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PubMed1997

Iopentol (Imagopaque 350) compared with diatrizoate (Urografin 370) in cerebral CT. A clinical trial assessing immediate and late (7 days) adverse events and diagnostic information (visualization quality and Hounsfield unit measurements).

The non-ionic contrast medium iopentol (Imagopaque, Nycomed Imaging AS, Oslo, Norway) 350 mg I/ml was compared for safety and efficacy with the ionic contrast medium diatrizoate (Urografin, Schering AG, Berlin, Germany) 370 mg I/ml in a randomized, double-blind, parallel-group clinical trial in cerebral computed tomography (CT). The numbers of participating patients was 79; forty in the iopentol group and 39 in the diatrizoate group. Safety was evaluated by assessing the numbers of patients reporting immediate adverse events (up to 30 min after injection) and delayed adverse events (within 7 days after the examination). Efficacy was expressed as the quality of visualization of the cerebral lesions after injection of the contrast medium. In addition, Hounsfield units were measured pre- and post-contrast. No patient in either group experienced any serious adverse event. The frequency of patients with immediate adverse events was statistically significantly lower in the iopentol group (23%) than in the diatrizoate group (64%), p = 0.0003. Delayed adverse events were also significantly less frequent in the iopentol group (43%) than in the diatrizoate group (69%), p = 0.047. Patients in the iopentol group reported significantly less discomfort (53%), especially sensation of warmth, than patients in the diatrizoate group (92%), p = 0.0001. The intensity of adverse events and injection-associated discomfort seemed, in general, to be lower for patients in the iopentol group. No difference was found between the two contrast media regarding efficacy.

Brain↗
PubMed2002

Effects of intrathecal injection of diatrizoate on dopamine receptors.

RATIONALE AND OBJECTIVES: The authors performed this study to determine whether adverse reactions similar to those that occur in patients receiving antipsychotic medication may occur after inadvertent intrathecal injections of some contrast material. MATERIALS AND METHODS: Recombinant human dopamine-2 (D-2) receptors were incubated together with tritiated (hydrogen 3) spiperone, a D-2 receptor agonist commonly used in binding studies, and three types of contrast material (sodium/meglumine diatrizoate; meglumine iothalamate; and iohexol) in different concentrations to determine competitive binding potentials. Nonspecific binding was also assessed. Membranes were washed, filtered, and counted in a scintillation counter. RESULTS: At several different concentrations, diatrizoate demonstrated a potential to displace the binding of spiperone to the D-2 receptors, whereas the other two contrast materials tested (iothalamate meglumine and iohexol) showed only weak binding potentials. CONCLUSION: Diatrizoate, which has been incriminated in most adverse reactions resulting from the inadvertent intrathecal injection of a contrast material, may produce symptoms similar to those of the neuroleptic malignant syndrome by blocking neurotransmission through dopamine receptors. Although antipsychotic drugs produce this parkinsonism-like effect only after prolonged use, it is probable that diatrizoate produces the effect immediately by virtue of the high concentrations that may accumulate at the base of the brain after myelography. Also worthy of note is the fact that the two other contrast materials that have produced a number of reported adverse reactions share a molecular similarity to diatrizoate that is not found with other contrast materials.

Animals↗
PubMed1976

A comparison of the clearance of urographic contrast medium (sodium diatrizoate) by peritoneal and haemodialysis.

1. The clearance of isotopically labelled sodium diatrizoate by haemodialysis was measured in vitro, with simulated extracellular fluid, and in vivo in eleven patients, at varying rates of fluid or plasma flow. Clearance was also measured in five patients undergoing peritoneal dialysis. In all instances simultaneous measurements of urea clearance were made and the diatrizoate/urea clearance ratio was calculated. 2. In haemodialysis studies, diatrizoate and urea clearances showed a linear increase with increasing 'extracellular fluid' or plasma flow through the dialyser diatrizoate/urea clearance ratio fell. 3. The clearance of diatrizoate in vivo was slightly less than clearance in vitro at corresponding flow rates, but the diatrizoate/urea clearance ratio showed no significant difference. 4. Diatrizoate and urea clearances during peritoneal dialysis were very much lower than during haemodialysis but the diatrizoate/urea clearance ratios were within the same range. 5. The rapid removal of diatrizoate in patients with renal failure requires haemodialysis.

Diatrizoate↗
PubMedDate not supplied

Liposomes carrying diatrizoate. Characterization of biophysical properties and imaging applications.

We have prepared and characterized a suspension of liposomes carrying diatrizoate. Vesicles were made with egg lecithin, cholesterol, and stearylamine in a 4:1:1 molar ratio, and contained meglumine sodium diatrizoate in their aqueous phase. They ranged up to 2.0 microns in size and had a multilamellar structure. These vesicles were then injected into normal and tumor-bearing rats, as well as normal dogs and a baboon. The iodine component proved to have a prolonged blood pool residence time, was cleared through reticuloendothelial and urinary tissues, and was completely excreted within seven days. The LD50 in mice was 2.3 g I/kg (38.5 g of liposome suspension/kg). Imaging studies with diatrizoate-carrying liposomes demonstrated marked and prolonged contrast enhancement of blood pool, liver, spleen, kidneys, urine, and tumor rims. Furthermore, the blood, liver, and spleen opacification was greater and longer sustained than when an equivalent amount of iodine in free diatrizoate was used. These diatrizoate-carrying liposomes are particularly well suited for computed tomographic imaging of blood pool and reticuloendothelial structures.

Animals↗
PubMed1988

Do contrast media aggravate Fanconi's syndrome in rats? A comparison of diatrizoate, iohexol, and ioxilan.

Urine profiles (albumin, glucose, N-acetyl-beta-D-glucosaminidase [NAG], lactate dehydrogenase [LDH], L-gamma-glutamyltransferase [GGT], sodium, and phosphate) were followed for seven days after intravenous (IV) administration of either diatrizoate, iohexol, ioxilan, or saline in 24 Wistar rats with a tubular dysfunction induced by IV sodium maleate. Ioxilan and saline had a similar effect on albumin excretion, iohexol had an intermediate effect, and diatrizoate increased it significantly from day 2 to day 7. Glucosuria was significantly greater after diatrizoate than after the nonionic contrast media (CM) or saline. Diatrizoate delayed normalization of enzymuria, whereas iohexol and ioxilan did not. None of the CM affected urinary sodium or phosphate excretion. It is concluded that Fanconi's syndrome is significantly aggravated only by diatrizoate.

Animals↗
PubMed1989

Hemodynamic and electrocardiographic effects of ioversol during cardiac angiography. Comparison with iopamidol and diatrizoate.

We studied the hemodynamic and electrocardiographic responses to left ventriculography and coronary arteriography with three angiographic contrast agents. Two were nonionic agents (ioversol 32% iodine, 60 patients, and iopamidol 37% iodine, 30 patients). The third was a conventional ionic agent (diatrizoate 37% iodine, 30 patients). Cardiovascular hemodynamics and the electrocardiogram were recorded for 5 minutes after left ventricular injection and for 2 minutes after coronary injections. Following left ventriculography, diatrizoate caused a greater increase in cardiac output, left ventricular end diastolic pressure, and corrected QT interval while causing a greater decrease in arterial pressure than did either ioversol or iopamidol, which were indistinguishable from each other. Following left coronary arteriography, diatrizoate caused a significant decrease in heart rate, prolongation of the corrected QT interval, and increase in T wave amplitude. In contrast, neither ioversol nor iopamidol caused significant changes in any electrocardiographic parameters. Adverse reactions were more common with diatrizoate than with either ioversol or iopamidol. There were no recognizable differences in angiographic image quality among the three agents. We conclude that the angiographic performance of ioversol is equivalent to that of iopamidol and that both cause less hemodynamic and electrocardiographic disturbance than diatrizoate.

Blood Pressure↗
PubMed1991

A comparison of iohexol and diatrizoate-meglumine in children undergoing cardiac catheterization.

Iohexol (Omnipaque) and meglumine and sodium diatrizoate (Renografin-76) were compared in a double-blind, randomized study for their efficacy, safety, and hemodynamic effects as angiographic contrast agents in children. Forty-four children were randomly allocated to receive either iohexol or diatrizoate as a component of their routine or emergency cardiovascular evaluation. Following age stratification, baseline physiologic parameters were not significantly different between patients receiving either iohexol or diatrizoate. After systemic ventricular injection, iohexol produced significantly less hemodynamic alteration in systemic systolic blood pressure, systemic ventricular end-diastolic pressure, and dP/dt. Less alteration in heart rate and significantly less effect on the QT interval were seen with iohexol. Image quality was comparable, although significantly more patient mobility was associated with diatrizoate-meglumine. This study shows that iohexol, a nonionic contrast medium, causes less hemodynamic disturbance than diatrizoate-meglumine in children. Therefore, its use to be preferred in these potentially high-risk patients.

Adolescent↗
PubMed1991

Urine profiles and kidney histology following intravenous diatrizoate and iohexol in the degeneration phase of gentamicin nephropathy in rats. Effects on urine and serum profiles.

Urine chemical profiles were followed for three or nine days after intravenous injection of diatrizoate, iohexol, or saline in 30 rats, where a tubulointerstitial nephropathy was induced by gentamicin given over an eight-day period. Another ten rats injected with saline served as controls. Compared to injection of saline, both iohexol and diatrizoate induced dysfunction. The excretion of the cytoplasmic enzyme lactate dehydrogenase was significantly greater following iohexol than following diatrizoate. No significant differences between the two media were shown by the various serum components examined. Among the gentamicin-treated rats, light microscopy showed prolonged occurrence of tubular necrosis and a more intensive round cell infiltration following iohexol than following diatrizoate and saline. Both contrast media induced further temporary renal dysfunction in rats with gentamicin nephropathy; iohexol induced more morphologic changes than diatrizoate.

Animals↗
PubMed1980

Diatrizoate distribution in dogs as a function of administration rate and time following intravenous injection.

In this study, we determined diatrizoate concentrations in plasma and the extravascular space in dogs following an injection of the same dose of diatrizoate under three different conditions: (A) subsequent to a rapid bolus injection of diatrizoate: (B) subsequent to a bolus injection followed by an intravenous drip infusion; and (C) subsequent to a slow intravenous drip infusion. The data indicate that the highest plasma level occurred immediately after bolus injection (A). Significantly more diatrizoate was present in plasma 10 to 25 min from the start of an intravenous drip infusion given over 12.5 min (C) than when the same dose was given as a rapid bolus (A). The slow infusion method also resulted in significantly higher diatrizoate plasma levels from 15 to 25 min when compared to the bolus plus drip method (B). The differences in the calculated extravascular concentrations were insignificant among the three groups once all of the contrast material had been infused, i.e., after 12.5 min. The results are discussed in terms of their practical application to cranial computed tomography.

Animals↗
PubMed1976

Effect of dose on renal diatrizoate concentrations in experimental acute renal failure.

In rats with glycerol-induced acute renal failure (ARF) and controls, renal concentrations of 125I-labelled sodium diatrizoate were measured 5 min after intravenous doses ranging from 14 to 1,800 mg/kg body weight. Renal concentrations of diatrizoate, at all doses, were much higher in controls than in ARF. A linear relationship existed between dose and renal concentration in ARF. In controls, at doses above 225 mg/kg body weight, the fraction of the dose present in the kidneys diminished and renal iodine content approached that observed in ARF. Differences in diatrizoate concentration which existed between cortical and medullary zones in healthy kidneys at low dises were progressively eliminated as dosage increased, consistent with the osmatic fiutryiv rggrvy of diatrizoate. In ARF, the pattern of intrarenal distribution at all doses was similar to that seen in controls at high doses, though concentrations in outer cortex were consistently slightly higher than those in inner cortex. These observations suggest continuing though reduced, filtration of diatrizoate in ARF by glomeruli already subjected to a large solute load.

Acute Kidney Injury↗
PubMed1989

Anticoagulant effects of contrast materials: in vitro study of iohexol, ioxaglate, and diatrizoate.

It has been reported that clot formation may occur when blood is mixed directly with nonionic contrast medium in a syringe during angiography. To investigate this possibility, we performed three in vitro experiments to determine the anticoagulant properties of a low-osmolar, nonionic contrast medium (iohexol); a low-osmolar, ionic medium (ioxaglate); and a high-osmolar, ionic medium (diatrizoate). In the first experiment, human arterial blood was incubated at room temperature in an angiographic syringe with each of the three media for 60 min, after which the mixture was filtered for clots. In the second experiment, the clotting times of venous blood in heparinized saline or serial dilutions of the three agents were determined. In the third experiment, the partial thromboplastin time of platelet-poor plasma in heparinized saline or serial dilutions of the three agents was measured. No clots were observed in any of the arterial blood samples. Iohexol prolonged the normal 15-min clotting time of venous blood to 160 min, compared with a clotting time of at least 330 min for ioxaglate and diatrizoate. Iohexol prolonged the normal 36-sec partial thromboplastin time of platelet-poor plasma to 40 sec, compared with 50 sec for diatrizoate and 54 sec for ioxaglate. Our data show that iohexol, like ioxaglate and diatrizoate, inhibits clot formation when mixed with blood in a syringe. It prolongs the clotting time to approximately the same degree as 600 U/l of heparinized saline, but to a lesser degree than the other two media. All three media have a minimal effect on the partial thromboplastin time. Our results do not show any risk of clot formation in the usual clinical setting in which there is inadvertent mixing of blood with iohexol, ioxaglate, or diatrizoate in an angiographic syringe.

Angiography↗
PubMed2001

Effects in vivo of iohexol and diatrizoate on human plasma acetyl- and butyryl-cholinesterase activity.

PURPOSE: The aim of this study was to evaluate the effects of two iodinate contrast agents (CA), iohexol and diatrizoate, on human plasma acetyl-(AC) and butyrylcholinesterase(BC) activity. MATERIAL AND METHODS: Forty-eight patients (24 males and 24 females) scheduled for intravenous pyelography were randomly divided into four groups of 6 males and 6 females each, receiving as CA, respectively: iohexol (Omnipaque, Schering) 0.6 ml/kg body weight (G1); iohexol 1.2 mg/kg (G2); sodium and meglumine diatrizoate 58% (Urografin, Schering) 0.6 ml/kg (G3); sodium and meglumine diatrizoate 58% 1.2 ml/kg (G4). Blood samples were taken before and 5, 10, and 20 min after the injection. Enzymatic activity of AC and BC were measured by spectrophotometry. Plasma concentration of K, Na, Ca, and Mg was measured in all blood samples; blood pressure and plasma pH were measured after each sample collection. Statistical analysis was performed by Student's test. RESULTS: In G1 a reversible decrease of AC (12.9%) and BC (8.2%) plasma activity was observed at 10 min. In G2 a progressive decrease of AC (13.9%) and BC (18.4%) plasma activity was observed with a maximum at 20 min. In G3 a modest reversible decrease of BC plasma activity (5.4%) was observed. In G4 a modest progressive decrease of AC (7.3%) and BC (6.5%) plasma activities was observed. In all cases, AC and BC plasma activities remained within the normal range of values. Plasma concentration of K, Na, Ca, and Mg, as well as pH and systolic and diastolic pressure, did not show any change. No adverse effects was observed in our patients. CONCLUSIONS: Iohexol and diatrizoate induce in vivo a significant decrease of AC and BC plasma activities. The decrease is more pronounced for iohexol, a non ionic CA, which has a lower pharmacotoxicity than diatrizoate and adverse effects rate. No inference can be drawn about the relationship between plasma cholinesterase activity and adverse effects.

Butyrylcholinesterase↗
PubMedDate not supplied

Effect of diatrizoate on renal extraction of PAH in man.

The effect of diatrizoate on the renal extraction of para-amino hippurate (EPAH) was studied in 8 healthy male volunteers. The contrast medium was injected into an antecubital vein and into a renal vein in each individual. A single-injection technique for the determination of EPAH was used and EPAH was measured before and over a period of 30 min after each contrast medium injection. In addition, the renal extraction of diatrizoate was measured simultaneously. Small but significant and similar decreases in EPAH were observed after both antecubital and renal venous administrations of the contrast medium, with a duration of less than 30 min after the injection. The renal extraction ratio for the diatrizoate was 0.20. It is concluded that diatrizoate should not be used before the determination of EPAH, at least not until 30 min after the administration of the contrast medium. The decrease in EPAH caused by diatrizoate seems to be due to a direct tubular depressant effect.

Adult↗
PubMedDate not supplied

Reducing the risk of ventricular fibrillation by adding sodium to ionic and non-ionic contrast media with low iodine concentration. Coronary perfusion of the isolated rabbit heart with meglumine diatrizoate or iopentol at 140 mg I/ml and 0-154 mmol Na+/l.

To compare the fibrillatory propensity of low concentrations of contrast media (140 mg I/ml) the ionic, ratio 1.5, contrast medium meglumine diatrizoate, the non-ionic, ratio 3, medium iopentol and equimolar glucose (0.37 mol/l) were perfused into 35 isolated rabbit hearts. The three substances were compared at three levels of sodium concentration (0.77 and 154 mmol Na+/l). Meglumine diatrizoate without sodium caused the highest frequency of ventricular fibrillation (91%). Iopentol without sodium caused a significantly lower frequency of ventricular fibrillation (17%). Glucose without sodium caused no fibrillation. The addition of 77 or 154 mmol Na+/l significantly decreased the frequency of ventricular fibrillation of both meglumine diatrizoate (3% and 6%) and iopentol (0%). Meglumine diatrizoate with sodium added caused a lower frequency of ventricular fibrillation than iopentol without sodium. At equal sodium concentrations (0.77 and 154 mmol Na+/l) glucose caused smaller reduction in contractile force and heart rate than iopentol, and iopentol caused smaller reduction in contractile force and heart rate than diatrizoate. It is concluded that addition of sodium to ionic or non-ionic contrast media without sodium decreases the risk of ventricular fibrillation.

Angiocardiography↗
PubMed1988

High dose brain CT with ioxaglate and diatrizoate adverse reactions and effects on urine protein tests.

Sodium meglumine ioxaglate (320 or 306 mg I/ml) and meglumine diatrizoate (306 mg I/ml) in an intravenous dose of 2 ml/kg were compared in a randomized double-blind test on the brain CT of 209 patients. Side effects were noted in 56% of the ioxaglate group and 90% of the diatrizoate group. Diatrizoate caused a sensation of heat significantly more often and more intensely, but the frequencies of other side effects did not differ significantly. No severe reactions occurred. The quality of the CT scans was equal. Neither ioxaglate nor diatrizoate impaired renal function. False-positive strip tests and falsely elevated protein values measured by the biuretic method were found in particular in the ioxaglate group. The results of urine protein measurements and strip tests are misleading on the day of the examination with both ioxaglate and diatrizoate.

Adult↗
PubMed1988

The effect on the blood-brain barrier of intracarotid contrast media--iopamidol and diatrizoate.

The effect on the blood-brain barrier (BBB) was assessed following intracarotid injection of iopamidol (300 mgI/ml.), meglumine diatrizoate (305 mgI/ml.) and isotonic saline. Four ml/kg of 2% Evans blue solution and 0.1 mCi 99m Technetium-DTPA (Tc-DTPA) were used as tracers. No blue staining was observed in the saline group. Three out of 10 animals showed blue staining in the iopamidol group. All ten animals showed blue staining in the diatrizoate group. There were statistical differences between the diatrizoate and the other two groups. Tc-DTPA extravasation was 0.37 +/- 0.13 (mean +/- SD) in the saline group, 1.29 +/- 0.77 in the iopamidol group and 3.88 +/- 1.67 in the diatrizoate group. Statistical differences were observed among three groups. These observations suggest that Tc-DTPA is very sensitive in detecting a subtle BBB injury and that iopamidol had a significantly smaller effect on the BBB than did meglumine diatrizoate.

Animals↗
PubMed2005

CT method for visualization of the appendix using a fixed oral dosage of diatrizoate--clinical experience in 525 cases.

PURPOSE: The purpose of this study is to determine if focused CT examinations of the pelvis, utilizing fixed oral dosage of diatrizoate contrast media, improve overall reader confidence in visualization of the appendix. MATERIALS AND METHODS: Five hundred and twenty-five patients referred for, rule out appendicitis, evaluations underwent focused CT examinations of the pelvis following fixed oral dosage of diatrizoate contrast media. A five-point scale was used to assess the effect of contrast enhancement of the distal small bowel, cecum, and appendix on overall reader confidence, and subsequent visualization of the appendix. RESULTS: Bowel preparation was ideal in 504 of 525 (96%) patients. Enhanced supine CT images following oral administration of fixed dosage of diatrizoate had consistently good scores for reader confidence for bowel opacification (4.8+/-0.1, P<0.005) and visualization of the appendix (3.7+/-0.1, P<0.005), at 50 min following oral contrast administration. This method improved visualization of the normal appendix in 446 of 504 (88%) patients, with a specificity of 99%. In a patients meeting CT criteria for appendicitis, 21 of 21 (100%) patients were proven at surgery. CONCLUSION: The use of fixed oral dosage of diatrizoate contrast media resulted in good overall reader confidence to visualize the appendix and peri-appendiceal area, in addition to high specificity and rapid transit time.

Administration, Oral↗
PubMed1985

Short-term hemodynamic effects of diatrizoate and ioxaglate contrast media in left ventriculography.

Short-term effects in left ventricular performance induced by two contrast media (low osmolar ioxaglate and high osmolar diatrizoate) were evaluated in 24 and 26 patients, respectively. In both groups a diagnosis of valvular heart disease with or without left ventricular disease had been made by noninvasive methods. Changes of hemodynamic data were evaluated in intervals of 20 sec for one min after left ventricular cineangiography. Heart rate increased following injection of both contrast media but was greater with diatrizoate for 20-60 sec (P less than 0.01). A difference in left ventricular systolic pressure was found during 0-60 sec (P less than 0.01), with a decrease in peak left ventricular systolic pressure using diatrizoate (P less than 0.01). In 16 patients without valvular insufficiency, the positive inotropic effect as shown by maximum positive left ventricular pressure slope was more pronounced for diatrizoate during the period of 40-60 sec (P less than 0.05). A decrease in left ventricle relaxation as shown by an increase in the time constant of pressure decay was found for both contrast media. There was no significant difference in relaxation time constant between the two contrast media. During the period of 20-40 sec, the increase in left ventricular end-diastolic pressure was more pronounced for ioxaglate (P less than 0.01) with no untoward consequences in our population of patients.

Adult↗