• Title, Summary, Keyword: Contrast medium

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A Contrast Nephropathy in a Preterm Infant Following Preoperative Embolization of Giant Sacrococcygeal Teratoma

  • Lee, Byong Sop
    • Childhood Kidney Diseases
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    • v.21 no.1
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    • pp.26-30
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    • 2017
  • Newborn infants with huge and highly vascular sacrococcygeal teratoma (SCT) are frequently subjected to renal hypoperfusion secondary to high-output cardiac failure. Any underlying renal dysfunction is a significant risk factor for the development of contrast-induced nephropathy (CIN). However, reports on CIN in infants are rare. I report here a case of a premature infant born at 28 weeks and 3 days of gestation with a huge SCT who survived preoperative embolization and surgical resection but presented with persistent non-oliguric renal failure that was suggestive of CIN. During radiological intervention, a contrast medium had been administered at about 10 times the manufacturer-recommended dose for pediatric patients. Despite hemodynamic stabilization and normalization of urine output immediately following surgery, the patient's serum creatinine and cystatin-C levels did not return to baseline until 4 months after birth. No signs of reflux nephropathy were observed in follow-up imaging studies. Dosing guidelines for the use of a contrast medium in radiological interventions should be provided for infants or young patients.

Transient Global Aphasia with Hemiparesis Following Cerebral Angiography : Relationship to Blood Brain Barrier Disruption

  • Kim, Dong-Ha;Choi, Chang-Hwa;Lee, Jung-Hwan;Lee, Jae-Il
    • Journal of Korean Neurosurgical Society
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    • v.48 no.6
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    • pp.524-527
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    • 2010
  • Temporary disruption of the blood-brain barrier (BBB) after cerebral angiography is presumably caused by nonionic radiographic contrast medium (CM). We hereby report a case of 58-year-old woman who developed decreased mentality, global aphasia and aggravated right hemiparesis after cerebral angiography. Brain CT examination demonstrated gyriform enhancement throughout the left cerebral cortex and thalamus. MR diffusion did not reveal acute infarction. MR angiography did not show any stenosis, spasm or occlusion at the major cerebral vessels. Follow-up CT scan after 1 day did not show any gyriform enhancement. Worsened neurologic signs and symptoms were improved completely after 7 days. In the present study, disruption of the BBB with contrast medium after angiography seems to be the causative factor of transient neurologic deterioration.

The Precaution Duty and the Product Liability for Adverse Reactions to the Contrast Media (조영제 부작용에 대한 주의의무와 제조물책임)

  • Kang, Yeong-Han
    • Journal of radiological science and technology
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    • v.30 no.4
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    • pp.305-311
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    • 2007
  • Contrast medium is a useful drug for radiological examinations and usability of it gradually increases while it has some inevitable adverse reaction and it is difficult to predict the occurrence and the degree of adverse reactions. Although the patient consented permission for the use of contrast media, the hospital could not be exempted from the responsibility for the adverse contrast media reaction. During radiological contrast media examination, the radiologist and the contrast media producer have the duty of precaution, prediction and avoid adverse results. In addition, they have reliabi lity of patient remedy for neglecting the duty. Since contrast medium are manufactured or processed as movable properties, the manufacturers are bound to the product liability if damages occur due to the defects in pharmaceuticals. In consideration of the characteristics of product liability, it is necessary to demand high degree of duty of care and diligence from producer or to reduce patient's burden of proof in a product liability lawsuit. For securing compensation ability and liability implementation, products compensation liability insurance is required for contrast medium manufacturers. In conclusion, contrast medium producer has legal liability for adverse reactions and the contract concluded with producer and hospital including legal liability will reduce liability of hospital and radiologist, patient.

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Intravenous contrast media application using cone-beam computed tomography in a rabbit model

  • Kim, Min-Sung;Kim, Bok-Yeol;Choi, Hwa-Young;Choi, Yoon-Joo;Oh, Song-Hee;Kang, Ju-Hee;Lee, Sae-Rom;Kang, Ju-Han;Kim, Gyu-Tae;Choi, Yong-Suk;Hwang, Eui-Hwan
    • Imaging Science in Dentistry
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    • v.45 no.1
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    • pp.31-39
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    • 2015
  • Purpose: This study was performed to evaluate the feasibility of visualizing soft tissue lesions and vascular structures using contrast-enhanced cone-beam computed tomography (CE-CBCT) after the intravenous administration of a contrast medium in an animal model. Materials and Methods: CBCT was performed on six rabbits after a contrast medium was administered using an injection dose of 2 mL/kg body weight and an injection rate of 1 mL/s via the ear vein or femoral vein under general anesthesia. Artificial soft tissue lesions were created through the transplantation of autologous fatty tissue into the salivary gland. Volume rendering reconstruction, maximum intensity projection, and multiplanar reconstruction images were reconstructed and evaluated in order to visualize soft tissue contrast and vascular structures. Results: The contrast enhancement of soft tissue was possible using all contrast medium injection parameters. An adequate contrast medium injection parameter for facilitating effective CE-CBCT was a 5-mL injection before exposure combined with a continuous 5-mL injection during scanning. Artificial soft tissue lesions were successfully created in the animals. The CE-CBCT images demonstrated adequate opacification of the soft tissues and vascular structures. Conclusion: Despite limited soft tissue resolution, the opacification of vascular structures was observed and artificial soft tissue lesions were visualized with sufficient contrast to the surrounding structures. The vascular structures and soft tissue lesions appeared well delineated in the CE-CBCT images, which was probably due to the superior spatial resolution of CE-CBCT compared to other techniques, such as multislice computed tomography.

Detection for Contrast Media Extravasation using Bolus Tracking Systems of CT (CT Bolus Tracking System을 이용한 조영제의 혈관외유출 검출)

  • Kweon, Dae-Cheol;Lee, Yong-Gu
    • Journal of the Institute of Electronics and Information Engineers
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    • v.53 no.9
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    • pp.137-142
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    • 2016
  • When injecting intravenously of CT inspection, the effusion of the contrast meium can induce the tissue damage with the blood vessel outside. We detect extravasation which is generated in the course where we inject the contrast medium into the blood vessel. And we use the bolus tracking system for the detection of that. By using MPR and VR images, moreover we detected the extravasation in order to prevent the tissue damage. In order to detect the effusion of the contrast medium, we used 16-MDCT and 64-MDCT. Three dimensional images about the outflow of the blood vessel can provide the treatment information which is important in the patient treatment. Moreover we applied the image processing technique in order to improve sharpness between contrast media and organization. And sharpness and contrast was improved.

High-Pitch Coronary CT Angiography at 70 kVp Adopting a Protocol of Low Injection Speed and Low Volume of Contrast Medium

  • Feng, Ruiqi;Tong, Jiajie;Liu, Xiaofei;Zhao, Yu;Zhang, Liang
    • Korean Journal of Radiology
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    • v.18 no.5
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    • pp.763-772
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    • 2017
  • Objective: To evaluate the feasibility and image quality (IQ) of prospectively high-pitch coronary CT angiography (CCTA) with low contrast medium injection rate at 70 kVp. Materials and Methods: One hundred and four patients with suspected coronary artery disease (body mass index < $26kg/m^2$, sinus rhythm and heart rate < 70 beats/min) were prospectively enrolled and randomly divided into two groups. In group A and group B, 28 mL and 40 mL of 370 mgI/mL iodinated contrast media was administrated at a flow rate of 3.5 and 5 mL/s, respectively. CT values, noise, signal-to-noise ratio, contrast-to-noise ratio (CNR) of the proximal segments of coronary arteries and subjective IQ were evaluated. Results: The CT values and noise in group A were significantly lower than those in group B (434-485 Hounsfield units [HU] vs. 772-851 HU, all p < 0.001; 17.8-22.3 vs. 23.3-26.4, all p < 0.005). The CNRs of the right coronary artery and left main artery showed no statistical difference between the two groups ($42.1{\pm}13.8$ vs. $36.8{\pm}16.0$, p = 0.074; $38.7{\pm}10.6$ vs. $38.1{\pm}17.0$, p = 0.819). No statistical difference was observed between the two groups in IQ scores ($3.04{\pm}0.75$ vs. $3.0{\pm}0.79$, p = 0.526) and diagnostic ratio (96.1% [50/52] vs. 94.2% [49/52], p = 0.647). Conclusion: Prospective high-pitch CCTA at 70 kVp with 28 mL of contrast media and injection rate of 3.5 mL/s could provide diagnostic IQ for normal-weight patients with heart rate of < 70 beats/min.

A Study on the Radiation Dose in Computed Tomographic Examinations (전산화단층촬영 검사의 방사선 선량에 관한 연구)

  • Lim, Chung-Hwang;Cho, Jung-Keun;Lee, Man-Koo
    • Journal of radiological science and technology
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    • v.30 no.4
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    • pp.381-389
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    • 2007
  • The purpose of this study is investigation of radiation dose in CT scan. Data were collected from various references and organizations. Doses measured by CT scanners of each medical organization were analyzed and they were calculated through the examination protocol. The results are as follows : 1. $CTDI_W$ value per 100mAs measured by Head Phantom was the highest in <4-slice MDCT scanner> of 24.20 mGy. $CTDI_W$ values were significantly different among scanner generations(p < 0.01). 2. $CTDI_W$ value per 100 mAs measured using body phantom was the highest in <4-slice MDCT scanner> of 13.58 mGy and the $CTDI_W$ values were significantly different among scanner generations(p < 0.01). 3. When contrast medium was not used, the highest scanner was <16 slice MDCT> of $818.83\;mGy{\codt}cm$ in exposure dose in brain scan(p < 0.05). When the contrast medium was used, the highest scanner was <4 slice MDCT> and its average was $1,460.77\;mGy{\cdot}cm$(p < 0.1). 4. When the contrast medium was not used, the highest scanner was <16-slice MDCT> of $521.63\;mGy{\cdot}cm$ on average in terms of the exposure dose in chest inspection(p<0.05). when the contrast medium was used, the highest scanner was found in 8 slice MDCT scanner and its average was $1,174.70\;mGy{\cdot}cm$. There was no statistically significant difference among scanners. 5. When the contrast medium was not used, the highest scanner was <16-slice MDCT> and its average was $856.27\;mGy{\cdot}cm$ in exposure dose on the abdomen-pelvis(p<0.05). when the contrast medium was used, the highest scanner was <16-slice MDCT> and its average was $1,720.64\;mGy{\cdot}cm$ on average (p < 0.05). 6. When the contrast medium was not used, the highest scanner was <8-slice MDCT> and its average was $612.07\;mGy{\cdot}cm$ in exposure dose in liver inspection(p < 0.05). when the contrast medium was used, the highest scanner was <8-slice MDCT scanner> and its average was $2,197.93\;mGy{\cdot}cm$ in exposure dose(p < 0.1). seventy six point two percent of medical facilities were in risk of radiation exposure while the number of phase was three to four times in their dose inspection of contrast medium.

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Cross-Borehole Incoherent Tomography for High-Contrast Cylindrical Cavity in Lossy Medium by Using Single-Frequency Time-Harmonic Signal (단일 주파수 시간조화 신호를 사용한 손실 매질내에 있는 high-contrast 원기둥 공동의 cross-borehole incoherent 단면영상법)

  • 강진섭
    • Journal of the Korean Institute of Telematics and Electronics D
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    • v.35D no.11
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    • pp.1-9
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    • 1998
  • In this paper, an incoherent imaging of a high-contrast cylindrical cavity in a lossy medium illuminated by the time-harmonic cylindrical wave is obtained via the backprojections of the intensity patterns of the forward total electric field in the cross-borehole measurement configuration. The phenomenon that the interference fringes in the intensity pattern, which are caused by the superposition of the incident field and the scattered field with different optical paths, are removed in the backprojection process is interpreted numerically. This imaging method is validated by imaging an air circular cylinder in a lossy medium of $\varepsilon$$_{r}$=9 and $\sigma$ = 0.0005, 0.002 S/m, and the conditions for obtaining better images are investigated.d.

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Study on Optimum Contrast Medium Quantity during Abdominal CT using Dual Energy Technique (복부 CT 검사 시 이중에너지 기법을 통한 적정한 조영제 양에 관한 연구)

  • Kang, Min;Choi, Namgil;Han, Jaebok;Kim, Wook;Jang, Yeongill;Song, Jongnam
    • Journal of the Korean Society of Radiology
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    • v.9 no.1
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    • pp.9-16
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    • 2015
  • The purpose of this study is finding optimum contrast medium quantity during abdominal CT using dual energy technique. The study subjects are 30 patients who had received general single energy abdominal CT and received double energy technique follow-up abdominal CT. dual energy technique abdominal CT images were obtained after setting contrast medium quantities at 30%, 40%, 50%, 60% and 70% of contrast medium quantity at the time of single energy technique. Then the contrast enhancement (Hounsfield Unit; HU) was estimated by setting-up the regions of interest at aorta, inferior vena cava, hepatic portal vein and hepatic parenchymal. The obtained values were compared to the values of the same parts measured during single energy technique abdominal CT. The results of the study were as following. The 60% set up group had HU in aorta : $210.80{\pm}13.609$, IVC : $190.40{\pm}25.215$, hepatic portal vein : $198.40{\pm}21.232$ and hepatic parenchymal : $119.20{\pm}7.98$, The single energy abdomianl CT images had HU in aorta : $205.40{\pm}16.426$, IVC : $188.20{\pm}21.476$, hepatic portal vein : $195.40{\pm}22.744$ and hepatic parenchymal : $121.00{\pm}6.595$. Therefore, it is possible to obtain contrast enhancement by dual energy technique abdominal CT similar to the same by single energy technique abdominal CT by setting-up the quantity of contrast medium at 60% of contrast medium at the time of single energy technique abdominal CT. Based on the result of this study, it is possible to decrease existing quantity of contrast medium by _% and the injection velocity can be also decreased. Accordingly, it is believed that the result of study would be quite useful for patients who have renal function disorder, weak vein or side effect of contrast medium in the past.

Organizational Liability for Adverse Reactions to the Contrast Media (조영제 부작용에 대한 조직책임)

  • Lim, Chang-Seon
    • Journal of radiological science and technology
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    • v.30 no.2
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    • pp.89-93
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    • 2007
  • Contrast medium is a very useful tool for X-ray examinations. But contrast medium has some unavoidable adverse reactions. For those patients who have never received contrast medium before, it is impossible to predict whether they will suffer from certain kinds of adverse reactions. Thus, radiologists should use strategies to minimize adverse events and be prepared to promptly recognize and manage any reactions to the contrast media. If a radiologist commits medical malpractice, he will face civil responsibility. Medical malpractice means a tort or breach of contract that occurs in a medical setting. Medical malpractices happen, despite the efforts of hospital staff. Many courts have applied the traditional doctrine of respondeat superior in actions against organizations for injuries caused by their employees. It is a legal doctrine, which states that an employer is responsible for employee actions performed within the course of the employment. A hospital is an organization for health purposes. An organization may be convicted of an offense committed by an employee of the organization acting in its behalf and within the scope of his office or employment. Organizational liability involves a wide variety of legal issues, including tort liability, wrongful employment practices, personal injury, breach of fiduciary duty, and so on. Many executive directors of organizations are aware of their personal and organizational risks of exposure to legal liabilities. The employer must have the right to control the physical conduct of the employee and must consent to receive the employee's services, while expecting some benefits from the services offered. Therefore, legal liability can be imposed for improper selection, assignment, training, and supervision of employees. In conclusion, the hospital itself has organizational liability for adverse reactions to the contrast medium.

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