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Assessing the effectiveness of X–ray contrast media for abdominal computed tomographic examinations: comparison of four low–osmolality agents
Author(s) -
Marti–Bonmati L.,
Ronchera–Oms C. L.,
Espinós M. A.,
Jordán Y.,
Lucas A.
Publication year - 1995
Publication title -
journal of clinical pharmacy and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.622
H-Index - 73
eISSN - 1365-2710
pISSN - 0269-4727
DOI - 10.1111/j.1365-2710.1995.tb00632.x
Subject(s) - iopromide , iohexol , medicine , contrast medium , nuclear medicine , computed tomographic , iodinated contrast , contrast (vision) , intravenous contrast , radiology , abdominal aorta , aorta , computed tomography , surgery , renal function , artificial intelligence , computer science
SUMMARY The objective of this investigation was to assess the effectiveness of four iodinated X–ray contrast media for abdominal computed tomographic (CT) examinations. Fifty–three patients were prospectively randomized to receive iohexol 300 mgl/ml (100 ml, n = 17), ioversol 320 mgl/ml (100 ml, n = 13), iopromide 300 mgl/ml (75 ml, n = 12), or iopentol 300 mgl/ml (100 ml, n = 11) to perform a dynamic contrast–enhanced abdominal CT. Imageenhancement profiles for the liver, aorta, and vena cava were studied. The maximum liver enhancement, the time to maximum liver enhancement, and the area under the hepatic enhancement–time curve (AUC) were determined for each examination. Liver–enhancement profile showed significant differences between the four contrast agents, with lower values for iopromide towards the final part of the CT examination ( P < 0–05). Hepatic peak values were attained earlier for iopromide, although these were lower than those produced by any other of the agents evaluated in this study. Iopentol produced fast and intense hepatic peaks. Consequently, high AUC values were obtained with iopentol, low values were obtained with iopromide ( P < 0–05), although this can be explained by the lower amount of contrast medium contained in the commercial vial and administered to the patient (75 ml vs 100 ml). When normalized to a 100 ml dose, the AUC value for iopromide becomes even higher than the average of the other three agents ( P = 0–05). Ioversol, although available and administered as a more concentrated solution (320 mg/ml), was comparable to the less concentrated iohexol and iopentol (300 mgl/ml). In an attempt to measure overall radiographic efficacy, data were normalized per gram of iodine administered. Iopentol and iopromide showed higher liver CT enhancement capacity and lower cost per gram of iodine. We conclude that there are no striking differences in image–enhancing ability of the four contrast media to recommend one over another. Nevertheless, other factors should be considered when selecting a low–osmolality contrast agent, especially iodine content and volume of the commercial formulation, and the cost per gram of iodine.