Two hundred abdominal computed tomographic (CT) scans in 200 patients, 100 performed with low osmolality contrast (ioversol 68%, 100 ml) and 100 performed with high osmolality contrast (diatrizoate meglumine 60%, 150 ml), were retrospectively evaluated for the presence of renal streak artifact. Contrast was administered by hand injection at a rate of approximately 1-2 ml/s and sequential scanning was employed. Of the scans performed with high osmolality contrast, 70% had no artifact, 28% had minimal artifact, and only 2% had marked artifact. Only 26% of the exams performed with low osmolality contrast were artifact-free, whereas 53% demonstrated minimal artifact and 21% demonstrated marked artifact. The likelihood of encountering renal streak artifact when using low osmolality contrast agents is almost seven times greater than when high osmolality contrast agents are used.
A retrospective study of 5,134 consecutive pediatric patients undergoing computed tomographic (CT) evaluation from January 1983 through December 1985 was conducted to analyze the need for sedation in a pediatric population; the safety, efficacy, and efficiency of various sedation regimens; and the pediatric radiologists' changing preference for certain sedatives. A marked preference for intravenous administration of pentobarbital sodium (Nembutal) evolved over the 3-year period analyzed. Intravenous Nembutal facilitated the most efficient use of available CT scanning time. Recovery times were reduced, and patient convenience was augmented. There were only two sedation failures in the 419 patients sedated with intravenous Nembutal, and there were no sedation-related complications.
One hundred consecutive children with blunt esophageal foreign bodies were treated with a non-operative method of foreign body removal utilizing a Foley catheter. Dislodgement was successful in 98 children. There were no complications. Performed properly, the technique is rapid and safe. It precludes hospitalization and the slight hazards of endoscopy and general anesthesia.
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