泛影葡胺胶浆支气管造影的实验研究及临床应用

笔者对４０只家兔分组并分别用泛影葡胺胶浆和７６％复方泛影葡胺做支气管造影，进行Ｘ线和病理的对照研究，并已临床应用２８３例。动物实验和临床应用结果表明，泛影葡胺胶浆对支气管显影效果好，对肺无损害，排出吸收快，肺内无存留，克服了单纯用７６％复方泛影葡胺做支气管造影有流动快，易进入肺泡，不易摄支气管像，刺激性大和易引起肺水肿的缺点。     

泛影葡胺胶浆支管造影的实验研究及临床应用

笔者对４０只家兔分组并分别用泛影葡胺胶浆和７６％复方泛影葡胺做支气管造影，进行Ｘ线和病理的对照研究，并已临床应用２８３例。动物实验和临床应用结果表明，泛影葡胺胶浆对支气管显影效果好，对肺无损害，排出吸收快，肺内无存留。克服了单纯用７６％复方泛影胺做支管造影有流动快，易进入肺泡，不易摄支气管像，刺激性大和易引起肺水肿的缺点。     

电子束CT腮腺造影并三维重建在腮腺肿块诊断中的应用

目的：探索电子束ＣＴ腮腺造影泛影葡胺的最佳浓度，电子束ＣＴ平扫、腮腺造影ＣＴ和三维ＣＴ在腮腺肿块诊断中的应用价值。材料和方法：对１６例腮腺肿块分别进行电子束ＣＴ平扫，４５％、６０％和７６％三种不同浓度泛影葡胺腮腺造影ＣＴ扫描，腮腺造影图像应用四种方法进行三维重建，显示结果进行统计学分析和与手术病理对照分析。结果：腮腺造影ＣＴ泛影葡胺浓度以６０％最佳，腮腺造影ＣＴ较电子束ＣＴ平扫对腮腺肿块的显示更为准确。三维ＣＴ对腮腺肿块和其与面神经的关系显示得更为直观，容积显示法可同时显示腮腺肿块和腮腺内导管的改变，较表面显示法更有价值。结论：电子束ＣＴ腮腺造影并三维重建是诊断腮腺肿块非常有价值的检查手段。     

子宫输卵管造影的诊断价值与临床应用

目的：探讨子宫输卵管造影检查在不孕症中的诊断价值和临床应用。方法：采用水剂76％的泛影葡胺作造影的对比剂，利用橡胶双腔管堵塞宫颈内口适当加压注射作造影检查。结果：100例不孕患者中，子宫病变31例，输卵管病变42例，未见病变27例。结论：子宫输卵管造影简便，快捷，准确。应用76％泛影葡胺造影，影像质量达到诊断要求，且价格低廉，是检查女性不孕原因简单而必要的方法之一。     

数字减影支气管造影的临床应用

目的：利用数字减影技术改善碘支气管造影影像及副作用。材料和方法：应用数字减影支气管造影（ＤＳＢ）技术共检查３５例患者，其中１９例选用７６％泛影葡胺磺胺混悬液，１２例用２０％泛影葡胺、４例用稀释的优维显（Ｕｌｔｒａｖｉｓｔ）做造影剂。结果：３５例ＤＳＢ影像均达优质，但用低浓度泛影葡胺病例的术中术后不良反应明显低于高浓度泛影葡胺。根据ＤＳＢ影像诊断支气管扩张１１例，支气管炎５例，支扩并支气管炎１５例、肺结核１例、支气管狭窄２例、正常１例。结论：ＤＳＢ技术可明显降低碘水的使用浓度，减少副反应，而且图像优良、易于实施。     

数字减影技术在不孕症诊断和治疗中的应用

目的：探索数字减影技术在不孕症诊断和治疗中的应用价值。方法：在X线数字减影设备下用复方泛影葡胺对164例不孕症患者行子宫输卵管造影，并用导丝对其中35例输卵管阻塞的患者进行输卵管再通治疗。结果：90.9％(149／164)患者造影发现异常，包括子宫发育异常24例，输卵管阻塞114例，输卵管结核3例，盆腔粘连29例。输卵管再通成功率82．9％，再通后受孕率为34．3％。结论:数字减影成像技术大大提高了子宫输卵管造影对病变的检出率和诊断的准确率；水溶性对比剂比碘油更加准确、安全；输卵管再通术可作为输卵管阻塞患者初步治疗的首选方法。     

乳腺导管扩张症X线表现

目的：增加对乳腺导管扩张症Ｘ线表现的认识。方法：对２０例２６支乳腺导管扩张症进行Ｘ线表现观察、分析及与临床、病理进行对照。采用美国ＬＯＡＲＤ公司ＭⅢ型乳腺机,所用造影剂为７６％复方泛影葡胺或３００ｍｇＩ／ｍｌ欧乃派克。结果：柱状扩张２４支（９２．３％）,囊状扩张２支（７．７％）;病变累及１～２级导管１０支,１～３或４级导管１１支,２～５级导管３支,末梢导管２支;病变长：１～２．５ｃｍ１１支,３～５ｃｍ１２支,６～９ｃｍ３支,导管扩张的造影表现与病理改变密切相关。结论：乳腺导管造影是诊断乳腺导管扩张症的可靠方法     

数字X线机行子宫输卵管造影及输卵管再通术的临床应用

作者自９６年至９７年应用数字Ｘ线机进行子宫输卵管造影共１６８例,并选择性的对输卵管施行再通术２９例,现就方法、结果及数字Ｘ线机的临床应用价值报告如下：资料与方法本组１６８例中原发不孕１４１例,继发不孕２７例。我们利用数字Ｘ线机进行子宫输卵管造影检查,以确诊不孕原因及拟定治疗方案。操作方法：病人仰卧,取膀胱截石位,常规消毒铺无菌巾,先行一般妇科检查,探清子宫位置及宫腔深度后,用双腔胶管插入宫颈内口,将气囊内注入生理盐水２～３毫升,然后向管内推注７６％泛影葡胺至充盈满意为止,一般用药１０毫升以内。对…     

子宫输卵管造影的临床应用

目的：评价子宫输卵管造影的临床价值。方法：对102例不孕患者采用76％泛影葡胺进行子宫输卯管造影，并分析其X线表现。结果：102例中，输卵管炎症及积水40例，占39，2%，输卵管通畅28例，子宫粘连8例，输卵管结核18例，先天畸形8例。结论：引起女性不孕的原因．有炎症，结核及子宫发育畸形，子宫输卵管造影是诊断女性不孕病因的最常用的简易方法，可为临床提供客观诊断依据。     

30％泛影葡胺用于乳腺导管造影的价值

30％泛影葡胺或复方泛影葡胺主要是用于血管造影前的碘过敏试验，因为有时用大剂量造影和不需要做过敏试验者．本院每年可剩余数10支1毫升的30％泛影葡胺。我们将其应用于乳腺导管造影，收到了良好的经济效益和技术效益。一、适应症和禁忌症非哺乳期的单侧性乳头溢液或双侧性乳     

螺旋CT泛影葡胺灌肠对结肠癌的诊断价值

目的 :评价螺旋CT结合 2 %泛影葡胺灌肠对结肠癌的诊断价值。方法 :65例结肠癌患者用 2 %泛影葡胺灌肠后行CT扫描 ,并与术后病理对照分析。结果 :结肠癌病灶术前诊断准确率为 10 0 %,术前分期与手术符合率为 89.2 %。结论 :螺旋CT结合 2 %泛影葡胺灌肠对结肠癌的诊断有重要意义     

Incompatibility of water-soluble contrast media and intravascular pharmacologic agents. An in vitro study.

In vitro incompatibilities between nine water-soluble contrast media and 21 intravascular pharmacologic agents were investigated using naked-eye observation and a centrifuge. Most of the previously reported incompatibilities were verified, and a few new incompatibilities were discovered: phentolamine mesylate with diatrizoate sodium, diatrizoate meglumine, ioxaglate, and iothalamate; diatrizoate meglumine with diazepam and meperidine hydrochloride; and diatrizoate sodium with meperidine hydrochloride. There were no incompatibilities when the pharmacologic agents investigated were mixed with ioxithalamate, iopromide, iopamidol, and iohexol.     

Ultrastructural changes in rat aortic endothelium during contrast media infusion

A rat model was employed to investigate contrast media (CM) induced ultrastructural changes in the vascular endothelium. Ionic contrast materials such as Renografin-76 (diatrizoate meglumine diatrizoate sodium), MD-76 (diatrizoate meglumine diatrizoate sodium), and Angiovist (meglumine diatrizoate) were injected into the femoral vein of anesthetized male Wistar rats (240-260 g) and allowed to circulate. Control animals were similarly injected with equiosmolar sucrose and physiologic saline. The thorax was opened 15 minutes, 1 hour, and 4 hours postinjection and cardiac perfusion performed using Karnovsky's fixative; the thoracic aorta was then surgically removed, and processed for transmission electron microscopy. All CM produced shrinkage in cell cytoplasm and nuclear structures thereby causing distortions in cell morphology. In control tissues, however, no such ultrastructural damages were noted. Within 15 minutes of CM infusion, electron dense granules were seen on the luminal surface of endothelial cells, in pinocytotic vesicles, as well as in the gap junctions between cells. These observations indicate that contrast media intake occurs via vesicular transport, and through the cell junction.     

螺旋CT对结肠癌的诊断及术前分期价值

目的评价口服清水、2%泛影葡胺灌肠后螺旋CT扫描对结肠癌的诊断及术前分期价值。方法40例结肠癌患者检查前一日进流质饮食,检查当日晨常规清洁灌肠,口服清水、2%泛影葡胺灌肠后行CT扫描,结果与术后病理对照分析。结果直肠癌2例,乙状结肠癌7例,降结肠癌6例,横结肠癌5例,升结肠癌20例;根据Dukes’改良分期法,分为B期22例,C期12例,D期6例,与手术符合率为89.6%。结论螺旋CT扫描结合口服清水、2%泛影葡胺灌肠对结肠癌的诊断及术前分期有重要意义。     

Antiplatelet action of intravascular contrast media. Implications in diagnostic procedures

The antiplatelet action of intravascular contrast media (CM) Renografin-76 (diatrizoate meglumine and diatrizoate sodium) was studied in vitro and in 21 patients undergoing radiodiagnostic procedures. In vitro studies suggested that in Renografin-76, meglumine was the chief constituent responsible for its antiplatelet action. In post-CM plasma from patients, clotting times were prolonged and platelet aggregation greatly impaired, albeit normal aggregation restored within 3 hours. Although changes in global clotting times and platelet aggregation were mostly transient, it is possible that CM usage in patients with thrombocytopenia, sickle cell phenomenon, and on anticoagulant-antiplatelet drugs may present a serious risk to their hemostatic integrity.     

The influence of contrast media additives upon ventricular fibrillation thresholds during coronary angiography in ischemic and normal canine hearts

Contrast media additives that bind calcium lower the total dose necessary to induce fibrillation. The method of measuring ventricular fibrillation threshold during coronary arteriography is sensitive and allows dose comparison at volumes relevant to clinical use. We compared two commercial formulations of sodium/meglumine diatrizoate for their effects upon fibrillation threshold in normal and ischemic dog hearts. Even though the formulations differed only by their additives, Hypaque 76 was significantly less fibrillatory than Renografin 76. This was observed at two different doses and in both ischemic and non-ischemic hearts. We conclude that amounts of additives capable of binding calcium should be kept as low as possible in sodium/meglumine diatrizoate formulations that are used for coronary angiography. Supported in part by the Veterans Administration and by Sterling Wintrop Research Institute     

Comparison of iohexol 300 and diatrizoate meglumine 60 for body CT: image quality, adverse reactions, and aborted/repeated examinations.

Six hundred patients were prospectively randomized and given either diatrizoate meglumine 60 or iohexol 300 during dynamic contrast-enhanced body CT in order to compare image quality, contrast reactions, and the number of aborted studies or studies in which images had to be repeated. Three hundred two patients received iohexol 300, and 298 patients received diatrizoate meglumine 60. Thirty-nine percent (119/302) of the patients given iohexol 300 and 63% (188/298) of the patients given diatrizoate meglumine 60 had at least one adverse reaction thought to be related to contrast material during, or within 24 hr of, the body CT scan. When reactions of discomfort (heat or warmth, flushing, bad taste) were excluded, 16% (48/302) of the patients who received iohexol and 33% (99/298) of the patients who were given diatrizoate meglumine 60 had at least one adverse reaction. The differences in both types of reactions between the two agents were significant (p less than .001). Among scans evaluated for study quality, 71% (214/302) of the iohexol 300 group and 62% (184/298) of the diatrizoate meglumine 60 group had optimal enhancement (p = .02). However, when the optimal and adequate categories were combined, 301 of 302 patients given iohexol 300 and 292 of 298 patients given diatrizoate meglumine 60 had diagnostic-quality studies (no statistical difference). Studies were not terminated nor were images repeated in 97% (292/302) of the patients given iohexol 300 and in 94% (280/298) of those given diatrizoate meglumine 60. The CT study was repeated because of movement during the contrast injection or aborted because of contrast-related reactions in 0.7% of the patients given iohexol 300 and in 3.0% of the patients given diatrizoate meglumine 60. This difference was statistically significant (p = .04). Our results suggest that the difference in image quality, number of adverse reactions, and number of aborted/repeated CT scans performed with iohexol 300 or diatrizoate meglumine 60 are not sufficiently different to warrant conversion to nonionic agents for body CT scans.     

Calcium binding by gadolinium-based MR contrast agents

PURPOSE: This study was conducted to characterize the alterations in ionic sodium, potassium, and calcium by gadolinium-based MR contrast agents. MATERIALS AND METHODS: An electrolyte solution (ES) containing 1.2 mM/L calcium ions,120 mM/L sodium, and 4.0 mM/L potassium were diluted with various gadolinium compounds and alterations in ionized electrolytes were measured using an ion-specific electrometer. Gadolinium compounds including Gd-DTPA, Gd-DOTA, gadoteridol, gadodiamide, meglumine/sodium diatrizoate (76% Urografin), and isotonic saline as a control were investigated. The dilution ranged from 5% (ES/test solution = 100/5) to 100%. Alterations of ionic electrolytes were measured. Calcium-binding capacities caused by each gadolinium compound also were measured. RESULTS: The alterations of ionic sodium and potassium by gadolinium compound were similar to those of isotonic saline. A significant reduction in ionized calcium was observed with Gd-DTPA and Gd-DOTA in comparison with gadoteridol and gadodiamide. CONCLUSION: Ionic gadolinium compounds induced significant reductions of calcium ions in vitro compared with non-ionic gadolinium compounds.     

Improvement in referral practices elicited by a redesigned request format

Intravascular injection of some radiographic contrast media causes a fall in the concentration of unbound serum calcium (Ca++) and an increase in serum immunoreactive parathyroid hormone (iPTH). The decrease in Ca++ levels was attributed to the presence in the contrast media of calcium chelating agents (disodium edetate and sodium citrate) and to the effects of high ionic strength and hemodilution on calcium ion activity. In the present study, we have tested whether omission of the calcium chelating agents from solutions of diatrizoate will lessen the alterations in systemic calcium metabolism. We compared Renografin-76 (RG-76) (diatrizoate meglumine and diatrizoate sodium), which contains disodium edetate and sodium citrate, with Hypaque-76 (H-76) (diatrizoate meglumine, diatrizoate sodium), which contains no calcium chelating activity. A bolus injection of a mean dose of 62 ml of either contrast medium decreased levels of Ca++ significantly (P less than 0.01) at five minutes. The decrease was significantly greater (P less than 0.025) with RG-76 (0.096 +/- 0.018 mM, mean +/- SE) than it was with H-76 (0.049 +/- 0.018 mM, mean +/- SE). The level of iPTH increased (P less than 0.01) by 68 +/- 13 nanoliter equivalents (nleq) per ml with RG-76 and by 28 +/- 8 nleq per ml with H-76 (P less than 0.01 vs RG-76). In vitro, RG-76 decreased levels of Ca++ in aqueous calcium solutions 3.7-fold more than did H-76, but neither contrast medium had any direct effect on the parathyroid hormone assay system. Omission of divalent cation chelating agents from solutions of diatrizoate reduces their effects on systemic calcium metabolism.