Comparison of iohexol 300 and diatrizoate meglumine 60 for body CT: image quality, adverse reactions, and aborted/repeated examinations.

Bernardino, ME; Fishman, Eliot; Jeffrey, R. Brooke; Brown, Paul C.

doi:10.2214/ajr.158.3.1739017

Cited by 14 publications

(4 citation statements)

References 4 publications

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“…IV contrast also allows better evaluation of wall enhancement of appendix, differentiation of pelvic blood vessels from a retro-cecal appendix [ 19 ]. Contrast material cost and reaction risks are definite disadvantages [ 20 , 21 ], though no significant contrast reaction was seen in our study.…”

Section: Discussioncontrasting

confidence: 48%

Diagnostic Efficiency of Multidetector Computed Tomography in the Evaluation of Clinically Equivocal Cases of Acute Appendicitis with Surgical Correlation

Iqbal¹,

Sayani²,

Tahir³

et al. 2018

Cureus

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Acute appendicitis is one of the most frequent causes of lower abdominal pain and requires immediate surgical intervention. The diagnosis often poses a lot of challenge even to experienced surgeon. Those patients with equivocal symptoms may require different imaging modalities like radiography, contrast examination and ultrasound with limited utility. Multidetector computed tomography (MDCT) used in suspected acute appendicitis has, however, resulted in improved diagnostic accuracy and also reduction of negative surgeries.ObjectiveWe intend to determine the diagnostic efficiency of MDCT in clinically equivocal cases of acute appendicitis correlating it with surgical/histopathological findings.Materials and methodsA group of 116 patients was included in this study. Spiral MDCT was performed in all these cases after administration of oral and intravenous contrast. All these patients underwent surgery and the CT findings were correlated with histopathology. Out of these 116 patients, 60 patients were male and 56 female. The age range was from three to seventy years and mean age was 28+1 years.ResultsThe results proved that MDCT had a sensitivity of 97.5%, specificity of 97.0%, and accuracy of 97.4% for the diagnosis of appendicitis with one false positive and two false negative cases. The study showed 100% accuracy in diagnosing acute appendicitis in children. In 33 patients, an alternate cause was identified with CT. The alternate diagnosis made on CT findings was consistent with the final diagnosis in 27 (81.8%) of 33 patients in whom there was no evidence of acute appendicitis. The clinical diagnosis disagreed with the CT diagnosis in six patients (18.18%).ConclusionOur study verifies that MDCT plays an important role in evaluation and consequent management of equivocal cases of acute appendicitis. MDCT is also able to diagnose appendicitis or detect alternative diagnosis in pediatric population.

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Section: Discussioncontrasting

confidence: 48%

Diagnostic Efficiency of Multidetector Computed Tomography in the Evaluation of Clinically Equivocal Cases of Acute Appendicitis with Surgical Correlation

Iqbal¹,

Sayani²,

Tahir³

et al. 2018

Cureus

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“…Due to the extremely high solubility in polar protic solvents such as water (up to 1 g/mL), meglumine is widely used to increase the aqueous solubility of drugs such as quercetin in water and both gadolinium-based MR contrast agents , and iodinated contrast agents − for intravenous injection. , Frozen, DMSO-prepared fumaric acid samples became cloudy after thawing at room temperature, demonstrating limitation in its use. Its solubility decreases exponentially as the temperature decreases, which is a primary limiting factor to get highly concentrated solutions of the substrate necessary for human usage …”

Section: Discussionmentioning

confidence: 99%

Enhanced Solubility and Polarization of ¹³C-Fumarate with Meglumine Allows for In Vivo Detection of Gluconeogenic Metabolism in Kidneys

Huynh,

Erfani,

Al Nemri

et al. 2024

ACS Appl. Mater. Interfaces

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Hyperpolarized 13 C-labeled fumarate probes tissue necrosis via the production of 13 C-malate. Despite its promises in detecting tumor necrosis and kidney injuries, its clinical translation has been limited, primarily due to the low solubility in conventional glassing solvents. In this study, we introduce a new formulation of fumarate for dissolution dynamic nuclear polarization (DNP) by using meglumine as a counterion, a nonmetabolizable derivative of sorbitol. We have found that meglumine fumarate vitrifies by itself with enhanced water solubility (4.8 M), which is expected to overcome the solubilityrestricted maximum concentration of hyperpolarized fumarate after dissolution. The achievable liquid-state polarization level of meglumine-fumarate is more than doubled (29.4 ± 1.3%) as compared to conventional dimethyl sulfoxide (DMSO)-mixed fumarate (13.5 ± 2.4%). In vivo comparison of DMSO-and meglumine-prepared 50-mM hyperpolarized [1,4-13 C 2 ]fumarate shows that the signal sensitivity in rat kidneys increases by 10-fold. As a result, [1,4-13 C 2 ]aspartate and [ 13 C]bicarbonate in addition to [1,[4][5][6][7][8][9][10][11][12][13] C 2 ]malate can be detected in healthy rat kidneys in vivo using hyperpolarized meglumine [1,4-13 C 2 ]fumarate. In particular, the appearance of [ 13 C]bicarbonate indicates that hyperpolarized meglumine [1,4-13 C 2 ]fumarate can be used to investigate phosphoenolpyruvate carboxykinase, a key regulatory enzyme in gluconeogenesis.

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“…Although some radiologists appear to be casually aware of this phenomena, to our knowledge this is the first study which compares the incidence of renal streak artifacts produced by LOCA with those produced by HOCA during contrastenhanced abdominal CT. In fact, in a recently published large multi-institutional study which compared image quality in body CT when using iohexol 300 versus diatrizoate meglumine 60, the authors make no mention of degradation of image quality by renal streak artifact [12]. The problem of increased artifact when using LOCA for enhanced renal CT has been alluded to by Bosniak who pointed out that, in his experience, there is an increased number of artifacts when using LOCA and that these must be carefully evaluated when attenuation measurements are made as these artifacts can affect CT numbers and give a false indication of enhancement [2].…”

Section: Discussionmentioning

confidence: 99%

Renal streak artifact during contrast-enhanced CT: Comparison of low versus high osmolality contrast media

et al. 1993

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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.

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Comparison of iohexol 300 and diatrizoate meglumine 60 for body CT: image quality, adverse reactions, and aborted/repeated examinations.

Cited by 14 publications

References 4 publications

Diagnostic Efficiency of Multidetector Computed Tomography in the Evaluation of Clinically Equivocal Cases of Acute Appendicitis with Surgical Correlation

Diagnostic Efficiency of Multidetector Computed Tomography in the Evaluation of Clinically Equivocal Cases of Acute Appendicitis with Surgical Correlation

Enhanced Solubility and Polarization of ¹³C-Fumarate with Meglumine Allows for In Vivo Detection of Gluconeogenic Metabolism in Kidneys

Renal streak artifact during contrast-enhanced CT: Comparison of low versus high osmolality contrast media

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Comparison of iohexol 300 and diatrizoate meglumine 60 for body CT: image quality, adverse reactions, and aborted/repeated examinations.

Cited by 14 publications

References 4 publications

Diagnostic Efficiency of Multidetector Computed Tomography in the Evaluation of Clinically Equivocal Cases of Acute Appendicitis with Surgical Correlation

Diagnostic Efficiency of Multidetector Computed Tomography in the Evaluation of Clinically Equivocal Cases of Acute Appendicitis with Surgical Correlation

Enhanced Solubility and Polarization of 13C-Fumarate with Meglumine Allows for In Vivo Detection of Gluconeogenic Metabolism in Kidneys

Renal streak artifact during contrast-enhanced CT: Comparison of low versus high osmolality contrast media

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Enhanced Solubility and Polarization of ¹³C-Fumarate with Meglumine Allows for In Vivo Detection of Gluconeogenic Metabolism in Kidneys