BACKGROUND Oil-based iodinated contrast media have excellent contrast properties and are widely used for hysterosalpingographic evaluation of female infertility.On abdominal radiography and computed tomography(CT)scan...BACKGROUND Oil-based iodinated contrast media have excellent contrast properties and are widely used for hysterosalpingographic evaluation of female infertility.On abdominal radiography and computed tomography(CT)scans,their radiodensity is similar to that of metallic objects,which can sometimes lead to diagnostic confusion in the postoperative settings.In this case,retained oil-based contrast medium was observed on an abdominal radiograph following a cesarean section,making it difficult to differentiate from an intraperitoneal foreign body from surgery.The patient was a 37-year-old pregnant woman who was referred to our hospital at 32 weeks and 1 day of pregnancy due to complete placenta previa for mana-gement of pregnancy and delivery.An elective cesarean section was performed at 37 weeks and 3 days.A plain abdominal radiograph taken immediately after surgery revealed a near-round,hyperdense,mass-like shadow with a regular margin in the pelvic cavity.An intraperitoneal foreign body was suspected;therefore,an abdominal CT scan was performed.The foreign body was located on the left side of the pouch of Douglas and had a CT value of 7000 Hounsfield units,similar to that of metals.The CT value strongly suggested the presence of an artificial object.However,further inquiries with the patient and her previous physician revealed a history of hysterosalpingography.Accordingly,retained oil-based iodinated contrast medium was suspected,and observation of the object’s course was adopted.CONCLUSION When intraperitoneal foreign bodies are suspected on postoperative radiographs,the possibility of oil-based iodinated contrast medium retention should be considered.展开更多
BACKGROUND Octreotide is widely used for the treatment of acromegaly,neuroendocrine tumors,and secretory diarrhea.However,long-term octreotide treatment can increase the incidence of gallstones.Vicarious contrast medi...BACKGROUND Octreotide is widely used for the treatment of acromegaly,neuroendocrine tumors,and secretory diarrhea.However,long-term octreotide treatment can increase the incidence of gallstones.Vicarious contrast medium excretion(VCME)through the hepatobiliary system is well known.However,few studies have reported octreotide-induced acute gallstones following VCME.CASE SUMMARY A 69-year-old man presented with left lower back pain and hematuria caused by a fall.The patient had a history of polycystic kidney disease.VCME occurred following renal artery embolization for a ruptured polycystic kidney.After 5 d of treatment with octreotide,the patient developed acute gallstones and intrahepatic cholestasis which further induced pancreatitis and cholangitis.He was discharged after hemodialysis,antibiotics,and supportive treatments.CONCLUSION For patients with a high-risk of VCME,octreotide should be cautiously administered and carefully monitored.展开更多
Objective To evaluate the feasibility of using a low concentration of contrast medium （Visipaque 270 mgl/mL）, low tube voltage, and an advanced image reconstruction algorithm in head and neck computed tomography ang...Objective To evaluate the feasibility of using a low concentration of contrast medium （Visipaque 270 mgl/mL）, low tube voltage, and an advanced image reconstruction algorithm in head and neck computed tomography angiography （CTA）. Methods Forty patients （22 men and 18 women; average age 48.7 ± 14.25 years; average body mass index 23.9 ± 3.7 kg/m^2） undergoing CTA for suspected vascular diseases were randomly assigned into two groups. Group A （n = 20） was administered 370 mgl/mL contrast medium, and group B （n = 20） was administered 270 mgl/mL contrast medium. Both groups were administered at a rate of 4.8 mL/s and an injection volume of 0.8 mL/kg. Images of group A were obtained with 120 kVp and filtered back projection （FBP） reconstruction, whereas images of group B were obtained with 80 kVp and 80% adaptive iterative statistical reconstruction algorithm （ASiR）. The CT values and standard deviations of intracranial arteries and image noise on the corona radiata were measured to calculate the contrast-to-noise ratio （CNR） and signal-to-noise ratio （SNR）. The beam-hardening artifacts （BHAs） around the skull base were calculated. Two readers evaluated the image quality with volume rendered images using scores from 1 to 5. The values between the two groups were statistically compared. Results The mean CT value of the intracranial arteries in group B was significantly higher than that in group A （P 〈 0.001）. The CNR and SNR values in group B were also statistically higher than those in group A （P 〈 0.001）. Image noise and BHAs were not significantly different between the two groups. The image quality score of VR images of in group B was significantly higher than that in group A （P = 0.001）. However, the quality scores of axial enhancement images in group B became significantly smaller than those in group A （P〈 0.001）. The CT dose index volume and dose-length product were decreased by 63.8% and 64%, respectively, in group B （P 〈 0.001 for both）. Conclusion Visipaque combined with 80 kVp and 80% ASiR provided similar image quality in intracranial CTA with 64% radiation dose reduction compared with the use of lopamidol, 120 kVp, and FBP reconstruc-tion.展开更多
Manganese compound with evident toxicity is widely employed as the contrast medium for clinicalexaminations such as magnetic resonance imaging(MRI).In the present work,a feasible way with the applica-tion of vacuum im...Manganese compound with evident toxicity is widely employed as the contrast medium for clinicalexaminations such as magnetic resonance imaging(MRI).In the present work,a feasible way with the applica-tion of vacuum impregnation and rotary evaporation was proposed to introduce manganese chloride hydrate intothe inner cavities of template - synthesized carbon nanotubes(CNTs),and then a process of alkali treatmentwas used to liberate the loaded CNTs from the template.It is notable that the alkali attack in the presence ofresidual oxygen also resulted in a series of changes in chemical compositions of vip substances,and the ulti-mate compound of manganese was found to be manganese oxide(Mn3O4) by X-ray diffraction and transmissionelectron microscopy.Determinations of energy dispersive spectrum under scanning electron microscopy showeda high-content filling(more than 50 wt%) of Mn3O4 in the loaded CNTs.This work developed a feasible andconvenient way for the encapsulation of vip substances to reduce bio-toxic effects.展开更多
Contrast medium induced nephropathy is the third most common cause of renal failure for inpatients and represents the 10% of all acute kidney injury occurring during hospital-stay. It is associated with prolonged hosp...Contrast medium induced nephropathy is the third most common cause of renal failure for inpatients and represents the 10% of all acute kidney injury occurring during hospital-stay. It is associated with prolonged hospitalization, cost increase and, above all, an unfavourable short- and long-term prognosis. Here, the authors discuss about the contrast medium induced nephropathy prevention strategies, from the identification of patients at risk and drugs potentially nephrotoxic, to the hydration with possible administration of drugs that appeared to be, in some contexts, nephron-protective, and finally we analyze the radiological procedure aimed at the correct choice of type and administration modality of the contrast medium according to current literature.展开更多
AIM:To evaluate the feasibility of low contrast medium and radiation dose for hepatic computed tomography(CT) perfusion of rabbit VX2 tumor.METHODS:Eleven rabbits with hepatic VX2 tumor underwent perfusion CT scanning...AIM:To evaluate the feasibility of low contrast medium and radiation dose for hepatic computed tomography(CT) perfusion of rabbit VX2 tumor.METHODS:Eleven rabbits with hepatic VX2 tumor underwent perfusion CT scanning with a 24-h interval between a conventional tube potential(120 k Vp) protocol with 350 mg I/m L contrast medium and filtered back projection,and a low tube potential(80 k Vp) protocol with 270 mg I/m L contrast medium with iterative reconstruction.Correlation and agreement among perfusion parameters acquired by the conventional and low dose protocols were assessed for the viable tumor component as well as whole tumor.Image noise and tumor-to-liver contrast to noise ratio during arterial and portal venous phases were evaluated.RESULTS:A 38% reduction in contrast medium dose(360.1 ± 13.3 mg I/kg vs 583.5 ± 21.5 mg I/kg,P < 0.001) and a 73% decrease in radiation dose(1898.5 m Gy·cm vs 6951.8 m Gy·cm) were observed.Interestingly,there was a strong positive correlation in hepatic arterial perfusion(r = 0.907,P < 0.001;r = 0.879,P < 0.001),hepatic portal perfusion(r = 0.819,P = 0.002;r = 0.831,P = 0.002),and hepatic blood flow(r = 0.945,P < 0.001;r = 0.930,P < 0.001) as well as a moderate correlation in hepatic perfusion index(r = 0.736,P = 0.01;r = 0.636,P = 0.035) between the low dose protocol with iterative reconstruction and the conventional protocol for the viable tumor component and the whole tumor.These two imaging protocols provided a moderate but acceptable agreement for perfusion parameters and similar tumorto-liver CNR during arterial and portal venous phases(5.63 ± 2.38 vs 6.16 ± 2.60,P = 0.814;4.60 ± 1.27 vs 5.11 ± 1.74,P = 0.587).CONCLUSION:Compared with the conventional protocol,low contrast medium and radiation dose with iterative reconstruction has no significant influence on hepatic perfusion parameters for rabbits VX2 tumor.展开更多
AIM: To provide the useful information for the diagnosis of liver cirrhosis by observing the morphology of peripheral hepatic vessels and the hemodynamics of microbubble arrival time in these vessels.METHODS: Twenty-o...AIM: To provide the useful information for the diagnosis of liver cirrhosis by observing the morphology of peripheral hepatic vessels and the hemodynamics of microbubble arrival time in these vessels.METHODS: Twenty-one subjects including 5 normal volunteers and 16 patients (liver cirrhosis, n=10;chronic hepatitis, n=6) were studied by contrast-enhanced coded phase inversion harmonic sonography (GE LOGIQ9 series) using a 6-8 MHz convex-arrayed wide-band transducer. The images of peripheral hepatic artery,portal and hepatic vein were observed in real-time for about 2 min after intravenous injection of Levovist. The time when microbubbles appeared in the peripheral vessels (microbubble arrival time) was also recorded. The morphologic changes of peripheral hepatic vasculature were classified as marked, slight, and no changes based on the regularity in caliber, course, ramification, and the delineation of vessels compared to normal subjects.RESULTS: The microbubble arrival time at peripheral artery, portal, and hepatic vein was shorter in cirrhotic patients than in chronic hepatitis patients and normal subjects. The marked, slight and no morphologic changes of peripheral hepatic vasculature found in 5 (5/6,83.3%), 1 (1/6, 16.7% ), and 0 (0/6, 0%) liver cirrhosis patients, respectively, and in 1 (1/10, 10%), 6 (6/10,60%), and 3 (3/10, 30%) chronic hepatitis patients,respectively. There was a significant difference between the two groups (P＜0.001).CONCLUSION: Evaluation of the hemodynamics and morphology of peripheral hepatic vasculature by contrast-enhanced coded pulse inversion harmonic sonography can provide useful information for the diagnosis of liver cirrhosis.展开更多
AIM: To investigate the value of contrast-enhanced C3-MODE technology in differentiating malignant nodules of liver from the benign ones. METHODS: Forty-six nodules in 36 patients (29 men and 7 women) were studied by ...AIM: To investigate the value of contrast-enhanced C3-MODE technology in differentiating malignant nodules of liver from the benign ones. METHODS: Forty-six nodules in 36 patients (29 men and 7 women) were studied by contrast-enhanced C3-MODE technology and contrast-enhanced CT in 1 wk before the biopsy or operation. A low MI monitor and a high MI flash imaging were intermittently performed. After the injection of contrast agent, the period from 10 to 30 s and the time later than 100 s were respectively defined as early arterial phase and the late phase. The vascularities of the liver nodules in the two phases were combined for differential diagnosis. Corresponding to the pathological diagnosis, the accuracy, sensitivity and specificity of contrast-enhanced C3-MODE technology were compared to those of contrast-enhanced CT. RESULTS: By C3-MODE technology, 33 of the 46 liver nodules were demonstrated as defected area in the late phase and were diagnosed as malignant tumors. Of them, 28 with hypervascularity in the early arterial phase were assessed as hepatocellular carcinoma, the other five nodules with rim-like enhancement in the early arterial phase were diagnosed as metastatic tumors. Thirteen nodules were shown as iso or hypervascularity in the late phase as well as centripetal filling in the early arterial phase and we made a diagnosis of hemangioma. Corresponding to the pathological results, the sensitivity, specificity and accuracy of contrast-enhanced C3-MODE technology in differentiating malignant and benign nodules in the liver were 97.0%, 92.3% and 95.7%, respectively. With comparison to those of contrast CT (sensitivity, 94.1%; specificity, 91.7%; accuracy, 93.5%), the difference was not significant. CONCLUSION: Contrast-enhanced C3-MODE technology can effectively differentiate malignant liver tumors from the benign nodules. It highly agrees diagnostically with the pathology. We suggest that it provides a new approach for differential diagnosis of liver nodules in addition to contrast-enhanced CT.展开更多
Biliary cystadenocarcinoma is a very rare malignant cystic tumor of the liver,which is often misdiagnosed due to a poor recognition of it.We report a case of a 60-year-old man with biliary cystadenocarcinoma with his ...Biliary cystadenocarcinoma is a very rare malignant cystic tumor of the liver,which is often misdiagnosed due to a poor recognition of it.We report a case of a 60-year-old man with biliary cystadenocarcinoma with his real time contrast enhanced ultrasound(CEUS)characteristics compared to those of computed tomography(CT)and magnetic resonance imaging(MRI),which were correlated with the surgical and pathologic findings.Cystic wall enhancement,internal septations and intra-cystic solid portions in the arterial phase were observed on CEUS after contrast agent injection.The enhancement was washed out progressively and depicted as hypo-enhancement in the portal and late phases.CT revealed a large irregular cystic lesion in the left liver lobe with no clear septations and solid components.MRI showed an irregular cystic occupying lesion with septations.展开更多
In order to evaluate the diagnostic value of three dimentional contrast enhanced MR angiography and MRI for pulmonary sequestration, 5 patients with pulmonary sequestration underwent 3D fast imaging by steady state ...In order to evaluate the diagnostic value of three dimentional contrast enhanced MR angiography and MRI for pulmonary sequestration, 5 patients with pulmonary sequestration underwent 3D fast imaging by steady state precession (FISP) with a contrast medium and breath holding following chest radiography, CT and MR scans. The reconstructed MR angiography was performed using maximum intensity projection (MIP) and multiplanar reconstruction (MPR) techniques. It was found that the chest radiography showed pulmonary sequestration as a persistent area of opacity in the posterior basal segment of the left lower lobe, which was close to mediastinum in 2 cases and close to diaphragma in 3 cases. CT revealed a soft issue mass beyond descending aorta and lobar emphysema around the pulmonary sequestration. And the supplying vessel was documented in 2 cases on enhanced CT. MRI demonstrated a hyperintensity mass with respect to normal lung parenchyma on T1WI and T2WI, and the origin of the supplying vessel in 3 cases. The reconstructed CE MRA using MIP or MRP techniques clearly showed the supplying vessel and its course, branches as well as draining vessels. It was concluded that 3D CE MRA of demonstrating the supplying and draining vessels to pulmonary sequestration, together with plain MRI, can provide a diagnosis and aid in surgical planning without the need for DSA.展开更多
BACKGROUND Many imaging methods such as ultrasonography,computed tomography(CT),magnetic resonance imaging,and endoscopy are used to identify the problems or complications that occur in the perioperative period and to...BACKGROUND Many imaging methods such as ultrasonography,computed tomography(CT),magnetic resonance imaging,and endoscopy are used to identify the problems or complications that occur in the perioperative period and to determine the appropriate therapeutic approach.Specialists at surgical clinics and intensive care units sometimes need diagnostic procedures that can give quick results or reveal unexpected results.In particular,rapid on-site evaluation of patients followed under intensive care conditions has several advantages.AIM To determine the problems developing in patients in the perioperative period by contrast-enhanced abdominal X-ray(CE-AXR),revealing their current status or defining the effectiveness of CE-AXR.METHODS The files of the patients who underwent hepatopancreatobiliary or upper gastrointestinal surgery,whose CE-AXR film was taken,were reviewed retrospectively.Abdominal X-ray radiographs taken after ingestion of a watersoluble contrast agent(iohexol,300 mg,50 cc vial)and its application in a drain,nasogastric tube,or stent were evaluated.The contribution of the data obtained in patients who underwent CE-AXR to the diagnosis,follow-up,and treatment processes and the effectiveness of the application were investigated.RESULTS CE-AXR was applied to 131 patients in our clinic,most of whom underwent hepatopancreatobiliary or upper gastrointestinal surgery.It was determined that the data obtained from CE-AXR films taken in 98(74.8%)of the patients contributed to the diagnosis,treatment,and follow-up expectations and positively affected the clinical processes.CONCLUSION CE-AXR is a simple procedure that can be applied anywhere,especially in intensive care patients and at bedside,with a portable X-ray device.The simplicity of the procedure,less radiation exposure for the patients,less time wastage,reduction in the CT and endoscopy procedure burden and costs,quick results,rapid assessment of the situation,and enabling the monitoring of processes with repetitive procedures are important advantages.X-rays taken will be useful in terms of being a reference value during the follow-up period of the patient and determining the situation in medicolegal processes.展开更多
The volume of contrast media to the creatinine clearance （V/CrCl） ratio correlate with the contrast-induced nephropathy （CIN）. The chronic kidney disease （CKD） more likely to develop CIN after primary percutaneo...The volume of contrast media to the creatinine clearance （V/CrCl） ratio correlate with the contrast-induced nephropathy （CIN）. The chronic kidney disease （CKD） more likely to develop CIN after primary percutaneous coronary intervention （PCI）. Objectiv has been shown to patients would be e To determine a relatively safe V/CrCl cutoff value to avoid CIN in CKD patients undergoing primary PCI. Methods We enrolled a total of 114 patients with CKD and calculated V/CrCl. Receiver-operator characteristic methods were used to identify the optimal sensitivity and specificity for the observed range of V/CrCl for CIN. We used multivariable logistic regression to assess the predictive value of V/CrCl for the risk of CIN in CKD patients. Results Overall, there were 24 cases （21%） of CIN. The baseline mean and median V/CrCl values were significantly greater among patients with CIN （mean 5.08 ±2.01, median 4.81, and interquartile range 3.53-6.33） than among those without CIN （mean 3.35 ±1.48, median 3.12, and interquartile range 2.27-4.14, P 〈 0.001）. The receiveroperator characteristic curve analysis indicated that a V/CrCl ratio of 3.62 was a fair discriminator for CIN （Cstatistic of 0.75） in CKD patients. After adjusting for other known predictors of CIN,a V/CrCl ratio 〉3.62 remained significantly associated with CIN in CKD patients（odds ratio 8.46,95% confidence interval 2.37-30.19, P 〈 0.001）. medium dose Conclusions based on the AV/CrCl ratio〉3.62 is a simple,useful indicator for determining the safe contrast pre-PCI CrCl values in CKDs.展开更多
AIM: To evaluate the effects of using CO2 as negative contrast agent in decreasing the overlapping on the pancreaticobiliary system from intestinal fluids.METHODS:We evaluated the magnetic resonance cholangiopancreato...AIM: To evaluate the effects of using CO2 as negative contrast agent in decreasing the overlapping on the pancreaticobiliary system from intestinal fluids.METHODS:We evaluated the magnetic resonance cholangiopancreatography(MRCP) images in 117 patients divided into two groups(group 1,without taking gas producing crystals to produce CO2,n=64;group 2,with CO2,n=53)in a 1.5T unit using MRCP sequence.Anatomic locations of intestinal fluids distribution,overlapping with common bile duct(CBD)and pancreatic duct(PD),were evaluated.RESULTS:In the group with CO2,the decrease in distribution of intestinal fluids was significant in the gastric antrum(P=0.001)and duodenal bulb(P<0.001),but not in the gastric fundus and body and in the second portion of the duodenum(P=1.000,P=0.171,and P=0.584 respectively).In the group with CO2,the decrease in overlapping with CBD was significant(P< 0.001),but the decrease in overlapping with PD was not (P=0.106).CONCLUSION:MRCP with carbon dioxide as negative contrast agent would decrease intestinal fluids in the gastric antrum and duodenal bulb,thereby decreasing overlapping with the CBD.展开更多
Purpose: The purpose of this study is to assess molecular interactions between several anticancer drugs and an iodinated contrast medium by Fourier transform infrared spectroscopy (FT-IR) and ultraviolet-visible spect...Purpose: The purpose of this study is to assess molecular interactions between several anticancer drugs and an iodinated contrast medium by Fourier transform infrared spectroscopy (FT-IR) and ultraviolet-visible spectroscopy (UV-Vis). Materials and Methods: Iopamidol (IPM) was used as an iodinated contrast medium, and mitomycin C (MTI), epirubicin hydrochloride (EPI), cisplatin (CDDP), 5-fluorouracil (5FU), irinotecan hydrochloride (CPT11), gemcitabine hydrochloride (dFdC), carboplatin (CBDCA), oxaliplatin (1OHP), paclitaxel hydrochloride (TAX) and docetaxel trihydrate (TXT) were used as anticancer drugs. For FT-IR, the purified IPM was mixed stoichiometrically with each anticancer drug as well as with a combination of MTI and EPI. After measuring each separated sample and the mixtures, the spectra of the mixtures were compared with the spectra of the sum of pure samples or the combination. For UV-Vis, IPM and anticancer drugs were dissolved in pure water;subsequently for the titration experiments, the mixtures were prepared by varying the molar ratio. IR absorption corresponds to stretching vibrations between atoms having covalent bonding, whereas UV-Vis spectra depend on molecular dynamics and shapes. Both UV-Vis and IR spectra change when there are molecular interactions such as aromatic ring stacking and hydrogen bonding. Result: IPM exhibited molecular interactions with MTI, EPI, CDDP, dFdC, CBDCA, 1OHP, TAX and TXT, as well as with the combination of MTI and EPI on FT-IR. However, molecular interactions were not observed on UV-Vis. Conclusion: Several anticancer drugs have molecular interactions with IPM, which could be clinically utilized for superselective intraarterial infusion chemotherapy.展开更多
Minimally invasive interventional surgery techniques using guidewire-based catheters are widely adopted to treat vascular diseases.However,commonly used interventional catheters lack active guidance.The use of guidewi...Minimally invasive interventional surgery techniques using guidewire-based catheters are widely adopted to treat vascular diseases.However,commonly used interventional catheters lack active guidance.The use of guidewires is associated with risks,including increased exposure to X-rays and potential vascular damage during withdrawal from complex vessels.Herein,we developed sub-millimeter microtubular ionic actuators(0.6-0.8 mm outer diameter)integrated into steerable interventional catheters.These actuators can generate large deformations(>10 mm)under 7 V direct current due to enhanced ion migration,enabling precise navigation without the need for guidewires.The designed catheters achieved active bending and accurate positioning in complex arterial vascular branches within a human model.They were also able to navigate within different arterial locations(e.g.,the innominate,subclavian,and carotid arteries)in pigs without the use of guidewires,and even access the ventricle and deliver contrast medium,indicating their great potential for future endovascular therapy.展开更多
文摘BACKGROUND Oil-based iodinated contrast media have excellent contrast properties and are widely used for hysterosalpingographic evaluation of female infertility.On abdominal radiography and computed tomography(CT)scans,their radiodensity is similar to that of metallic objects,which can sometimes lead to diagnostic confusion in the postoperative settings.In this case,retained oil-based contrast medium was observed on an abdominal radiograph following a cesarean section,making it difficult to differentiate from an intraperitoneal foreign body from surgery.The patient was a 37-year-old pregnant woman who was referred to our hospital at 32 weeks and 1 day of pregnancy due to complete placenta previa for mana-gement of pregnancy and delivery.An elective cesarean section was performed at 37 weeks and 3 days.A plain abdominal radiograph taken immediately after surgery revealed a near-round,hyperdense,mass-like shadow with a regular margin in the pelvic cavity.An intraperitoneal foreign body was suspected;therefore,an abdominal CT scan was performed.The foreign body was located on the left side of the pouch of Douglas and had a CT value of 7000 Hounsfield units,similar to that of metals.The CT value strongly suggested the presence of an artificial object.However,further inquiries with the patient and her previous physician revealed a history of hysterosalpingography.Accordingly,retained oil-based iodinated contrast medium was suspected,and observation of the object’s course was adopted.CONCLUSION When intraperitoneal foreign bodies are suspected on postoperative radiographs,the possibility of oil-based iodinated contrast medium retention should be considered.
文摘BACKGROUND Octreotide is widely used for the treatment of acromegaly,neuroendocrine tumors,and secretory diarrhea.However,long-term octreotide treatment can increase the incidence of gallstones.Vicarious contrast medium excretion(VCME)through the hepatobiliary system is well known.However,few studies have reported octreotide-induced acute gallstones following VCME.CASE SUMMARY A 69-year-old man presented with left lower back pain and hematuria caused by a fall.The patient had a history of polycystic kidney disease.VCME occurred following renal artery embolization for a ruptured polycystic kidney.After 5 d of treatment with octreotide,the patient developed acute gallstones and intrahepatic cholestasis which further induced pancreatitis and cholangitis.He was discharged after hemodialysis,antibiotics,and supportive treatments.CONCLUSION For patients with a high-risk of VCME,octreotide should be cautiously administered and carefully monitored.
文摘Objective To evaluate the feasibility of using a low concentration of contrast medium （Visipaque 270 mgl/mL）, low tube voltage, and an advanced image reconstruction algorithm in head and neck computed tomography angiography （CTA）. Methods Forty patients （22 men and 18 women; average age 48.7 ± 14.25 years; average body mass index 23.9 ± 3.7 kg/m^2） undergoing CTA for suspected vascular diseases were randomly assigned into two groups. Group A （n = 20） was administered 370 mgl/mL contrast medium, and group B （n = 20） was administered 270 mgl/mL contrast medium. Both groups were administered at a rate of 4.8 mL/s and an injection volume of 0.8 mL/kg. Images of group A were obtained with 120 kVp and filtered back projection （FBP） reconstruction, whereas images of group B were obtained with 80 kVp and 80% adaptive iterative statistical reconstruction algorithm （ASiR）. The CT values and standard deviations of intracranial arteries and image noise on the corona radiata were measured to calculate the contrast-to-noise ratio （CNR） and signal-to-noise ratio （SNR）. The beam-hardening artifacts （BHAs） around the skull base were calculated. Two readers evaluated the image quality with volume rendered images using scores from 1 to 5. The values between the two groups were statistically compared. Results The mean CT value of the intracranial arteries in group B was significantly higher than that in group A （P 〈 0.001）. The CNR and SNR values in group B were also statistically higher than those in group A （P 〈 0.001）. Image noise and BHAs were not significantly different between the two groups. The image quality score of VR images of in group B was significantly higher than that in group A （P = 0.001）. However, the quality scores of axial enhancement images in group B became significantly smaller than those in group A （P〈 0.001）. The CT dose index volume and dose-length product were decreased by 63.8% and 64%, respectively, in group B （P 〈 0.001 for both）. Conclusion Visipaque combined with 80 kVp and 80% ASiR provided similar image quality in intracranial CTA with 64% radiation dose reduction compared with the use of lopamidol, 120 kVp, and FBP reconstruc-tion.
文摘Manganese compound with evident toxicity is widely employed as the contrast medium for clinicalexaminations such as magnetic resonance imaging(MRI).In the present work,a feasible way with the applica-tion of vacuum impregnation and rotary evaporation was proposed to introduce manganese chloride hydrate intothe inner cavities of template - synthesized carbon nanotubes(CNTs),and then a process of alkali treatmentwas used to liberate the loaded CNTs from the template.It is notable that the alkali attack in the presence ofresidual oxygen also resulted in a series of changes in chemical compositions of vip substances,and the ulti-mate compound of manganese was found to be manganese oxide(Mn3O4) by X-ray diffraction and transmissionelectron microscopy.Determinations of energy dispersive spectrum under scanning electron microscopy showeda high-content filling(more than 50 wt%) of Mn3O4 in the loaded CNTs.This work developed a feasible andconvenient way for the encapsulation of vip substances to reduce bio-toxic effects.
文摘Contrast medium induced nephropathy is the third most common cause of renal failure for inpatients and represents the 10% of all acute kidney injury occurring during hospital-stay. It is associated with prolonged hospitalization, cost increase and, above all, an unfavourable short- and long-term prognosis. Here, the authors discuss about the contrast medium induced nephropathy prevention strategies, from the identification of patients at risk and drugs potentially nephrotoxic, to the hydration with possible administration of drugs that appeared to be, in some contexts, nephron-protective, and finally we analyze the radiological procedure aimed at the correct choice of type and administration modality of the contrast medium according to current literature.
基金National Natural Science Foundation of China,No.NSFC 81171389Key Program of Basic Research from Shanghai Municipal Science and Technology Commission,No.12JC1406500the Program of Shanghai Municipal Health Outstanding Discipline Leader,No.XBR 2013110
文摘AIM:To evaluate the feasibility of low contrast medium and radiation dose for hepatic computed tomography(CT) perfusion of rabbit VX2 tumor.METHODS:Eleven rabbits with hepatic VX2 tumor underwent perfusion CT scanning with a 24-h interval between a conventional tube potential(120 k Vp) protocol with 350 mg I/m L contrast medium and filtered back projection,and a low tube potential(80 k Vp) protocol with 270 mg I/m L contrast medium with iterative reconstruction.Correlation and agreement among perfusion parameters acquired by the conventional and low dose protocols were assessed for the viable tumor component as well as whole tumor.Image noise and tumor-to-liver contrast to noise ratio during arterial and portal venous phases were evaluated.RESULTS:A 38% reduction in contrast medium dose(360.1 ± 13.3 mg I/kg vs 583.5 ± 21.5 mg I/kg,P < 0.001) and a 73% decrease in radiation dose(1898.5 m Gy·cm vs 6951.8 m Gy·cm) were observed.Interestingly,there was a strong positive correlation in hepatic arterial perfusion(r = 0.907,P < 0.001;r = 0.879,P < 0.001),hepatic portal perfusion(r = 0.819,P = 0.002;r = 0.831,P = 0.002),and hepatic blood flow(r = 0.945,P < 0.001;r = 0.930,P < 0.001) as well as a moderate correlation in hepatic perfusion index(r = 0.736,P = 0.01;r = 0.636,P = 0.035) between the low dose protocol with iterative reconstruction and the conventional protocol for the viable tumor component and the whole tumor.These two imaging protocols provided a moderate but acceptable agreement for perfusion parameters and similar tumorto-liver CNR during arterial and portal venous phases(5.63 ± 2.38 vs 6.16 ± 2.60,P = 0.814;4.60 ± 1.27 vs 5.11 ± 1.74,P = 0.587).CONCLUSION:Compared with the conventional protocol,low contrast medium and radiation dose with iterative reconstruction has no significant influence on hepatic perfusion parameters for rabbits VX2 tumor.
文摘AIM: To provide the useful information for the diagnosis of liver cirrhosis by observing the morphology of peripheral hepatic vessels and the hemodynamics of microbubble arrival time in these vessels.METHODS: Twenty-one subjects including 5 normal volunteers and 16 patients (liver cirrhosis, n=10;chronic hepatitis, n=6) were studied by contrast-enhanced coded phase inversion harmonic sonography (GE LOGIQ9 series) using a 6-8 MHz convex-arrayed wide-band transducer. The images of peripheral hepatic artery,portal and hepatic vein were observed in real-time for about 2 min after intravenous injection of Levovist. The time when microbubbles appeared in the peripheral vessels (microbubble arrival time) was also recorded. The morphologic changes of peripheral hepatic vasculature were classified as marked, slight, and no changes based on the regularity in caliber, course, ramification, and the delineation of vessels compared to normal subjects.RESULTS: The microbubble arrival time at peripheral artery, portal, and hepatic vein was shorter in cirrhotic patients than in chronic hepatitis patients and normal subjects. The marked, slight and no morphologic changes of peripheral hepatic vasculature found in 5 (5/6,83.3%), 1 (1/6, 16.7% ), and 0 (0/6, 0%) liver cirrhosis patients, respectively, and in 1 (1/10, 10%), 6 (6/10,60%), and 3 (3/10, 30%) chronic hepatitis patients,respectively. There was a significant difference between the two groups (P＜0.001).CONCLUSION: Evaluation of the hemodynamics and morphology of peripheral hepatic vasculature by contrast-enhanced coded pulse inversion harmonic sonography can provide useful information for the diagnosis of liver cirrhosis.
基金Supported by the Science Foundation of the Department of Science and Technology of Guangdong Province, No. 2002C30315
文摘AIM: To investigate the value of contrast-enhanced C3-MODE technology in differentiating malignant nodules of liver from the benign ones. METHODS: Forty-six nodules in 36 patients (29 men and 7 women) were studied by contrast-enhanced C3-MODE technology and contrast-enhanced CT in 1 wk before the biopsy or operation. A low MI monitor and a high MI flash imaging were intermittently performed. After the injection of contrast agent, the period from 10 to 30 s and the time later than 100 s were respectively defined as early arterial phase and the late phase. The vascularities of the liver nodules in the two phases were combined for differential diagnosis. Corresponding to the pathological diagnosis, the accuracy, sensitivity and specificity of contrast-enhanced C3-MODE technology were compared to those of contrast-enhanced CT. RESULTS: By C3-MODE technology, 33 of the 46 liver nodules were demonstrated as defected area in the late phase and were diagnosed as malignant tumors. Of them, 28 with hypervascularity in the early arterial phase were assessed as hepatocellular carcinoma, the other five nodules with rim-like enhancement in the early arterial phase were diagnosed as metastatic tumors. Thirteen nodules were shown as iso or hypervascularity in the late phase as well as centripetal filling in the early arterial phase and we made a diagnosis of hemangioma. Corresponding to the pathological results, the sensitivity, specificity and accuracy of contrast-enhanced C3-MODE technology in differentiating malignant and benign nodules in the liver were 97.0%, 92.3% and 95.7%, respectively. With comparison to those of contrast CT (sensitivity, 94.1%; specificity, 91.7%; accuracy, 93.5%), the difference was not significant. CONCLUSION: Contrast-enhanced C3-MODE technology can effectively differentiate malignant liver tumors from the benign nodules. It highly agrees diagnostically with the pathology. We suggest that it provides a new approach for differential diagnosis of liver nodules in addition to contrast-enhanced CT.
文摘Biliary cystadenocarcinoma is a very rare malignant cystic tumor of the liver,which is often misdiagnosed due to a poor recognition of it.We report a case of a 60-year-old man with biliary cystadenocarcinoma with his real time contrast enhanced ultrasound(CEUS)characteristics compared to those of computed tomography(CT)and magnetic resonance imaging(MRI),which were correlated with the surgical and pathologic findings.Cystic wall enhancement,internal septations and intra-cystic solid portions in the arterial phase were observed on CEUS after contrast agent injection.The enhancement was washed out progressively and depicted as hypo-enhancement in the portal and late phases.CT revealed a large irregular cystic lesion in the left liver lobe with no clear septations and solid components.MRI showed an irregular cystic occupying lesion with septations.
文摘In order to evaluate the diagnostic value of three dimentional contrast enhanced MR angiography and MRI for pulmonary sequestration, 5 patients with pulmonary sequestration underwent 3D fast imaging by steady state precession (FISP) with a contrast medium and breath holding following chest radiography, CT and MR scans. The reconstructed MR angiography was performed using maximum intensity projection (MIP) and multiplanar reconstruction (MPR) techniques. It was found that the chest radiography showed pulmonary sequestration as a persistent area of opacity in the posterior basal segment of the left lower lobe, which was close to mediastinum in 2 cases and close to diaphragma in 3 cases. CT revealed a soft issue mass beyond descending aorta and lobar emphysema around the pulmonary sequestration. And the supplying vessel was documented in 2 cases on enhanced CT. MRI demonstrated a hyperintensity mass with respect to normal lung parenchyma on T1WI and T2WI, and the origin of the supplying vessel in 3 cases. The reconstructed CE MRA using MIP or MRP techniques clearly showed the supplying vessel and its course, branches as well as draining vessels. It was concluded that 3D CE MRA of demonstrating the supplying and draining vessels to pulmonary sequestration, together with plain MRI, can provide a diagnosis and aid in surgical planning without the need for DSA.
文摘BACKGROUND Many imaging methods such as ultrasonography,computed tomography(CT),magnetic resonance imaging,and endoscopy are used to identify the problems or complications that occur in the perioperative period and to determine the appropriate therapeutic approach.Specialists at surgical clinics and intensive care units sometimes need diagnostic procedures that can give quick results or reveal unexpected results.In particular,rapid on-site evaluation of patients followed under intensive care conditions has several advantages.AIM To determine the problems developing in patients in the perioperative period by contrast-enhanced abdominal X-ray(CE-AXR),revealing their current status or defining the effectiveness of CE-AXR.METHODS The files of the patients who underwent hepatopancreatobiliary or upper gastrointestinal surgery,whose CE-AXR film was taken,were reviewed retrospectively.Abdominal X-ray radiographs taken after ingestion of a watersoluble contrast agent(iohexol,300 mg,50 cc vial)and its application in a drain,nasogastric tube,or stent were evaluated.The contribution of the data obtained in patients who underwent CE-AXR to the diagnosis,follow-up,and treatment processes and the effectiveness of the application were investigated.RESULTS CE-AXR was applied to 131 patients in our clinic,most of whom underwent hepatopancreatobiliary or upper gastrointestinal surgery.It was determined that the data obtained from CE-AXR films taken in 98(74.8%)of the patients contributed to the diagnosis,treatment,and follow-up expectations and positively affected the clinical processes.CONCLUSION CE-AXR is a simple procedure that can be applied anywhere,especially in intensive care patients and at bedside,with a portable X-ray device.The simplicity of the procedure,less radiation exposure for the patients,less time wastage,reduction in the CT and endoscopy procedure burden and costs,quick results,rapid assessment of the situation,and enabling the monitoring of processes with repetitive procedures are important advantages.X-rays taken will be useful in terms of being a reference value during the follow-up period of the patient and determining the situation in medicolegal processes.
基金supported by Guangdong Provincial Cardiovascular Clinical Medicine Research Fund support.Guangzhou,China(2009X41)
文摘The volume of contrast media to the creatinine clearance （V/CrCl） ratio correlate with the contrast-induced nephropathy （CIN）. The chronic kidney disease （CKD） more likely to develop CIN after primary percutaneous coronary intervention （PCI）. Objectiv has been shown to patients would be e To determine a relatively safe V/CrCl cutoff value to avoid CIN in CKD patients undergoing primary PCI. Methods We enrolled a total of 114 patients with CKD and calculated V/CrCl. Receiver-operator characteristic methods were used to identify the optimal sensitivity and specificity for the observed range of V/CrCl for CIN. We used multivariable logistic regression to assess the predictive value of V/CrCl for the risk of CIN in CKD patients. Results Overall, there were 24 cases （21%） of CIN. The baseline mean and median V/CrCl values were significantly greater among patients with CIN （mean 5.08 ±2.01, median 4.81, and interquartile range 3.53-6.33） than among those without CIN （mean 3.35 ±1.48, median 3.12, and interquartile range 2.27-4.14, P 〈 0.001）. The receiveroperator characteristic curve analysis indicated that a V/CrCl ratio of 3.62 was a fair discriminator for CIN （Cstatistic of 0.75） in CKD patients. After adjusting for other known predictors of CIN,a V/CrCl ratio 〉3.62 remained significantly associated with CIN in CKD patients（odds ratio 8.46,95% confidence interval 2.37-30.19, P 〈 0.001）. medium dose Conclusions based on the AV/CrCl ratio〉3.62 is a simple,useful indicator for determining the safe contrast pre-PCI CrCl values in CKDs.
文摘AIM: To evaluate the effects of using CO2 as negative contrast agent in decreasing the overlapping on the pancreaticobiliary system from intestinal fluids.METHODS:We evaluated the magnetic resonance cholangiopancreatography(MRCP) images in 117 patients divided into two groups(group 1,without taking gas producing crystals to produce CO2,n=64;group 2,with CO2,n=53)in a 1.5T unit using MRCP sequence.Anatomic locations of intestinal fluids distribution,overlapping with common bile duct(CBD)and pancreatic duct(PD),were evaluated.RESULTS:In the group with CO2,the decrease in distribution of intestinal fluids was significant in the gastric antrum(P=0.001)and duodenal bulb(P<0.001),but not in the gastric fundus and body and in the second portion of the duodenum(P=1.000,P=0.171,and P=0.584 respectively).In the group with CO2,the decrease in overlapping with CBD was significant(P< 0.001),but the decrease in overlapping with PD was not (P=0.106).CONCLUSION:MRCP with carbon dioxide as negative contrast agent would decrease intestinal fluids in the gastric antrum and duodenal bulb,thereby decreasing overlapping with the CBD.
文摘Purpose: The purpose of this study is to assess molecular interactions between several anticancer drugs and an iodinated contrast medium by Fourier transform infrared spectroscopy (FT-IR) and ultraviolet-visible spectroscopy (UV-Vis). Materials and Methods: Iopamidol (IPM) was used as an iodinated contrast medium, and mitomycin C (MTI), epirubicin hydrochloride (EPI), cisplatin (CDDP), 5-fluorouracil (5FU), irinotecan hydrochloride (CPT11), gemcitabine hydrochloride (dFdC), carboplatin (CBDCA), oxaliplatin (1OHP), paclitaxel hydrochloride (TAX) and docetaxel trihydrate (TXT) were used as anticancer drugs. For FT-IR, the purified IPM was mixed stoichiometrically with each anticancer drug as well as with a combination of MTI and EPI. After measuring each separated sample and the mixtures, the spectra of the mixtures were compared with the spectra of the sum of pure samples or the combination. For UV-Vis, IPM and anticancer drugs were dissolved in pure water;subsequently for the titration experiments, the mixtures were prepared by varying the molar ratio. IR absorption corresponds to stretching vibrations between atoms having covalent bonding, whereas UV-Vis spectra depend on molecular dynamics and shapes. Both UV-Vis and IR spectra change when there are molecular interactions such as aromatic ring stacking and hydrogen bonding. Result: IPM exhibited molecular interactions with MTI, EPI, CDDP, dFdC, CBDCA, 1OHP, TAX and TXT, as well as with the combination of MTI and EPI on FT-IR. However, molecular interactions were not observed on UV-Vis. Conclusion: Several anticancer drugs have molecular interactions with IPM, which could be clinically utilized for superselective intraarterial infusion chemotherapy.
基金the National Natural Science Foundation of China(No.52375293)the Research Fund of State Key Laboratory of Mechanics and Control for Aerospace Structures(Nanjing University of Aeronautics and astronautics,Nos.1005-IZD2300225 and IZD2400217)+2 种基金the Nanjing Life and Health Technology Special Project(No.202305031)the Clinical Competence Enhancement Project in Healthcare(No.JSPH-MB-2022-4)the Medical Engineering Translational Fund of Jiangsu Province Hospital(No.NM202402).
文摘Minimally invasive interventional surgery techniques using guidewire-based catheters are widely adopted to treat vascular diseases.However,commonly used interventional catheters lack active guidance.The use of guidewires is associated with risks,including increased exposure to X-rays and potential vascular damage during withdrawal from complex vessels.Herein,we developed sub-millimeter microtubular ionic actuators(0.6-0.8 mm outer diameter)integrated into steerable interventional catheters.These actuators can generate large deformations(>10 mm)under 7 V direct current due to enhanced ion migration,enabling precise navigation without the need for guidewires.The designed catheters achieved active bending and accurate positioning in complex arterial vascular branches within a human model.They were also able to navigate within different arterial locations(e.g.,the innominate,subclavian,and carotid arteries)in pigs without the use of guidewires,and even access the ventricle and deliver contrast medium,indicating their great potential for future endovascular therapy.
