增强CT对比剂不良反应的预防

增强CT是经周围静脉注射水溶性有机碘剂后,再扫描的方法,较常应用.但造影剂常产生不良反应,特别是离子型造影剂其不良反应较多,故在注射造影剂前采用预防性给药等综合措施,能有效地降低不良反应的发生率.     

系统性心理护理降低造影剂不良反应的效果观察

目的 探讨心理护理对减少造影剂不良反应的作用.方法 将504例64排螺旋CT血管像（CTA）检查患者分为心理护理组256例及对照组248例,对照组采用常规方法进行检查护理,心理护理组在常规检查的同时进行规范、有针对性的心理护理,对两组患者应用造影剂后的不良反应进行评估,并对2组患者的临床症状进行观察比较.结果 心理护理组较对照组在使用造影剂不良反应的发生率等方面均有显著的降低（P＜005）.结论 心理护理能显著减轻使用造影剂后的临床症状,降低不良反应的发生率.     

双体与单体造影剂在股动脉造影中注射性不适的对比试验

目的:比较非离子双体造影剂碘克沙醇(威视派克)与非离子单体体造影剂碘海醇(欧乃派克)在股动脉造影中的安全性及有效性的试验。方法:对2006~2007年中的60名DSA造影的患者作回顾性比较。对患者的不适、不良反应,图像的有效性分别进行了纪录。结果:对照组中,在注射性不适碘克沙醇明显优于碘海醇,不良反应无明显差异。2组图像均达到诊断要求。结论:碘克沙醇在注射性不适方面优于碘海醇,碘克沙醇和碘海醇均是安全、有效及耐受性好的造影剂。     

应用PACS系统行改良式子宫输卵管造影的临床应用

目的:探讨应用影像的存储与传输系统(PACS)减少非离子型造影剂用量进行改良式子宫输卵管造影的可行性和有效性。方法:76例不孕妇女,其中39例行改良式子宫输卵管造影,37例对照组行常规子宫输卵管造影。改良式子宫输卵管造影先用3～6 ml造影剂经folly管充盈子宫后再以生理盐水10 ml加压推注造影剂由子宫进入输卵管再进入盆腔。对照组以同剂型造影剂行传统子宫输卵管造影。评估两种造影方法图像质量、诊断价值并记录两组造影方法的造影剂用量及造影术中及术后患者的疼痛。结果:数字化设备下改良式子宫输卵管造影有很好的诊断价值,图像质量与传统造影图像比较无差异(P>0.5),造影剂用量明显减少(P<0.001);10 ml生理盐水可成功推注造影剂由子宫经输卵管进入盆腔,造影术中及术后的疼痛较对照组明显减低(P<0.05)。结论:改良式子宫输卵管造影可减少造影剂用量,并能明显减轻疼痛,安全可行。     

CT增强扫描注射碘对比剂的观察与急救护理

目的:观察CT增强扫描注射碘对比剂的应用及总结出现过敏反应的急救护理措施.方法:选2014年3月至2016年8月在我院进行CT增强扫描的患者200例,观察非离子型与离子型造影剂的增强效果与不良反应症状.结果:非离子型造影剂导致患者的过敏反应要低于离子型造影剂,差异有统计意义(P<0.05).结论:采用非离子型造影剂可以减少临床不良反应的发生,施行有效的急救护理措施,可以减轻造影剂引发的不良反应症状.     

造影剂脑病2例报告并相关文献复习

目的通过病例报告正确认识造影剂脑病诊断和治疗。方法回顾性分析2例进行脑血管造影的患者,其中一例患者在造影后出现了逆行性遗忘,一例患者在介入治疗后出现了癫痫、昏迷。2例患者介入相关并发症均不是由于术中斑块脱落、脑出血、术后脑血流过度灌注以及支架内血栓形成等原因引起。结合相关文献复习,明确诊断为造影剂脑病。结果造影剂脑病临床表现多样,一旦确诊,应尽快积极处理,可防止脑功能不可逆损害的发生。结论造影剂脑病是一种临床罕见的由于造影剂不良反应引起的神经系统功能异常,早期预防以及正确处理非常关键。     

超声造影在眼内肿瘤诊断的应用

超声造影检查是一项新的诊断技术,将其应用到眼内肿瘤的诊断与鉴别诊断是一个大胆的尝试与创新.本文分三个部分介绍了超声造影在眼部应用的基本情况:1.如何理解超声造影在眼部的应用.比较传统的眼内肿瘤的诊断方法如眼底血管造影、CT、MR等,超声造影的优势何在?2.超声造影在眼内良、恶性肿瘤诊断及鉴别诊断的应用,通过对眼内良、恶性肿瘤的超声造影进行时间——强度曲线分析,表明恶性肿瘤病变内的造影剂浓度低于良性肿瘤,恶性肿瘤病变内造影剂的平均渡越时间小于良性肿瘤.即恶性肿瘤为快进快出,良性肿瘤为快进慢出.3.超声造影在眼部使用的局限性.通过对造影剂特点的研究,建议严格选择眼部超声造影诊断的病例,即年龄大于18周岁,以肿瘤为主要的研究对象.超声造影的出现,为眼内肿瘤的诊断提供了一条新途径.     

超声造影在妇产科的研究及应用进展

随着以SonoVue为代表的第二代超声造影剂的问世以及第三代携带基因片段的超声造影剂的研发,超声造影技术近10年来发展迅速,超声造影剂与超声造影技术开拓了超声诊断成像的新领域.很多学者就其临床应用价值在很多领域做了广泛而深入的研究.超声造影为超声鉴别诊断卵巢良恶性肿瘤提供了有希望和有价值的诊断工具,同时其在子宫肿瘤、输卵管疾病以及一些产科方面的超声成像也显示出一定的潜能.该文就该技术在妇产科的研究及应用进展进行综述.     

两种碘造影剂在子宫输卵管造影检查中的应用比较

在女性不孕的诊断中,子宫输卵管造影（HSG）起重要作用。碘化油因其经济实用,是HSG中最常用的造影剂,但其存在过敏和栓塞的危险,且吸收缓慢,可刺激腹膜形成肉芽肿。近年出现的非离子型造影剂——碘海醇因不良反应小,吸收代谢快,被逐渐应用于HSG中。笔者从2009年开始同时使用碘化油和碘海醇进行子宫输卵管造影,现将其应用情况比较如下。     

碘造影剂在儿童静脉肾盂造影中应用分析

为了比较离子型造影剂与非离子型造影剂在儿童静脉肾盂造影中的安全性,对我院发生的12例儿童碘造影剂过敏反应的病例进行回顾性分析.     

造影剂碘普罗胺在妇科盆腔CT检查中的效果及其安全性

目的 探究与分析造影剂碘普罗胺在妇科盆腔CT检查中的效果及其安全性.方法 运用回顾性研究方法,选取我院2018年2月-2021年1月收治的78例接受妇科盆腔CT增强检查者作为研究对象,观测全部患者的影像质量、全身及局部耐受性和相关不良反应.结果 在78例检查中,影像质量优良率为97.44％,患者耐受度为97.44％.患...     

Gadofosveset-enhanced magnetic resonance angiography

Gadofosveset (Vasovist, Bayer Schering Pharma AG, Berlin/Germany) is the first intravascular contrast agent approved for use with magnetic resonance angiography in the European Union, Switzerland, Turkey, Canada, and Australia. Gadofosveset reversibly binds to albumin providing extended intravascular enhancement compared wth existing extracellular magnetic resonance contrast agents. Prior to approval, gadofosveset underwent extensive testing to evaluate the safety and efficacy of the drug; the clinical trials show that gadofosveset-enhanced magnetic resonance angiography (MRA) is safe and well tolerated in patients with vascular disease and effective for the detection of vascular stenosis and aneurysms gadofosveset has the potential to open new horizons in diagnostic MRA by increasing the spatial resolution and the robustness of MRA examinations and facilitating the examination of multiple vascular beds.     

Viable myocardium revealed by contrast echocardiography

In patients with acute ischemic syndrome left ventricular dysfunction may indicate necrotic myocardium as well as viable tissue. Among the well known non-invasive techniques like dobutamine echocardiography, rest-redistribution thallium scintigraphy or positron emission tomography a new method, contrast echocardiography is evolving. In the presented case stunning resulting in left ventricular aneurysm formation was confirmed after intravenous injection of contrast agent and the use of intermittent harmonic imaging in the acute phase of ischemia. The negative coronary angiography and the complete restoration of the left ventricular function confirmed the results of contrast echocardiography. With the development of new second generation contrast agents and new techniques contrast echocardiography will become a feasible method for detection of viable myocardium after intravenous injection.     

超声造影应用于肝脏占位性病变的价值研究进展

超声造影指的是将超声造影剂注入人体,使血流与组织的回声对比得到增强,通过周围组织与待查目标之间在血流灌注方面差异明确待查目标情况,给予定性诊断。第一代造影剂指的是包含空气同时可经肺循环的一种较为稳定微泡造影剂,之后选择惰性气体取代空气,微泡在人体存留时间有明显提高,其稳定性明显好于第一代超声造影剂,将其称之为第二代超声造影剂。将超声造影剂应用在肝脏占位性病变诊断方面有重要价值,在此作一综述。     

Comprehensive evaluation of a Thorotrast patient: an overview.

For several decades, thousands of people received Thorotrast during the course of angiography and other radiologic procedures. Eventually, as the hazards of this radioactive, radiographic contrast agent became apparent, research was initiated to further evaluate its associated adverse effects. In 1988 and 1989, Charles W. Mays, together with colleagues at a variety of sites, developed a detailed protocol for the comprehensive postmortem evaluation of one subject who had been administered Thorotrast 36 y previously. This case represents the first holistic approach to the analysis of Thorotrast in a whole body, simultaneously assembling clinical and autopsy findings with dosimetric, radiochemical, autoradiographic, and molecular evaluations.     

Intravascular radiographic contrast media: issues for family physicians

BACKGROUND: Family physicians frequently order and in some instances supervise diagnostic tests using intravascular radiographic contrast media. METHODS: MEDLINE database was searched from 1966 to the present using the key terms "contrast media," "adverse reaction," "anaphylaxis," "anaphylactoid," "nephropathy," "renal failure," "kidney failure," and "MRI" in combinations. Other sources were found by back referencing these articles and in recent texts. RESULTS AND CONCLUSIONS: The adverse reactions likely to be encountered in most patients are acute anaphylactoid and cardiovascular reactions, delayed reactions, and renal effects. Mild acute reactions usually require no treatment, but if more severe reaction symptoms occur, emergency treatment is indicated. Acute reactions can be prevented or reduced by close attention to risk factors and pretreatment. Delayed reactions seldom require specific treatment. The type of contrast agent used might lessen the risk of immediate reactions. Contrast-associated nephropathy is most likely to occur in patients who have preexisting renal disease, heart failure, and volume depletion. Optimization of precontrast hydration can lessen the renal effects of contrast material. Magnetic resonance imaging contrast agents might be safer, because of smaller volumes administered, but adverse reactions have occurred.     

Contrast-enhanced magnetic resonance angiography]

Contrast-enhanced magnetic resonance angiography (MRA) involves intravenous injection of a contrast medium that increases the signal intensity of blood by shortening its T1 value. With contrast-enhanced MRA the acquisition time is short (less than 40 s for the abdominal aorta and the iliac vessels) and the images obtained can be interpreted accurately. The contrast medium currently in use virtually never causes adverse effects and is not nephrotoxic. After obtaining a three-dimensional dataset projections can be made at will. In addition, the individual partitions should be evaluated. The postprocessing time is about 15 min per examination. Current clinical applications are diagnostic examination of (stenoses of) the aortic arch and its branches, the thoracic and abdominal aorta, the visceral vessels, the renal arteries and the peripheral arteries. The sensitivity and specificity of contrast-enhanced MRA in most studies amount to over 90%.     

数字减影血管造影系统性能检测和质量控制

为保证数字减影血管造影（DSA）系统的安全性和有效性,必须定期进行性能检测和质量控制。本文按照JJG 1067-2011《医用诊断数字减影血管造影（DSA）系统X射线辐射源国家计量检定规程》,介绍了对数字减影血管造影系统的空气比释动能率、HVL（辐射输出的质）、X射线管电压、模拟血管最小尺寸、空间分辨力、低对比度分辨力、对比度线性和减影性能影响等的检测方法。     

直接冠脉支架植入治疗急性心肌梗死的有效性和安全性观察

目的:观察直接冠脉支架植入治疗急性心肌梗死的有效性和安全性。方法:回顾性分析2016年6月~2018年6月在本院心内科诊断为急性心肌梗死的患者110例,术前常规药物准备,行冠状动脉造影,判断梗死相关动脉,根据冠脉病变特点对照组行球囊预扩张后支架植入,观察组行直接支架植入。比较两组患者的手术时间、造影剂使用剂量、照射剂量和X线照射时间,并比较两组患者的不良反应发生情况。结果:观察组患者的手术时间为(41.4±7.8)min,造影剂使用剂量(114.9±39.2)mL,照射剂量(0.9±0.3)mGy,X线照射时间(8.6±1.1)min;对照组患者的手术时间为(55.2±7.3)min,造影剂使用剂量(137.1±58.7)mL,照射剂量(1.5±0.4)mGy,X线照射时间(11.8±1.2)min。组间各项比较,P<0.05,差异有统计学意义。观察组与对照组患者的不良反应发生率,P>0.05,差异无统计学意义。结论:对急性心肌梗死患者直接冠脉支架植入安全性好,且能在更短时间内完成手术,X线照射时间短,造影剂使用剂量和照射剂量小,疗效确切。     

Three cases of intralobar pulmonary sequestration--demonstration of an aberrant artery by contrast CT

Three cases of intralobar pulmonary sequestration, whose aberrant arteries could be demonstrated by contrast CT were reported. We confirmed these aberrant arteries both by selective angiography and/or surgical resection. We conclude that contrast CT may be of great use and benefit in the radiological workup of suspected cases of pulmonary sequestration proceeding to angiography.