institute, Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Beijing 100142, China.
| | - Xiao-Yan Zhang
- Department of Radiology, Peking University Cancer Hospital and Institute, Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Beijing 100142, China.
| | - Ying-Shi Sun
- Department of Radiology, Peking University Cancer Hospital and Institute, Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Beijing 100142, China
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Telek E, Ujfalusi Z, Nyitrai M, Bogner P, Lukács A, Németh T, Hild G, Hild G. Deconvolution Analysis of the Non-Ionic Iomeprol, Iobitridol and Iodixanol Contrast Media-Treated Human Whole Blood Thermograms: A Comparative Study. Diagnostics (Basel) 2023; 13:2523. [PMID: 37568886 PMCID: PMC10417150 DOI: 10.3390/diagnostics13152523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 07/26/2023] [Accepted: 07/27/2023] [Indexed: 08/13/2023] Open
Abstract
To study the effect of non-ionic contrast media on anticoagulated and non-anticoagulated human whole blood samples, calorimetric measurements were performed. The anticoagulated plasma showed the greatest fall in the total ΔH after Iodixanol treatment. The plasma-free erythrocytes revealed a pronounced shift in the Tmax and a decrease in the ΔH of hemoglobin and transferrin. The total ΔH of Iodixanol treatment showed the highest decline, while Iomeprol and Iobitridol had fewer adverse effects. Similarly, the non-anticoagulated samples revealed a decrease both in the Tmax and the ΔH of albumin and immunoglobulin-specific transitions. The total ΔH showed that Iodixanol had more influence on the serum. The serum-free erythrocyte samples resulted in a significant drop in the Tmax of erythrocyte and transferrin (~5-6 °C). The ΔH of deconvolved hemoglobin and transferrin decreased considerably; however, the ΔH of albumin increased. Surprisingly, compared to Iomeprol and Iobitridol treatments, the total ΔH of Iodixanol was less pronounced in the non-anticoagulated erythrocyte samples. In sum, each non-ionic contrast medium affected the thermal stability of anticoagulated and non-anticoagulated erythrocyte proteins. Interestingly, Iodixanol treatment caused more significant effects. These findings suggest that conformational changes in blood components can occur, which can potentially lead to the increased prevalence of cardiovascular dysfunctions and blood clotting.
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Affiliation(s)
- Elek Telek
- Department of Biophysics, Medical School, University of Pécs, Szigeti Str. 12, H-7624 Pécs, Hungary; (E.T.); (Z.U.); (M.N.); (A.L.)
| | - Zoltán Ujfalusi
- Department of Biophysics, Medical School, University of Pécs, Szigeti Str. 12, H-7624 Pécs, Hungary; (E.T.); (Z.U.); (M.N.); (A.L.)
| | - Miklós Nyitrai
- Department of Biophysics, Medical School, University of Pécs, Szigeti Str. 12, H-7624 Pécs, Hungary; (E.T.); (Z.U.); (M.N.); (A.L.)
- Szentágothai Research Center, Ifjúság Str. 34, H-7624 Pécs, Hungary
- MTA-PTE Nuclear-Mitochondrial Interactions Research Group, Szigeti Str. 12, H-7624 Pécs, Hungary
| | - Péter Bogner
- Department of Medical Imaging, Clinical Centre, University of Pécs, Ifjúság Str. 13, H-7624 Pécs, Hungary;
| | - András Lukács
- Department of Biophysics, Medical School, University of Pécs, Szigeti Str. 12, H-7624 Pécs, Hungary; (E.T.); (Z.U.); (M.N.); (A.L.)
- Szentágothai Research Center, Ifjúság Str. 34, H-7624 Pécs, Hungary
| | - Tímea Németh
- Languages for Biomedical Purposes and Communication, Medical School, University of Pécs, Szigeti Str. 12, H-7624 Pécs, Hungary; (T.N.); (G.H.)
| | - Gabriella Hild
- Languages for Biomedical Purposes and Communication, Medical School, University of Pécs, Szigeti Str. 12, H-7624 Pécs, Hungary; (T.N.); (G.H.)
| | - Gábor Hild
- Department of Biophysics, Medical School, University of Pécs, Szigeti Str. 12, H-7624 Pécs, Hungary; (E.T.); (Z.U.); (M.N.); (A.L.)
- Department of Medical Imaging, Clinical Centre, University of Pécs, Ifjúság Str. 13, H-7624 Pécs, Hungary;
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Soares S, Faria I, Aires F, Monteiro A, Pinto G, Sales MG, Correa-Duarte MA, Guerreiro SG, Fernandes R. Application of Gold Nanoparticles as Radiosensitizer for Metastatic Prostate Cancer Cell Lines. Int J Mol Sci 2023; 24:ijms24044122. [PMID: 36835538 PMCID: PMC9964626 DOI: 10.3390/ijms24044122] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 02/12/2023] [Accepted: 02/13/2023] [Indexed: 02/22/2023] Open
Abstract
More than 50% of all prostate cancer (PCa) patients are treated by radiotherapy (RT). Radioresistance and cancer recurrence are two consequences of the therapy and are related to dose heterogeneity and non-selectivity between normal and tumoral cells. Gold nanoparticles (AuNPs) could be used as potential radiosensitizers to overcome these therapeutic limitations of RT. This study assessed the biological interaction of different morphologies of AuNPs with ionizing radiation (IR) in PCa cells. To achieve that aim, three different amine-pegylated AuNPs were synthesized with distinct sizes and shapes (spherical, AuNPsp-PEG, star, AuNPst-PEG, and rods, AuNPr-PEG) and viability, injury and colony assays were used to analyze their biological effect on PCa cells (PC3, DU145, and LNCaP) when submitted to the accumulative fraction of RT. The combinatory effect of AuNPs with IR decreased cell viability and increased apoptosis compared to cells treated only with IR or untreated cells. Additionally, our results showed an increase in the sensitization enhancement ratio by cells treated with AuNPs and IR, and this effect is cell line dependent. Our findings support that the design of AuNPs modulated their cellular behavior and suggested that AuNPs could improve the RT efficacy in PCa cells.
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Affiliation(s)
- Sílvia Soares
- ICBAS—School of Medicine and Biomedical Sciences, University of Porto, 4050-313 Porto, Portugal
- FP-I3ID, FP-BHS, Universidade Fernando Pessoa (UFP), 4249-004 Porto, Portugal
- Instituto de Investigação e Inovação em Saúde (i3S), 4200-135 Porto, Portugal
- Faculty of Chemistry, University of Vigo, 36310 Vigo, Spain
- CEB, Centre of Biological Engineering of Minho University, 4710-057 Braga, Portugal
- BioMark@ISEP/CEB—Center of Biological Engineering of Minho University, School of Engineering, Polytechnic Institute of Porto, 4249-015 Porto, Portugal
| | - Isabel Faria
- School of Health, Polytechnic of Porto, 4200-072 Porto, Portugal
| | - Fátima Aires
- Radiotherapy Service, São João Hospital Center, 4200-319 Porto, Portugal
| | - Armanda Monteiro
- Radiotherapy Service, São João Hospital Center, 4200-319 Porto, Portugal
| | - Gabriela Pinto
- Radiotherapy Service, São João Hospital Center, 4200-319 Porto, Portugal
| | - Maria Goreti Sales
- ICBAS—School of Medicine and Biomedical Sciences, University of Porto, 4050-313 Porto, Portugal
- CEB, Centre of Biological Engineering of Minho University, 4710-057 Braga, Portugal
- Biomark@UC/CEB—Centre of Biological Engineering of Minho University, Department of Chemical Engineering, Faculty of Sciences and Technology, Coimbra University, 3030-790 Coimbra, Portugal
| | - Miguel A. Correa-Duarte
- CINBIO, University of Vigo, 36310 Vigo, Spain
- Southern Galicia Institute of Health Research (IISGS), and Biomedical Research Networking Center for Mental Health (CIBERSAM), 36310 Madrid, Spain
| | - Susana G. Guerreiro
- Instituto de Investigação e Inovação em Saúde (i3S), 4200-135 Porto, Portugal
- Institute of Molecular Pathology, Immunology of the University of Porto-IPATIMUP, 4200-465 Porto, Portugal
- Department of Biomedicine, Biochemistry Unit, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
- Correspondence: (S.G.G.); (R.F.)
| | - Rúben Fernandes
- FP-I3ID, FP-BHS, Universidade Fernando Pessoa (UFP), 4249-004 Porto, Portugal
- Instituto de Investigação e Inovação em Saúde (i3S), 4200-135 Porto, Portugal
- Faculty of Health Sciences (FCS) & Hospital Escola Fernando Pessoa (HEFP), University Fernando Pessoa (UFP), 4249-004 Porto, Portugal
- Correspondence: (S.G.G.); (R.F.)
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Liu PY, Zhao SC, Zhang MY, Song L, Wang C, Yu F, Meng Q, Zhang Z, He YP. Pd-Catalyzed γ-Acetoxylation of Alkylamides: Structural Influence of Directing Groups. J Org Chem 2022; 87:6378-6386. [PMID: 35422116 DOI: 10.1021/acs.joc.2c00085] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Peng-Yu Liu
- Key Laboratory for Functional Material, Educational Department of Liaoning Province, School of Chemical Engineering, University of Science and Technology Liaoning, Anshan 114051, China
- Key Laboratory of Petrochemical Catalytic Science and Technology, Liaoning Petrochemical University, Dandong Load West 1, Fushun 113001, China
| | - Shi-Chen Zhao
- Key Laboratory of Petrochemical Catalytic Science and Technology, Liaoning Petrochemical University, Dandong Load West 1, Fushun 113001, China
| | - Ming-Yuan Zhang
- Key Laboratory of Petrochemical Catalytic Science and Technology, Liaoning Petrochemical University, Dandong Load West 1, Fushun 113001, China
| | - Lijuan Song
- Key Laboratory for Functional Material, Educational Department of Liaoning Province, School of Chemical Engineering, University of Science and Technology Liaoning, Anshan 114051, China
- Key Laboratory of Petrochemical Catalytic Science and Technology, Liaoning Petrochemical University, Dandong Load West 1, Fushun 113001, China
| | - Caiping Wang
- Beijing Winsunny Pharmaceutical CO., LTD, Beijing 101113, China
| | - Fang Yu
- State Key Laboratory Fine Chemicals, Ningbo Institute of Dalian University of Technology, No. 26 Yucai Road, Jiangbei District, Ningbo 315016, China
| | - Qingtao Meng
- Key Laboratory for Functional Material, Educational Department of Liaoning Province, School of Chemical Engineering, University of Science and Technology Liaoning, Anshan 114051, China
| | - Zhiqiang Zhang
- Key Laboratory for Functional Material, Educational Department of Liaoning Province, School of Chemical Engineering, University of Science and Technology Liaoning, Anshan 114051, China
| | - Yu-Peng He
- Key Laboratory for Functional Material, Educational Department of Liaoning Province, School of Chemical Engineering, University of Science and Technology Liaoning, Anshan 114051, China
- State Key Laboratory Fine Chemicals, Ningbo Institute of Dalian University of Technology, No. 26 Yucai Road, Jiangbei District, Ningbo 315016, China
- Key Laboratory of Petrochemical Catalytic Science and Technology, Liaoning Petrochemical University, Dandong Load West 1, Fushun 113001, China
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Oyaert M, Speeckaert MM, Delanghe JR. Estimated urinary osmolality based on combined urinalysis parameters: a critical evaluation. Clin Chem Lab Med 2020; 57:1169-1176. [PMID: 30753156 DOI: 10.1515/cclm-2018-1307] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 01/21/2019] [Indexed: 01/05/2023]
Abstract
Background Urinary conductivity allows a coarse prediction of urinary osmolality in most cases but is insensitive to the osmolal contribution of uncharged particles and the presence of roentgen contrast media. Urinary osmolality can be estimated on the recently introduced Sysmex UF-5000 urine analyzer using conductivity. In this study, we evaluated the analytical performance of this research parameter. Secondly, we aimed to improve the manufacturer's algorithm for estimating urinary osmolality, based on standard urinalysis parameters (creatinine, glucose, relative density). Methods The analytical performance was determined and a prediction model to estimate urinary osmolality based on urinalysis parameters was developed. We further developed and validated a prediction model using another set of routine urine samples. In addition, the influence of roentgen contrast media on urinary osmolality was studied. Results The within-run and between imprecision for osmolality and conductivity measured on the Sysmex UF-5000 ranged from 1.1% to 4.9% and 0.7% to 4.8%, respectively. Multiple regression analysis revealed urinary creatinine, conductivity and relative density to be the strongest predictors to estimate urinary osmolality. A mean difference of 1.3 mOsm/kg between measured and predicted osmolality demonstrated that the predictive performance of our model was favorable. An excellent correlation between the relative density and % contrast media was demonstrated. Conclusions Urinary osmolality is an important parameter for assessing specimen dilution in urinalysis. Urinary conductivity, along with relative density and urinary creatinine allows a coarse prediction of urinary osmolality and is insensitive to the osmolal contribution of uncharged particles and the presence of roentgen contrast media.
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Affiliation(s)
- Matthijs Oyaert
- Department of Laboratory Medicine, University Hospital Ghent, Ghent, Belgium
| | | | - Joris R Delanghe
- Department of Laboratory Medicine, University Hospital Ghent, Ghent, Belgium
- Department of Clinical Chemistry, Ghent University, C. Heymanslaan 10, 9000 Ghent, Belgium
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Devriendt N, Velde N, Stock E, Bakker E, Rooster H. Suspected haemorrhagic cystitis in a dog as delayed complication after contrast‐enhanced computed tomography. VETERINARY RECORD CASE REPORTS 2020. [DOI: 10.1136/vetreccr-2019-001011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Nausikaa Devriendt
- Small Animal DepartmentFaculty of Veterinary MedicineGhent UniversityMerelbekeBelgium
| | - Norbert Velde
- Department of Pathology, Bacteriology and Poultry DiseasesFaculty of Veterinary MedicineGhent UniversityMerelbekeBelgium
| | - Emmelie Stock
- Department of Medical Imaging of Domestic Animals and Small Animal OrthopaedicsFaculty of Veterinary MedicineGhent UniversityMerelbekeBelgium
| | - Evelien Bakker
- Department of Medical Imaging of Domestic Animals and Small Animal OrthopaedicsFaculty of Veterinary MedicineGhent UniversityMerelbekeBelgium
| | - Hilde Rooster
- Small Animal DepartmentFaculty of Veterinary MedicineGhent UniversityMerelbekeBelgium
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Xu B, Xu B, Shan S, Xue G, Wang T, Qiu X, Zhan C. Co-metabolic degradation of iomeprol by a Pseudomonas sp. and its application in biological aerated filter systems. JOURNAL OF ENVIRONMENTAL SCIENCE AND HEALTH. PART A, TOXIC/HAZARDOUS SUBSTANCES & ENVIRONMENTAL ENGINEERING 2018; 53:310-316. [PMID: 29215947 DOI: 10.1080/10934529.2017.1401385] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 10/20/2017] [Indexed: 06/07/2023]
Abstract
The non-ionic water-soluble X-ray contrast agent iomeprol (IOM) enters the water supply through sewage treatment plants, which can cause considerable environmental harm. In this study, Pseudomonas sp. I-24 (I-24) was tested for its ability to remove IOM from water via co-metabolic pathways. The optimum removal rate of IOM by I-24 was 38.43% ± 3.70% when starch served as the source of external carbon, and its co-metabolism of IOM conformed to the first-order kinetics. The highest activity of intracellular enzyme (degrading enzyme) extracted from I-24 was 0.143 ± 0.005 mU in starch condition. The Michaelis constant of the degrading enzyme was found to be 91.08 μmol L-1. However, glucose and maltose showed the best promotive effects on the growth and electron transport activity of I-24, indicating that overgrowth may result in competitive inhibition and a reduced degradation rate of IOM. Adding I-24 and degrading enzymes to biological aerated filters increased IOM removal rates without affecting CODMn removal.
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Affiliation(s)
- Bingjie Xu
- a College of Chemistry and Environmental Engineering , Jiujiang University , Jiujiang , China
- b Jiangxi Province Engineering Research Center of Ecological Chemical Industry , Jiujiang University , Jiujiang , China
- c College of Environmental Science and Engineering , Donghua University , Shanghai , China
| | - Bin Xu
- d Sinopec Jiujiang Company , Jiujiang , China
| | - Shiwei Shan
- a College of Chemistry and Environmental Engineering , Jiujiang University , Jiujiang , China
| | - Gang Xue
- c College of Environmental Science and Engineering , Donghua University , Shanghai , China
| | - Tianfeng Wang
- a College of Chemistry and Environmental Engineering , Jiujiang University , Jiujiang , China
| | - Xiuwen Qiu
- a College of Chemistry and Environmental Engineering , Jiujiang University , Jiujiang , China
| | - Changchao Zhan
- a College of Chemistry and Environmental Engineering , Jiujiang University , Jiujiang , China
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Tiu C, Terecoasă EO, Grecu N, Dorobăţ B, Marinescu AN, Băjenaru OA. Transient Global Amnesia After Cerebral Angiography With Iomeprol: A Case Report. Medicine (Baltimore) 2016; 95:e3590. [PMID: 27175660 PMCID: PMC4902502 DOI: 10.1097/md.0000000000003590] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Transient global amnesia is now considered a very rare complication of cerebral angiography. Various etiological mechanisms have been suggested to account for this complication, but no consensus has been reached yet. This case report documents one of the few reported cases of cerebral angiography-related transient global amnesia associated with magnetic resonance imaging (MRI) evidence of unilateral hippocampal ischemia, most probably as a consequence of a transient reduction in regional hippocampal blood flow. However, the possibility of a direct neurotoxic effect of the nonionic contrast media Iomeprol on the Cornu ammonis - field 1 neurons cannot be firmly ruled out.We describe the case of a 54-year-old woman admitted to our department for left upper limb weakness with acute onset 8 days before. The brain computed tomography (CT) scan performed at admission revealed subacute ischemic lesions in the right watershed superficial territories and a right thalamic lacunar infarct. Diagnostic digital subtraction cerebral angiography was performed 4 days after admission with the nonionic contrast media Iomeprol. A few minutes after completion of the procedure, the patient developed symptoms suggestive for transient global amnesia. The brain MRI performed 22 hours after the onset of symptoms demonstrated increased signal within the lateral part of the right hippocampus on the diffusion-weighted imaging (DWI) sequences, associated with a corresponding reduction in the apparent diffusion coefficient (ADC) and increased signal on the fluid-attenuated inversion recovery (FLAIR) sequences, consistent with acute hippocampal ischemia and several T2/FLAIR hyperintensities in the right watershed superficial territories and in the right thalamus, corresponding to the lesions already identified on the CT scan performed at admission. A follow-up MRI, performed 2 months later, demonstrated the disappearance of the increased signal within the right hippocampus on the DWI, T2/FLAIR, and ADC sequences.The precise mechanism of transient global amnesia related to cerebral angiography is still unclear, and further studies aimed to determine the definite pathophysiology of this syndrome and consequently to establish specific preventive measures are needed. Although the condition itself is considered to be self-limited, the long-term prognosis and the risk of recurrence in the cases where subsequent angiographic procedures are performed are not established yet.
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Affiliation(s)
- Cristina Tiu
- From the Stroke Unit, Department of Neurology (CT, EOT, NG, OAB), University Emergency Hospital Bucharest; "Carol Davila" University of Medicine and Pharmacy (CT, EOT, ANM, OAB); Department of Interventional Neuroradiology (BD); and Department of Radiology (ANM), University Emergency Hospital Bucharest, Bucharest, Romania
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Tomsick TA, Foster LD, Liebeskind DS, Hill MD, Carrozella J, Goyal M, von Kummer R, Demchuk AM, Dzialowski I, Puetz V, Jovin T, Morales H, Palesch YY, Broderick J, Khatri P, Yeatts SD. Outcome Differences between Intra-Arterial Iso- and Low-Osmolality Iodinated Radiographic Contrast Media in the Interventional Management of Stroke III Trial. AJNR Am J Neuroradiol 2015; 36:2074-81. [PMID: 26228892 DOI: 10.3174/ajnr.a4421] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Accepted: 03/03/2015] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND PURPOSE 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). MATERIALS AND METHODS 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. RESULTS 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. CONCLUSIONS While data favoring the use of iso-osmolal iodixanol for reperfusion of M1 occlusion following IV rtPA are inconclusive, potential pathophysiologic mechanisms suggesting clinical benefit warrant further investigation.
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Affiliation(s)
- T A Tomsick
- From the Department of Radiology (T.A.T., J.C., H.M.), University of Cincinnati Academic Health Center, University Hospital, Cincinnati, Ohio
| | - L D Foster
- Department of Public Health Sciences (L.D.F., Y.Y.P., S.D.Y.), Medical University of South Carolina, Charleston, South Carolina
| | - D S Liebeskind
- University of California, Los Angeles Stroke Center (D.S.L.), Los Angeles, California
| | - M D Hill
- Department of Radiology and Clinical Neurosciences (M.D.H., M.G.)
| | - J Carrozella
- From the Department of Radiology (T.A.T., J.C., H.M.), University of Cincinnati Academic Health Center, University Hospital, Cincinnati, Ohio
| | - M Goyal
- Department of Radiology and Clinical Neurosciences (M.D.H., M.G.)
| | | | - A M Demchuk
- Calgary Stroke Program (A.M.D.), Department of Clinical Neurosciences/Medicine/Community Health Sciences, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - I Dzialowski
- Department of Neurology (I.D.), Elblandklinikum Meissen, Academic Teaching Hospital of Universitätsklinikum, Carl Gustav Carus Technische Universität Dresden, Meißen, Germany
| | - V Puetz
- Neurology (V.P.), Dresden University Stroke Center, Universitätsklinikum Carl Gustav Carus Technischen Universität Dresden, Dresden, Germany
| | - T Jovin
- The Stroke Institute (T.J.), University of Pittsburgh Medical Center, Pittsburgh. Pennsylvania
| | - H Morales
- From the Department of Radiology (T.A.T., J.C., H.M.), University of Cincinnati Academic Health Center, University Hospital, Cincinnati, Ohio
| | - Y Y Palesch
- Department of Public Health Sciences (L.D.F., Y.Y.P., S.D.Y.), Medical University of South Carolina, Charleston, South Carolina
| | - J Broderick
- Department of Neurology (J.B., P.K.), University of Cincinnati Academic Health Center, Cincinnati, Ohio
| | - P Khatri
- Department of Neurology (J.B., P.K.), University of Cincinnati Academic Health Center, Cincinnati, Ohio
| | - S D Yeatts
- Department of Public Health Sciences (L.D.F., Y.Y.P., S.D.Y.), Medical University of South Carolina, Charleston, South Carolina
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Fontanive L, D'Amelio N, Cesàro A, Gamini A, Tavagnacco L, Paolantoni M, Brady JW, Maiocchi A, Uggeri F. Myelography iodinated contrast media. I. Unraveling the atropisomerism properties in solution. Mol Pharm 2015; 12:1939-50. [PMID: 25945970 DOI: 10.1021/mp5007486] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
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.
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Affiliation(s)
- Luca Fontanive
- †Laboratory of Physical and Macromolecular Chemistry, Department of Chemical and Pharmaceutical Sciences, University of Trieste, Via Giorgieri 1, 34127 Trieste, Italy
| | - Nicola D'Amelio
- ‡Bracco Imaging SpA-CRB Trieste, AREA Science Park, SS 14, Km 163,5, 34012 Basovizza (Trieste), Italy
| | - Attilio Cesàro
- †Laboratory of Physical and Macromolecular Chemistry, Department of Chemical and Pharmaceutical Sciences, University of Trieste, Via Giorgieri 1, 34127 Trieste, Italy.,§Elettra Sincrotrone Trieste, Area Science Park, I-34149 Trieste, Italy
| | - Amelia Gamini
- ∥Department of Life Sciences, University of Trieste, Via Giorgieri 1, 34127 Trieste, Italy
| | - Letizia Tavagnacco
- †Laboratory of Physical and Macromolecular Chemistry, Department of Chemical and Pharmaceutical Sciences, University of Trieste, Via Giorgieri 1, 34127 Trieste, Italy.,⊥Department of Food Science, Cornell University, Ithaca, New York 14853, United States
| | - Marco Paolantoni
- #Department of Chemistry, Biology, and Biotechnologies, University of Perugia, Via Elce di Sotto 8, I-06123 Perugia, Italy
| | - John W Brady
- ⊥Department of Food Science, Cornell University, Ithaca, New York 14853, United States
| | - Alessandro Maiocchi
- ◆Centro Ricerche Bracco, Bracco Imaging SpA, Via Ribes 5, 10010 Colleretto Giacosa (TO), Italy
| | - Fulvio Uggeri
- ◆Centro Ricerche Bracco, Bracco Imaging SpA, Via Ribes 5, 10010 Colleretto Giacosa (TO), Italy
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Ebrahimpour L, Morteza A, Akhlaghpoor S. Management of Intravenous Contrast Extravasations with Ultrasonography: A Case Report. J Med Imaging Radiat Sci 2014; 45:327-329. [PMID: 31051986 DOI: 10.1016/j.jmir.2014.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2013] [Revised: 12/23/2013] [Accepted: 01/03/2014] [Indexed: 11/19/2022]
Abstract
Extravasation of ionic and nonionic contrast materials is a well-recognized complication of contrast-enhanced imaging studies. Complications vary from minimal swelling to severe skin and subcutaneous ulceration, necrosis, and compartment syndrome. We report a case of Omnipaque (iohexol) extravasation in a 50-year-old man with erythema, blistering, and compartment syndrome who was treated medically but was not cured. Using gray scale ultrasonography, we determined the characteristics of the lesion, its distance from the skin, and its proximity to the vessels. We then determined the depth of the lesion, and then inserted the tip of the needle into the lesion. We also used ultrasonography in locations where extravasation was near an artery. After aspiration, the diameter of the lesion decreased significantly. The patient was cured by ultrasonography-guided aspiration from the extravasated site.
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Affiliation(s)
- Laleh Ebrahimpour
- Department of Radiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Afsaneh Morteza
- Advanced Diagnostic and Interventional Radiology Research Center, Medical Imaging Center, Imam Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahram Akhlaghpoor
- Department of Radiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
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Morales H, Lu A, Kurosawa Y, Clark JF, Leach J, Weiss K, Tomsick T. Decreased infarct volume and intracranial hemorrhage associated with intra-arterial nonionic iso-osmolar contrast material in an MCA occlusion/reperfusion model. AJNR Am J Neuroradiol 2014; 35:1885-91. [PMID: 24812016 DOI: 10.3174/ajnr.a3953] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND PURPOSE Infarct volume and intracranial hemorrhage after reperfusion with nonionic low-osmolar and iso-osmolar iodinated IRCM has not been previously compared. We postulated that iso-osmolar and low-osmolar iodinated contrast media exert varied effects on cerebral infarct after intra-arterial injection. We compared infarct volume and hemorrhagic changes following intra-arterial infusion of iodixanol, iopamidol, or normal saline in a rat MCA occlusion/reperfusion model. MATERIALS AND METHODS Infarct was induced in 30 rats by a previously validated method of MCA suture occlusion. Reperfusion was performed after 5 hours with either iodixanol (n = 9), iopamidol (n = 12), or saline (n = 9). MR images were obtained at both 6 and 24 hours after ischemia, followed by sacrifice. Infarct volume was measured with T2WI and DWI by semiautomatic segmentation. Incidence and area of hemorrhage were measured on brain sections postmortem. RESULTS T2WI mean infarct volumes were 242 ± 89, 324 ± 70, and 345 ± 92 mm(3) at 6 hours, and 341 ± 147,470 ± 91, and 462 ± 71 mm(3) at 24 hours in the iodixanol, iopamidol, and saline groups, respectively. Differences in infarct volume among groups were significant at 6 hours (P < .03) and 24 hours (P < .05). In the iodixanol, iopamidol, and saline groups, mean areas for cortical intracranial hemorrhage were 0.8, 18.2, and 25.7 mm(2); and 28, 31, and 56.7 mm(2), respectively, for deep intracranial hemorrhage. The differences in intracranial hemorrhage area among groups were statistically significant for cortical intracranial hemorrhage (P < .01). CONCLUSIONS Intra-arterial infusion of nonionic iso-osmolar iodixanol showed reduced infarct volume and reduced cortical intracranial hemorrhage areas in comparison with nonionic low-osmolar iopamidol and saline. Our results may be relevant in the setting of intra-arterial therapy for acute stroke in humans, warranting further investigation.
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Affiliation(s)
- H Morales
- From the Departments of Radiology (H.M., J.L., T.T.)
| | - A Lu
- Neurology (A.L., Y.K., J.F.C.), University of Cincinnati, Cincinnati, Ohio
| | - Y Kurosawa
- Neurology (A.L., Y.K., J.F.C.), University of Cincinnati, Cincinnati, Ohio
| | - J F Clark
- Neurology (A.L., Y.K., J.F.C.), University of Cincinnati, Cincinnati, Ohio
| | - J Leach
- From the Departments of Radiology (H.M., J.L., T.T.)
| | - K Weiss
- Department of Radiology (K.W.), University of Mississippi, Oxford, Mississippi
| | - T Tomsick
- From the Departments of Radiology (H.M., J.L., T.T.)
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García M, Aguirre U, Martinez A, Ruiz B, Lertxundi U, Aguirre C. Acute adverse reactions to iopromide vs iomeprol: a retrospective analysis of spontaneous reporting from a radiology department. Br J Radiol 2014; 87:20130511. [PMID: 24191124 PMCID: PMC4612218 DOI: 10.1259/bjr.20130511] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2013] [Revised: 10/29/2013] [Accepted: 10/30/2013] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE To compare the safety of iopromide and iomeprol use in a hospital that switched from the former to the latter and found an apparent increase in the number (and a different profile) of adverse reactions reported for iomeprol, putting the safety of its use into question. METHODS This was a retrospective study of cases of acute reactions to iopromide and iomeprol reported in two successive time periods. Data from examinations using iopromide (62539 CT scans and 10348 urography scans) and iomeprol (34308 CT scans and 2846 urography scans) were obtained from the computer system of the hospital. RESULTS For each period, 154 cases of reactions were reported for iopromide and 86 for iomeprol, being severe in 10 (6.5%) patients for iopromide vs 17 (19.8%) patients for iomeprol; a statistically significant difference of p<0.003 was recorded. The most frequent adverse reactions (%/%) for iopromide/iomeprol were urticaria (29.1/17.2), pruritus (22.6/15.6), upper respiratory tract signs and symptoms (12.1/16.7), oedema (4.3/0), erythemas (3.4/5.0), nausea or vomiting (1.2/11.7) and chest pain (0/3.9) (p<0.0001 for the global comparison). The distribution of the reactions (%/%) by System Organ Class for iopromide/iomeprol was skin (56.7/41.1), respiratory (19.2/26.7), vascular (6.8/2.2), general (5.3/7.2), gastrointestinal (4.6/15.0) and others (7.4/7.9) (p<0.0002 for the global comparison). CONCLUSION Adverse reactions were more severe for iomeprol. Skin and vascular reactions with no chest pain were more frequent for iopromide, whereas gastrointestinal reactions were more frequent for iomeprol. ADVANCES IN KNOWLEDGE Comparative studies of media contrast safety are scarce and summary information on product characteristics is insufficient. This study showed the differences in severity and profile of adverse reactions between iopromide and iomeprol.
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Affiliation(s)
- M García
- Basque Country Pharmacovigilance Unit, Galdakao-Usansolo Hospital, Galdakao, Spain
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14
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Cardiac Catheterization and Postoperative Acute Kidney Failure in Congenital Heart Pediatric Patients. Anesth Analg 2013; 117:455-61. [DOI: 10.1213/ane.0b013e318299a7da] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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15
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Mayer B, Leo A, Herziger A, Houben P, Schemmer P, Salama A. Intravascular immune hemolysis caused by the contrast medium iomeprol. Transfusion 2013; 53:2141-4. [PMID: 23347254 DOI: 10.1111/trf.12089] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2012] [Revised: 11/20/2012] [Accepted: 11/21/2012] [Indexed: 11/28/2022]
Abstract
BACKGROUND Immune-mediated hemolysis is not included in the list of adverse reactions related to contrast medium (CM). Here, we report on a patient who developed immune hemolytic anemia (IHA) related to iomeprol, a nonionic CM. STUDY DESIGN AND METHODS A 34-year-old female patient developed massive hemolysis during infusion of 50 mL of iomeprol. Serologic studies were performed using standard techniques. RESULTS Before hemolysis, the patient's serum was weakly positive with e+ red blood cells (RBCs; autoanti-e) and the direct antiglobulin test (DAT) was negative. After hemolysis, the patient's serum samples became significantly reactive with e- RBCs in the presence of iomeprol but not in the presence of two other similar CM. The DAT became strongly positive only with anti-C3d. CONCLUSION Initially, an allergic reaction was suggested, and as the hemolysis became obvious, a toxic hemolysis was suspected. However, serologic reexamination revealed an iomeprol-dependent antibody. IHA related to CM has yet only been described in one patient in 1991. The hemolysis in that patient was related to Isopaque, an older ionic CM. Here, we describe an additional patient and recommend that CM should be considered as a rare risk in the development of IHA.
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Affiliation(s)
- Beate Mayer
- Institute for Transfusion Medicine, Charité-University Medicine Berlin, Berlin, Germany; Institute for Clinical Transfusion Medicine and Cellular Therapy, and Clinic for General, Visceral and Transplantation Surgery, University Medical Hospital, Heidelberg, Germany
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Azzouz M, Rømsing J, S. Thomsen H. Acute non-renal adverse events after unenhanced and enhanced computed tomography and magnetic resonance imaging. ACTA ACUST UNITED AC 2013. [DOI: 10.4236/ojcd.2013.33016] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Lois C, Bezrukov I, Schmidt H, Schwenzer N, Werner MK, Kupferschläger J, Beyer T. Effect of MR contrast agents on quantitative accuracy of PET in combined whole-body PET/MR imaging. Eur J Nucl Med Mol Imaging 2012; 39:1756-66. [PMID: 22890801 DOI: 10.1007/s00259-012-2190-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2012] [Accepted: 07/02/2012] [Indexed: 11/28/2022]
Abstract
PURPOSE Clinical PET/MR acquisition protocols entail the use of MR contrast agents (MRCA) that could potentially affect PET quantification following MR-based attenuation correction (AC). We assessed the effect of oral and intravenous (IV) MRCA on PET quantification in PET/MR imaging. METHODS We employed two MRCA: Lumirem (oral) and Gadovist (IV). First, we determined their reference PET attenuation values using a PET transmission scan (ECAT-EXACT HR+, Siemens) and a CT scan (PET/CT Biograph 16 HI-REZ, Siemens). Second, we evaluated the attenuation of PET signals in the presence of MRCA. Phantoms were filled with clinically relevant concentrations of MRCA in a background of water and (18)F-fluoride, and imaged using a PET/CT scanner (Biograph 16 HI-REZ, Siemens) and a PET/MR scanner (Biograph mMR, Siemens). Third, we investigated the effect of clinically relevant volumes of MRCA on MR-based AC using human pilot data: a patient study employing Gadovist (IV) and a volunteer study employing two different oral MRCA (Lumirem and pineapple juice). MR-based attenuation maps were calculated following Dixon-based fat-water segmentation and an external atlas-based and pattern recognition (AT&PR) algorithm. RESULTS IV and oral MRCA in clinically relevant concentrations were found to have PET attenuation values similar to those of water. The phantom experiments showed that under clinical conditions IV and oral MRCA did not yield additional attenuation of PET emission signals. Patient scans showed that PET attenuation maps are not biased after the administration of IV MRCA but may be biased, however, after ingestion of iron oxide-based oral MRCA when segmentation-based AC algorithms are used. Alternative AC algorithms, such as AT&PR, or alternative oral contrast agents, such as pineapple juice, can yield unbiased attenuation maps. CONCLUSION In clinical PET/MR scenarios MRCA are not expected to lead to markedly increased attenuation of the PET emission signals. MR-based attenuation maps may be biased by oral iron oxide-based MRCA unless advanced AC algorithms are used.
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Affiliation(s)
- Cristina Lois
- Department of Particle Physics, University of Santiago de Compostela, Campus Vida S/N, 15782 Santiago de Compostela, Spain.
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18
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Dennhardt N, Schoof S, Osthaus WA, Witt L, Bertram H, Sümpelmann R. Alterations of acid-base balance, electrolyte concentrations, and osmolality caused by nonionic hyperosmolar contrast medium during pediatric cardiac catheterization. Paediatr Anaesth 2011; 21:1119-23. [PMID: 21966960 DOI: 10.1111/j.1460-9592.2011.03706.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE This prospective clinical observational study was conducted to investigate the effects of contrast medium on acid-base balance, electrolyte concentrations, and osmolality in children. BACKGROUND For pediatric cardiac catheterization, high doses of nonionic hyperosmolar contrast medium are widely used. METHODS Forty pediatric patients (age 0-16 years) undergoing cardiac angiography with more than 3 ml·kg(-1) of nonionic hyperosmolar contrast medium (Iomeprol) were enrolled, and the total amount of the contrast agent given was documented. Before and after contrast medium administration, a blood sample was collected to analyze electrolytes, acid-base parameters, osmolality, hemoglobin, and hematocrit. RESULTS After cardiac catheterization, pH, hemoglobin, hematocrit, bicarbonate, base excess, sodium, chloride, calcium, anion gap and strong ion difference decreased, whereas osmolality increased significantly (base excess -1.8 ± 1.8 vs -3.4 ± 2.3, sodium 138 ± 2.9 vs 132 ± 4.1 mm, osmolality 284 ± 5.7 vs 294 ± 7.6 mosmol·kg(-1), P < 0.01). Seventy-eight percent of the children developed hyponatremia (sodium <135 mm). No changes were seen in pCO(2) , lactate, and potassium levels. CONCLUSIONS Regarding the differential diagnosis of metabolic disturbances after pediatric cardiac catheterization, low-anion gap metabolic acidosis and hyponatremia should be considered as a possible side effect of the administered contrast medium.
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Affiliation(s)
- Nils Dennhardt
- Department of Anesthesiology, Hannover Medical School, Hannover, Germany.
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Laplante SR, D Fader L, Fandrick KR, Fandrick DR, Hucke O, Kemper R, Miller SPF, Edwards PJ. Assessing atropisomer axial chirality in drug discovery and development. J Med Chem 2011; 54:7005-22. [PMID: 21848318 DOI: 10.1021/jm200584g] [Citation(s) in RCA: 492] [Impact Index Per Article: 37.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Steven R Laplante
- Department of Chemistry, Boehringer Ingelheim (Canada) Ltd., 2100 Cunard Street, Laval, Quebec, H7S 2G5, Canada.
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20
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Evaluation with 64-slice CT of the prevalence of coronary artery variants and congenital anomalies: a retrospective study of 3,236 patients. Radiol Med 2011; 116:675-89. [DOI: 10.1007/s11547-011-0627-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2010] [Accepted: 06/11/2010] [Indexed: 11/27/2022]
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LaPlante SR, Edwards PJ, Fader LD, Jakalian A, Hucke O. Revealing Atropisomer Axial Chirality in Drug Discovery. ChemMedChem 2011; 6:505-13. [DOI: 10.1002/cmdc.201000485] [Citation(s) in RCA: 279] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2010] [Indexed: 11/09/2022]
Affiliation(s)
- Steven R. LaPlante
- Department of Chemistry, Boehringer Ingelheim (Canada) Ltd., 2100 Cunard Street, Laval, QC, H7S 2G5 (Canada), Fax: (+1) 450‐682‐8434
| | - Paul J. Edwards
- Department of Chemistry, Boehringer Ingelheim (Canada) Ltd., 2100 Cunard Street, Laval, QC, H7S 2G5 (Canada), Fax: (+1) 450‐682‐8434
| | - Lee D. Fader
- Department of Chemistry, Boehringer Ingelheim (Canada) Ltd., 2100 Cunard Street, Laval, QC, H7S 2G5 (Canada), Fax: (+1) 450‐682‐8434
| | - Araz Jakalian
- Department of Chemistry, Boehringer Ingelheim (Canada) Ltd., 2100 Cunard Street, Laval, QC, H7S 2G5 (Canada), Fax: (+1) 450‐682‐8434
| | - Oliver Hucke
- Department of Chemistry, Boehringer Ingelheim (Canada) Ltd., 2100 Cunard Street, Laval, QC, H7S 2G5 (Canada), Fax: (+1) 450‐682‐8434
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Mitsuyama T, Sato S, Ishii A, Kawamata T. Contrast medium-induced seizures and prolonged motor weakness after cerebral angiography: case report. Neurosurgery 2010; 67:E1460-3; discussion E1463. [PMID: 20948393 DOI: 10.1227/neu.0b013e3181f352a1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND AND IMPORTANCE Neurological complications of cerebral angiography are usually embolic events resulting in stroke or seizure of vascular origin. Contrast media rarely induce neurological complications. CLINICAL PRESENTATION Repeated seizures and prolonged motor weakness developed in a 26-year-old woman after cerebral angiography. Neurological deficits remained the next day with slow recovery. Repeat magnetic resonance imaging did not demonstrate any cerebral ischemia even on diffusion-weighted images. The contrast medium was the most likely cause of the neurological deficits. She recovered completely after infusion of the osmotic diuretic. CONCLUSION Although rare, we should take into consideration that contrast media may induce neurological complications after cerebral angiography.
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Affiliation(s)
- Tetsuryu Mitsuyama
- Department of Neurosurgery, Tokyo Women's Medical University, Yachiyo Medical Center, Chiba, Japan
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Romesburg J, Ragozzino M. Aseptic meningoencephalitis after iohexol CT myelography. AJNR Am J Neuroradiol 2008; 30:1074-5. [PMID: 19039046 DOI: 10.3174/ajnr.a1365] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
We describe the case of a patient with aseptic meningoencephalitis after intrathecal iohexol injection for myelography and review the previous literature on similar cases of contrast-induced neurotoxicity.
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Affiliation(s)
- J Romesburg
- Department of Radiology, Wake Forest University Baptist Medical Center, Winston-Salem, NC 27157, USA.
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Böhm I, Schild HH. A practical guide to diagnose lesser-known immediate and delayed contrast media-induced adverse cutaneous reactions. Eur Radiol 2006; 16:1570-9. [PMID: 16770655 DOI: 10.1007/s00330-006-0202-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2005] [Revised: 01/11/2006] [Accepted: 02/07/2006] [Indexed: 10/24/2022]
Abstract
The terms "immediate" and "delayed" adverse reactions induced by contrast media (CM) refer to the reactions' onset but do not provide substantial information concerning the clinical manifestation, the potential risk factors, the treatment modalities, or prevention. Because a variety of different reactions caused by different pathophysiological mechanisms may arise immediately or be delayed after CM injection, and because these need different management, the aim of the present paper is to present the clinical features and to exactly characterize lesser-known cutaneous reactions. A thorough knowledge of the clinical features, their adequate treatment, and, possibly, the subsequent diagnostic procedure for preventing recurrence after reexposure to CM would improve patient management.
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Affiliation(s)
- Ingrid Böhm
- Department of Radiology, University of Bonn, Sigmund-Freud Strasse 25, 53105, Bonn, Germany.
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25
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Marchianò A, Spreafico C, Lanocita R, Frigerio L, Di Tolla G, Patelli G, Garbagnati F, Heiman F, Taroni P, Damascelli B. Does iodine concentration affect the diagnostic efficacy of biphasic spiral CT in patients with hepatocellular carcinoma? ACTA ACUST UNITED AC 2005; 30:274-80. [PMID: 15654576 DOI: 10.1007/s00261-004-0233-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND We investigated the effect of iodinated contrast medium concentration on increased neoplastic lesion enhancement and its direct relation to diagnostic efficacy in biphasic spiral computed tomography for detection of hepatocellular carcinoma. METHODS A pilot, single-center, randomized, double-blind, crossover, comparative study was performed and included 22 participants. Each patient underwent two separate biphasic contrast-enhanced spiral computed tomographic examinations. Scans were performed with iomeprol containing 400 (iomeprol 400) or 300 (iomeprol 300) mg of iodine per milliliter (Iomeron, Bracco Imaging SpA, Milan, Italy) with a 2- to 12-day window scan; patients were given an equal total dose of 45 g of iodine at a fixed injection rate of 4 mL/s. Comparison included assessment of quantitative and qualitative parameters. RESULTS Lesion density and lesion-to-liver contrast increased more markedly with the higher concentration of contrast medium during the arterial phase (p = 0.0016 and 0.0005, respectively). There was no significant difference in any parameter between the two concentrations during the portal phase. Number of lesions detected during the arterial phase increased from 37 with iomeprol 300 to 42 with iomeprol 400; in the portal phase, the respective numbers were 34 and 36. CONCLUSION Even though a small number of patients was examined, our study suggests that, in patients with cirrhosis, an increased concentration of iodine improves liver-to-lesion contrast and may improve the detection of hepatocellular carcinoma.
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Affiliation(s)
- A Marchianò
- National Cancer Institute, Via Venezian 1, 20123 Milan, Italy.
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26
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Joubert A, Biston MC, Boudou C, Ravanat JL, Brochard T, Charvet AM, Estève F, Balosso J, Foray N. Irradiation in presence of iodinated contrast agent results in radiosensitization of endothelial cells: Consequences for computed tomography therapy. Int J Radiat Oncol Biol Phys 2005; 62:1486-96. [PMID: 16029811 DOI: 10.1016/j.ijrobp.2005.04.009] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2005] [Revised: 04/07/2005] [Accepted: 04/07/2005] [Indexed: 10/25/2022]
Abstract
PURPOSE To date, iodinated contrast agents (ICA) are commonly used in medical imaging to improve tumor visualization by attenuating scanners X-rays. However, some adverse reactions to ICAs are still reported, and their molecular origin remains unclear. In 1983, it was proposed to visualize and treat ICA-loaded tumors by using scanners as therapy machines to enhance X-rays absorption at the iodine atoms. Theoretically, such physical conditions are optimized at 50 keV and can be easily obtained with synchrotrons. METHODS AND MATERIALS Here, we examined the molecular and cellular responses of mammalian endothelial cells to radiation in the presence of iomeprol, one of the most extensively used ICAs. RESULTS Irradiation with X-rays at 50 keV in the presence of iomeprol produced a strong radiosensitization effect. The same conclusion was reached with a standard medical irradiator but to a lesser extent. While such treatment did not produce additional DNA double-strand breaks, we observed a dose-dependent production of iodides due to the iomeprol radiolysis that inhibit double-strand break repair rate by decreasing DNA-PK kinase activity. CONCLUSIONS Our data suggest that the concomitant use of ICA and radiation may be toxic when radiation-produced iodide concentrations and double-strand break yields are sufficient. The potential toxicity of ICAs during X-rays for diagnosis and therapy is discussed.
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Affiliation(s)
- Aurélie Joubert
- Institut de Radioprotection et de Sûreté Nucléaire, Fontenay-aux-Roses, France
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Fenchel S, Fleiter TR, Aschoff AJ, van Gessel R, Brambs HJ, Merkle EM. Effect of iodine concentration of contrast media on contrast enhancement in multislice CT of the pancreas. Br J Radiol 2004; 77:821-30. [PMID: 15482993 DOI: 10.1259/bjr/19527646] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
The purpose of this study was to determine the influence of two different iodine concentrations of the non-ionic contrast agent, Iomeprol, on contrast enhancement in multislice CT (MSCT) of the pancreas. To achieve this MSCT of the pancreas was performed in 50 patients (mean age 57+/-14 years) with suspected or known pancreatic tumours. The patients were randomly assigned to group A (n=25 patients) or group B (n=25 patients). There were no statistically significant differences in age, height or weight between the patients of the two groups. The contrast agent, Iomeprol, was injected with iodine concentrations of 300 mg ml(-1) in group A (130 ml, injection rate 5 ml s(-1)) and 400 mg ml(-1) in group B (98 ml, injection rate 5 ml s(-1)). Arterial and portal venous phase contrast enhancement (HU) of the vessels, organs, and pancreatic masses were measured and a qualitative image assessment was performed by two independent readers. In the arterial phase, Iomeprol 400 led to a significantly greater enhancement in the aorta, superior mesenteric artery, coeliac trunk, pancreas, pancreatic carcinomas, kidneys, spleen and wall of the small intestine than Iomeprol 300. Portal venous phase enhancement was significantly greater in the pancreas, pancreatic carcinomas, wall of the small intestine and portal vein with Iomeprol 400. The two independent readers considered Iomeprol 400 superior over Iomeprol 300 concerning technical quality, contribution of the contrast agent to the diagnostic value, and evaluability of vessels in the arterial phase. No differences were found for tumour delineation and evaluability of infiltration of organs adjacent to the pancreas between the two iodine concentrations. In conclusion the higher iodine concentration leads to a higher arterial phase contrast enhancement of large and small arteries in MSCT of the pancreas and therefore improves the evaluability of vessels in the arterial phase.
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Affiliation(s)
- S Fenchel
- Department of Radiology, University of Ulm, Steinhoevelstr. 9, 89075 Ulm, Germany
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