We describe high-resolution CT findings of pulmonary edema following the administration of intravenous nonionic contrast media in a patient who had no previous history of cardiovascular disease ; areas of ground glass opacity and interlobular septal thickenings which partly disappeared on scans obtained 90 minutes after the initial scans. The proposed mechanisms of pulmonary edema are briefly discussed.
Administration, Intravenous* ; Cardiovascular Diseases ; Contrast Media* ; Glass ; Humans ; Pulmonary Edema*

A biliary contrast agents pushing device, including a syringe pushing system and a remote controller is introduced. The syringe pushing system comprises an injector card slot, a support platform and an injection bolus fader. A 20 mL syringe can be fitted on the syringe pushing system and kept with the ground about 30 degree. This system can perform air bubble pumping back and contrast agents bolus injection as well as speed adjustment. Remote controller is an infrared remote control which can start and stop the syringe pushing system. With this device, the remote controlled cholangiography technology can be achieved, which can not only protect doctors from X-ray radiation but also improve the traditional T-tube cholangiography and the contrast effect, reduce postoperative complications in patients as well. The application of this device will improve the current diagnosis and treatment system, the device will benefit the majority of doctors and patients.
Contrast Media ; administration & dosage ; Humans ; Injections ; Postoperative Complications ; Syringes

Radiocontrast media-induced acute severe thrombocytopenia is a very rare complication and potentially life-threatening. Here, we report the case of a 63-year-old male patient with severe acute thrombocytopenia following first exposure to intravenous non-ionic contrast media without immediate allergic reactions. His platelet count dropped from 107000/µL to 2000/µL after six hours of radiocontrast infusion. After administration of corticosteroid and transfusion of platelet concentrates, the platelet count returned gradually to normal within 5 days. To the best of our knowledge, non-ionic contrast media-induced isolated acute severe thrombocytopenia following no signs or symptoms of immediate allergic reaction has never been described.
Acute Disease ; Administration, Intravenous ; Contrast Media/administration & dosage ; Contrast Media/adverse effects ; Humans ; Infusions, Intravenous ; Male ; Middle Aged ; Platelet Count ; Thrombocytopenia/etiology

PURPOSE: We studied the usefullness of intravenous administration of contrast material to facilitate in situ shock wave lithotripsy(SWL) of ureteral stones in cases that stone localization was difficult as radioluscent, less radiodense, small stone, and interference with visualization by bone or intestinal gas. MATERIALS AND METHODS: From March 1992 to June 1997 we treated 831 patients with ureteral stone by in-situ SWL using EDAP-LT02 piezoelectric lithotriptor which utilizes ultrasono and fluroscopy for stone localization. Among 831 patients, intravenous contrast material were used in 53 cases to facilitate stone localization during SWL treatments. To evaluate the effectiveness of stone localization by the assistance of intravenous contrast media we compared success rate, storages, treatment sessions, durations, and side effects of two groups with or without intravenous contrast material, based on the location and the size of stones. RESULTS: Among 53 patients, stone was localized without ureteral catheterization in 5.7%(25/437) of upper ureteral stone, 18.2%(18/99) of mid-ureteral stone, and 3.4%(10/295) of lower ureteral stone after administration of intravenous contrast material. There were no significant differences in success rate, storages, treatment sessions, and durations(p>0.05). There were no significant complications except dye hypersensitivity in two patients, who were managed conservatively. CONCLUSIONS: The administration of intravenous contrast material during SWL allows effective localization of ureteral stones that otherwise could not be imaged adequately without ureteral catheterization. We believe that the use of intravenous contrast material for localization of ureteral stone in SWL have the benefits of inexpensiveness, noninvasiveness, and painlessness.
Administration, Intravenous ; Contrast Media ; Humans ; Hypersensitivity ; Shock ; Ureter* ; Urinary Catheterization ; Urinary Catheters

BACKGROUND AND OBJECTIVES: Contrast-induced nephropathy (CIN) is associated with increased morbidity and mortality in coronary angiography. Although the mechanism is unclear, N-acetylcysteine (NAC) is known to protect against CIN. Preliminary studies with NAC have found conflicting results for the prevention of CIN in patients undergoing coronary angiography. This study was designed to evaluate the efficacy and safety of NAC for the prevention of CIN in patients undergoing coronary angiography. SUBJECTS AND METHODS: 48 patients with chronic renal insufficiency (mean [+/-SD] serum creatinine concentration, 2.06+/-0.56 mg/dL), who were undergoing coronary angiography with a nonionic, low-osmolar contrast agent, were prospectively studied. Patients were randomly assigned to receive either the antioxidant, NAC (600 mg orally twice daily), and 0.45% saline intravenously (n=25), before and after administration of contrast agents, or saline only (n=23). The renal function parameters were assessed 48 hour before and after radiocontrast media administration. RESULTS: 14 of the 48 patients (29%) showed an increase in the 0.5 mg/dL serum creatinine concentration after 48 hours of contrast media administration: 4 of the 25 patients in the NAC group (16%) and 10 of the 23 in the control group (43%; p=0.036; relative risk, 0.37; 95% confidence interval, 1.04 to 7.79). In the NAC group, the mean serum creatinine concentration insignificantly increased (p=0.54), from 2.2+/-0.8 to 2.3+/-0.9 mg/dL, after 48 hours of contrast media administration; whereas, in the control group, the mean serum creatinine concentration significantly increased (p=0.011), from 1.9+/-0.4 to 2.2+/-0.8 mg/dL. The absolute change in serum creatinine concentration was significantly greater in the control than the NAC group (p=0.044). CONCLUSION: Prophylactic oral administration of the antioxidant NAC, along with hydration, prevents the decrease in the renal function induced by a nonionic, low-osmolality contrast agent in patients with chronic renal insufficiency.
Acetylcysteine* ; Administration, Oral ; Contrast Media ; Coronary Angiography* ; Creatinine ; Humans ; Mortality ; Prospective Studies ; Renal Insufficiency, Chronic

PURPOSE: To analyze the enhancement patterns and morphology of peripheral cholangiocarcinomas (CCs), as seen on three-phase helical CT. MATERIALS AND METHODS: Three-phase helical CT scans of 25 cases of 24 patients with pathologically-proven CCs were retrospectively reviewed. After intravenous administration of contrast media, scans of the hepatic arterial phase (HAP) were obtained at 30 seconds, of the portal venous phase (PVP) at 70 seconds, and of the delayed phase (DP) at 3 minutes. RESULTS: Linear, dense, marginal enhancement was seen in 17 CCs (68%), mainly on HAP images (64%) while thick, band-like, peripheral enhancement was seen in 18 (72%), on either PVP (52%) or DP (44%). Internal enhancement was observed in 23 CCs (92%) on PVP (68%) and/or DP (88%), and 19 CCs (76%) among them showed incomplete enhancement of stippled and/or septated patterns. Most (76%) were seen throughout all three phases to be hypoattenuating, as compared to the surrounding parenchyma. On HAP, wedge-shaped parenchymal enhancement was demonstrated at the periphery of 19 CCs (76%) suggesting impaired portal flow. Associated morphologic findings were satellate nodules (n=15, 60%), lymphadenopathy (n=14, 56%), focal dilatation of intrahepatic ducts around the tumor (44%), umbilication of the liver surface (50%), and clonorchiasis (44%). CONCLUSION: On three-phase helical CT, peripheral cholangiocarcinoma showed linear marginal enhancement on HAP, thick peripheral enhancement on PVP and/or DP, stippled and septated enhancing foci on DP, and peritumoral wedge enhancement on HAP. Associcated findings such as satellite nodules, focal dilatation of the intrahepatic ducts, umbilication of the tumor, and clonorchiasis were helpful.
Administration, Intravenous ; Cholangiocarcinoma* ; Clonorchiasis ; Contrast Media ; Dilatation ; Humans ; Liver ; Lymphatic Diseases ; Retrospective Studies ; Tomography, Spiral Computed*

PURPOSE: To assess the frequency and severity of acute adverse reactions to intravenous administration of gadolinium-based contrast agents using computerized reporting system at a single large academic institution. MATERIALS AND METHODS: We assessed data from electronic hospital information system from October 2008 to December 2010. Reactions were classified as mild, moderate, or severe. We compared the frequency of adverse reactions among three contrast agents (Gd-BT-DO3A, Gd-DTPA and Gd-EOB-DTPA). RESULTS: The total number of administrated contrast agents was 33,600, and the number of administration of Gd-BT-DO3A, Gd-DTPA and Gd-EOB-DTPA were 20,824 (62%), 10,417 (31%) and 2,359 (7%), respectively. Total 39 adverse reactions were reported accounting for 0.1161% of all administrations. The incidences of adverse reactions were 0.1248% (26/39, 67%) for Gd-BT-DO3A, 0.0768% (8/39, 21%) for Gd-DTPA, and 0.2120% (5/39, 13%) for Gd-EOB-DTPA. The difference of frequencies of adverse reaction among three contrast agents was not significant. Most cases of the adverse effect were mild (35/39, 89.7%). Moderate and severe adverse reactions were encountered in two patients, respectively. CONCLUSION: Among Koreans, adverse effects were rare, and especially, moderate to severe adverse reactions were much rarer. There was no difference among the frequencies of adverse reactions caused by three different contrast agents.
Accounting ; Administration, Intravenous ; Contrast Media ; Electronics ; Electrons ; Gadolinium DTPA ; Hospital Information Systems ; Humans ; Incidence ; Retrospective Studies

OBJECTIVETo explore the efficacy of injectable gelatin matrix as a hemostatic agent for treatment of grade III-IV hepatic trauma to a canine model with contrast-enhanced ultrasound (CEUS) guidance.

METHODSTwenty-seven healthy adult dogs underwent celiotomy in induce grade III-IV hepatic trauma in the left lateral lobe of the liver. The dogs were then randomized into 3 groups, namely the treatment group in which the injectable hemostat was percutaneously injected into the injury site under CEUS guidance, and the positive and negative control groups with thrombin solution and normal saline treatment, respectively. Intra-abdominal blood loss within 30 min postoperatively, and alanine aminotransferase (ALT) and aspartate aminotransferase (AST) 7 days postoperatively were compared among the groups. Follow-up CEUS was performed in each animal 7 days after the operation.

RESULTSThe mean blood loss was 47.69 ml in the treatment group, significantly less than that in the positive control group (81.77 ml, P/0.01) and negative control group (110.35 ml, P<0.01). The treatment group had also significantly lower ALT and AST levels than the two control groups (ALT: 49.37, 62.81, and 82.83 U/L, respectively, P<0.05; AST: 48.32, 67.16, and 82.54 U/L, respectively, P<0.05). In the treatment group, CEUS did not detect hepatic lesions or ascites as found in the two control groups, and the perfusion of the liver was homogeneous.

CONCLUSIONThe injectable hemostat injected under the guidance of CEUS can effectively control grade III-IV hepatic hemorrhage in the canine model and show strong effects of stopping bleeding and promoting wound healing.

Animals ; Contrast Media ; Dogs ; Gelatin ; administration & dosage ; therapeutic use ; Hemostasis, Surgical ; Liver ; injuries ; Ultrasonography, Interventional

Branchioma ; diagnostic imaging ; surgery ; Contrast Media ; administration & dosage ; Head and Neck Neoplasms ; diagnostic imaging ; surgery ; Humans ; Radiography

Animals ; Contrast Media ; Dogs ; Dose-Response Relationship, Drug ; Echocardiography ; Haplorhini ; Hydrogen Peroxide ; administration & dosage