• Title, Summary, Keyword: Contrast medium

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Anaphylactic Shock Following Nonionic Contrast Medium during Caudal Epidural Injection

  • Lee, Sang Hyun;Park, Jae Woo;Hwang, Byeong Mun
    • The Korean Journal of Pain
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    • v.28 no.4
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    • pp.280-283
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    • 2015
  • Caudal epidural injection is a common intervention in patients with low back pain and sciatica. Even though the complications of fluoroscopically directed epidural injections are less frequent than in blind epidural injections, complications due to contrast media can occur. We report a case of anaphylactic shock immediately after injection of an intravenous nonionic contrast medium (iohexol) during the caudal epidural injection for low back pain and sciatica in a patient without a previous allergic history to ionic contrast media (ioxitalamate). Five minutes after the dye was injected, the patient began to experience dizziness, and the systolic blood pressure dropped to 60 mmHg. Subsequently, the patient exhibited a mild drowsy mental state. About 30 minutes after the subcutaneous injection of 0.2 mg epinephrine, the systolic blood pressure increased to 90 mmHg. The patient recovered without any sequela. Life-threatening complications after injection of intravenous contrast medium require immediate treatment.

A Case Report of Treatment of Numbness Associated with Contrast Medium Injection using Modified Samul-tang (조영제 투여 후 초발한 저린감에 대한 사물탕가미(四物湯加味) 치료 증례보고)

  • Kwon, Jung-yeon;Bae, Ji-yong;Kong, Kyung-hwan;Go, Ho-yeon
    • The Journal of Internal Korean Medicine
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    • v.40 no.5
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    • pp.983-989
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    • 2019
  • Objective: Many types of delayed adverse reactions, such as long-term numbness, occur after injecting contrast medium, but few clinical studies have reported effective treatments for these reactions. We report that herbal medicine can have a positive clinical effect in patients who have experienced long-term numbness after contrast medium injection. Method: A patient who had felt numbness in her head and whole limbs presented at Semyung University Korean Medicine hospital. Her numbness had first started 2 days after injection of contrast medium, and she had felt it constantly for almost 2 years. After admission at the hospital, she took "modified Samul-tang" herbal medicine (120 cc three times per day) from 29 January 2019 to 2 February 2019. We measured her numbness using a numeric rating scale (NRS) on 29 January and 2 February and we compared both scores to determine the degree of favorable and clinical effects of herbal medicine. Result: The NRS score for numbness was 5 for her head and limbs on the first day (29 January), but after 4 days (2 February), the NRS score decreased to 0 for her head and both arms and hands, and it decreased from 5 to 2 for both her legs and feet. Conclusion: Korean herbal medicine can have positive clinical effects on treating adverse reactions due to injection of contrast medium.

조영제 사용 전${\cdot}$후 불균질 조직 보정 알고리즘에 따른 선량변화에 대한 연구

  • Kim, Ju-Ho;Jo, Jeong-Hui;Lee, Seok;Jeon, Byeong-Cheol;Park, Jae-Il
    • The Journal of Korean Society for Radiation Therapy
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    • v.13 no.1
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    • pp.38-46
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    • 2001
  • Purpose : The aim of this study is to investigate the effect of tissue inhomogeneities when appling to contrast medium among Homogeneous, Batho and ETAR dose calculation method in RTP system. Method and Material : We made customized heterogeneous phantom it filled with water or contrast medium slab. Phantom scan data have taken PQ 5000 (CT scanner, Marconi, USA) and then dose was calculated in 3D RTP (AcQ-Plan, Marconi, USA) depends on dose calculation algorithm (Homogeneous, Batho, ETAR). The dose comparisons were described in terms of 2D isodose distribution, percent depth dose data, effective path length and monitor unit. Also dose distributions were calculated with homogeneous and inhomogeneous correction algorithm, Batho and ETAR, in each patients with different clinical sites. Results : Result indicated that Batho and ETAR method gave rise to percent depth dose deviation $1.5{\sim}2.7\%,\;2.3{\sim}3.5\%$ (6MV, field size $10{\times}10cm^2$) in each status with and without contrast medium. Also show that effective path lengths were more increase in contrast status (23.14 cm) than Non-contrast (22.07 cm) about $4.9\%$ or 10.7 mm (In case Hounsfield Unit 270) and these results were similary showned in each patient with different clinical site that was lung. prostate, liver and brain region. Concliusion : In conclusion we shown that the use of inhomogeneity correction algorithm for dose calculation in status of injected contrast medium can not represent exact dose at GTV region. These results mean that patients will be more irradiated photon beam during radiation therapy.

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Analysis of Adverse Reactions to Computed Tomography Contrast Medium (컴퓨터 단층촬영에 사용되는 조영제의 부작용 발생에 대한 분석)

  • Kwon, Ki-Soo;Jeong, Jae-Sim
    • Journal of Korean Biological Nursing Science
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    • v.6 no.2
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    • pp.57-68
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    • 2004
  • The contrast medium is very commonly used in more than 90% of computed tomography(CT) scans. It is difficult to predict the occurrence of adverse reactions and the degree of adverse reactions are diverse from mild urticaria, itching, nausea, vomiting to even cardiopulmonary arrest. The purpose of this study was to evaluate the symptoms, occurrence rate and risk factors of the adverse reactions in patients after contrast injection during CT examinations. Two hundreds sixty-five patients showed symptoms of adverse reactions out of 71,117 adult patients who received intravenous contrast administration during CT scans from January 2003 to December 2003 at a general hospital. Data was collected by reviewing adverse reaction records and electronic medical record. The results of this study were as follows; 1. Adverse reactions occurred in 265 out of a total of 71,117 patients(0.37%). Clinical symptoms of adverse reactions were most commonly dermatologic problems such as urticaria(69.81%) and itching(63.02%), followed by dyspnea(14.34%), dizziness(11.70%), nausea(6.79%), and vomiting(7.17%). 2. Anaphylactoid reactions occurred in 47 out of a total of 265 patients, and their pattern of symptoms were most commonly related to cardiovascular system(90.91%), followed by respiratory system(82.22%), gastrointestinal system(51.72%), and dermatologic system(16.51%). Eleven patients were transferred to emergency room for further treatment and two patients needed cardiopulmonary resuscitation. 3. The adverse reactions were significantly more common in women than in men(0.46% vs.0.32%, p=.003) and in type D contrast medium than the others(p<.001). The occurrence rate of adverse reactions was not significantly different according to the age and infusion speed of the contrast medium.

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Optimization of Protocol for Injection of Iodinated Contrast Medium in Pediatric Thoracic CT Examination (소아 흉부 CT검사에서 조영제 주입에 관한 프로토콜의 최적화)

  • Kim, Yung-Kyoon;Kim, Yon-Min
    • Journal of the Korean Society of Radiology
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    • v.13 no.6
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    • pp.879-887
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    • 2019
  • The purpose of this study is to establish a physiological injection protocol according to body weight, in order to minimize amount of contrast medium and optimize contrast enhancement in pediatric patients performing thoracic CT examinations. The 80 pediatric patients under the age of 10 were studied. Intravenous contrast material containing 300 mgI/ml was used. The group A injected with a capacity of 1.5 times its weight, and groups B, C and D added 5 to 15 ml of normal saline with a 10% decrease in each. The physiologic model which can be calculated by weight about amount of injection of contrast medium and normal saline, flow rate and delay time were applied. To assess image quality, measured average HU value and SNR of superior vena cava, pulmonary artery, ascending and descending aorta, right and left atrium, right and left ventricle. CT numbers of subclavian vein and superior vena cava were compared to identify the effects of reducing artifacts due to normal saline. Comparing SNR according to the contrast medium injection protocol, significant differences were found in superior vena cava and pulmonary artery, descending aorta, right and left ventricle, and CT numbers showed significant differences in all organs. In particular, B group with a 10% decrease in contrast medium and an additional injection of saline showed a low degree of contrast enhancement in groups with a decrease of more than 20%. In addition, the group injected with normal saline greatly reduced contrast enhancement of subclavian vein and superior vena cava, and the beam hardening artifact by contrast medium was significantly attenuated. In conclusion, the application of physiological protocol for injection of contrast medium in pediatric thoracic CT examinations was able to reduce artifacts by contrast medium, prevent unnecessary use of contrast medium and improve the effect of contrast enhancement.

Analysis on the Entrance Surface Dose and Contrast Medium Dose at Computed Tomography and Angiography in Cardiovascular Examination (심장혈관검사에서 전산화단층검사와 혈관조영검사의 입사표면선량 및 조영제 사용량에 관한 분석)

  • Seo, Young-Hyun;Han, Jae-Bok;Choi, Nam-Gil;Song, Jong-Nam
    • Journal of radiological science and technology
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    • v.39 no.4
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    • pp.535-541
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    • 2016
  • This study aimed to identify dose reduction measures by retrospectively analyzing the entrance surface dose at computed tomography and angiography in cardiovascular examination and to contribute the patients with renal impairmend and a high probability of side effects to determine the inspection's direction by measuring the contrast usages actually to active actions for the dose by actually measuring the contrast medium dose. The CTDIvol value and air kerma value, which are the entrance surface doses of the two examinations, and the contrast medium dose depending on the number of slides were compared and analyzed. This study was conducted in 21 subjects (11 males; 10 females) who underwent Cardiac Computed Tomographic Angiography (CCTA) and Coronary Angiography (CAG) in this hospital during the period from May 2014 to May 2016. The subject's age was 48~85 years old (mean $65{\pm}10$ years old), and the weight was 37.6~83.3 kg (mean $63{\pm}6kg$). Dose reduction could be expected in the cardiovascular examination using CCTA rather than in the examination using CAG. In terms of contrast medium dose, CAG used a smaller dose than CCTA. In particular, as the number of slides increases at CAG, the contrast medium dose increases. Therefore, in order to reduce the contrast medium dose, the number of slides suitable for the scan range must be selected.

Ultrasonographic appearance of stomach, pylorus and duodenum in relation to food intake and administration of contrast medium (개에서 사료섭취 및 조영제 투여에 따른 위, 유문부 및 십이지장의 초음파상)

  • Kim, Myung-cheol;Byun, Hong-sub;Park, Myeong-ho
    • Korean Journal of Veterinary Research
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    • v.37 no.2
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    • pp.445-450
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    • 1997
  • The purpose of this study is to determine the changes of ultrasonographic appearance of stomach, pylorus and duodenum in relation to food intake and administration of contrast medium in dogs. Ultrasonograms were obtained with 5.0MHz sector transducer. After placing the dogs in dorsal recumbency, scanning was performed at the 8th intercostal space. The mean inner diameter of stomach immediately after food intake, 2, 4 and 6 hours was 47.9, 51.5, 46.8 and 40.6mm, respectively. The diameter of pylorus immediately after food intake, 2, 4 and 6 hours was 7.4, 9.7, 8.9 and 6.0mm, respectively(p<0.01). The diameter of duodenum immediately after food intake 2, 4 and 6 hours was 12.5, 7.9, 11.9 and 11.8mm, respectively(p<0.01). Before administration of contrast medium, the mean inner diameter of stomach, pylorus and duodenum was 38.6, 7.2 and 9.5mm, respectively. After administration of contrast medium, the diameters of stomach, pylorus and duodenum was 42.8, 7.7 and 9.9mm, respectively. It may be concluded that the ultrasonographic values determined in this study can be used as references for the diagnosis of gastrointestinal disease in dogs.

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3D MDCT Reformation Findings of the Radiographic Contrast Medium Extravasation (조영제 혈관외유출 현상의 3D MDCT 재구성 영상)

  • Kweon Dae-Cheol;Kim Jeong-Koo
    • The Journal of the Korea Contents Association
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    • v.6 no.5
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    • pp.145-152
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    • 2006
  • Radiographic contrast medium may cause tissue injury by extravasation during intravenous automated injection during CT examination. A large - volume extravasation (140 mL) occurred in an adult during contrast-enhanced CT The patient had a swelling and injury on the dorsum right hand of intravenous catheter region. The extravasation injury site was determined by CT scanning. The extavasation compartment syndrome case was examined using four separate display techniques. These 3D MDCT findings might help to determine the best course of treatment for patient with contrast extravasation. 3D image reconstructions provide accurate views of high-resolution and soft-tissue imaging. This paper introduces extravasation with the radiography and 3D MDCT findings.

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Effects of Use of the Iodine Contrast Medium on Gamma Camera Imaging (요오드 조영제 사용이 감마카메라 영상에 미치는 영향)

  • Pyo, Sung-Jae;Cho, Yun-Ho;Choi, Jae-Ho
    • Journal of radiological science and technology
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    • v.39 no.4
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    • pp.557-564
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    • 2016
  • Effects of Gamma camera imaging on gamma ray counting rates as a function of use and density of the iodine contrast medium currently in primary use for clinics, and changes in gamma ray counting rates as a function of the contrast medium status upon attenuation correction using a CT absorption coefficient in an SPECT/CT attenuation correction will be considered herein. For experimental materials used $^{99m}TcO_4$ 370 MBq and Pamiray 370 mg, Iomeron 350 mg, Visipaque 320 mg, Bonorex 300 mg of iodine contrast medium. For image acquisition, planar imaging was consecutively filmed for 1, 2, 3, 4, 5 min, respectively, 30 min after administration of $^{99m}TcO_4$. while 60 views were filmed per frame for 20 min at 55 min for the SPECT/CT imaging. In planar imaging, the gamma ray counting rates as a function of filming time were reduced showing a statistically significant difference when mixed according to the type of contrast medium density rather than when the radioactive isotope $^{99m}TcO_4$ and the saline solution were mixed. In the tomography for mixing of the radioactive isotope $^{99m}TcO_4$ and saline solution, the mean counting rate without correction by the CT absorption coefficient is $182{\pm}26counts$, while the counting rate with correction by the CT absorption coefficient is $531.3{\pm}34counts$. In the tomography for mixing of the radioactive isotope $^{99m}TcO_4$ and the saline solution with the contrast medium, the mean values before attenuation correction by CT absorption coefficient were $166{\pm}29$, $158.3{\pm}17$, $154{\pm}36$, and $150{\pm}33counts$ depending on the densities of the contrast medium, while the mean values after attenuation correction were $515{\pm}03$, $503{\pm}10$, $496{\pm}31$, and $488.7{\pm}33counts$, showing significant differences in both cases when comparatively evaluated with the imaging for no mixing of the contrast medium. Iodine contrast medium affects the rate of gamma ray. Therefore, You should always be preceded before another test on the day of dignosis.

Influence of Intravenous Contrast Medium on Proton range and SOBP(Spread-Out Bragg peak) (조영제 사용이 양성자 Range와 SOBP(Spread-Out Bragg peak)에 미치는 영향)

  • Kim, Ho Sik;Choi, Seung Oh;Kim, Eun Sook;Jeon, Sang Min;Youm, Doo Seok
    • The Journal of Korean Society for Radiation Therapy
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    • v.26 no.2
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    • pp.183-189
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    • 2014
  • Purpose : Intravenous contrast medium is a substance used to enhance the contrast of normal tissues or malignant tissues within the body. For this reason, intravenous contrast media have been extensively used form treatment-planning CT. However, when the patient is receiving proton therapy, there is no contrast medium in that moment. In this study, evaluate the influence of intravenous contrast medium on proton range and Spread-Out Bragg peak(SOBP) in Treatment Planning System(TPS). Materials and Methods : Hounsfield Unit(HU) value were measured by 20 liver cancer patients with phase change. and evaluate the proton range and SOBP on 5 liver proton treatment plan. By using the hand made water phantom measure the proton range and SOBP on proton treatment plan with changing HU and Depth. Results : Changing value(Pre contrast, Arterial phase, Portal phase) in liver cancer patient were ($58{\pm}5.7$, $75{\pm}9.5$, $117{\pm}14.6$ for liver tissue) and ($40{\pm}6.1$, $279{\pm}49.0$, $154{\pm}22.8$ for aorta), respectively. The mean difference of range was 2.5mm and SOBP was 1.4mm according to HU change. In phantom study, proton range was shorter and SOBP was narrowed with increasing HU. Conclusion : We verify that HU change lead to range and SOBP change in TPS. Additional study is required to verify that change of HU make range and SOBP be changed in actual substance.