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Spores and parasporal crystals of Bacillus thuringiensis can be separated at moderate centrifugation speeds (10,000 to 12,000 rpm) in gradients of Renografin or sodium diatrizoate.
Renal biopsies were performed in 211 patients which 10 days of excretory urography or renal arteriogrpahy in which diatrizoate, iothalamate or ioxithalamate had been used. In 47 renal specimens, osmotic nephrosis of the proximal tubular cells was found. Previous renal function had been normal in 10 patients, moderately impaired in 19, and severely impaired in 18. Tubular atrophy and/or necrosis was associated with histological features in 29 of 47 patients. Diffuse osmotic nephrosis was more often found in patients biopsied soon after roentgenography and also with severe renal insufficiency, but was not necessarily associated with declining renal function. The mechanism(s) by which contrast media may induce osmotic nephrosis remains unclear.
Myocardial imaging with 133-Xe and a gamma camera was employed to evaluate total and regional myocardial blood flow. The technique detected vasodilatation after injection of papaverine or diatrizoate. Contrast medium caused transient vasodilatation with return to baseline flow within five minutes. Myocardial tissue flow tended to decrease as coronary artery stenosis became more severe. There was overlap of flow measurements in patients with and without coronary artery disease. Coronary flow measurements made at rest are not considered to be an essential clinical tool. gpreater diagnostic benefit is obtained from the scintigram which distinguishes between akinesia caused by ischemia and akinesia due to extensive scarring.
A total of 450 brain examinations were performed using computed tomography before and after intravenous infusion of methylglucamine diatrizoate 30%. In 110 cases involving a documented intracranial lesion, the scans were analyzed to determine the degree and usefulness of contrast enhancement. Enhancement was achieved in a wide variety of neoplastic and non-neoplastic lesions and was found to be of considerable help in detection of abnormality as well as in defining tumor morphology.
The effects of isotonic solutions of three contrast agents, administered intrathecally, were studied in cats. A pronounced increase in the electrically evoked cortico-spinal responses and segmental spinal polysynaptic reflexes was recorded after administration of methylglucamine diatrizoate. Injection of methylglucamine iothalamate resulted in an increase of the amplitudes of these reflexes, while metrizamide did not show any consistent effect. The data suggest that water-soluble media have direct effects upon spinal gray matter.
Double contrast examination of the male urethra can be performed with a combination of sodium diatrizoate solution and air. In a patient with an anterior urethral diverticulum, improved definition of anatomic relationships was obtained.
Aortofemoral runoff angiography was performed 63 times in a total of 21 patients, each of whom was injected three times with different contrast materials (60% methylglucamine iothalamate, 78%) sodium methylglucamine iothalamate, and 76% sodium methylglucamine diatrizoate). Neither the examiner nor the patient was aware which contrast material was being given. Significantly fewer patients reported severe injection pain with methylglucamine iothalamate than with the other two agents.
Intravenous glucagon and diuresis caused by diagnostic doses of sodium diatrizoate were used to treat 5 patients with ureteral colic and urographic findings consistent with partial obstruction by a ureteral calculus. Pain was relieved and the calculus passed within two hours in 4 patients and within eight hours in the fifth. No complications were noted.
Sequential dynamic computed tomographic (CT) body scans were performed during administration of diatrizoate (intravascular bolus and infusion) in 18 cancer patients, three patients with cysts, and four rabbits with V2 carcinoma. The best diagnostic images occurred soon after the bolus was given (within 60--90 sec.). Tumors and normal tissue became isodense with drip infusions and on delayed scans. Tumors had increased CT numbers (mean, 29.2; range, 11--64); unchanging CT numbers helped identify cysts. Three cancer patients were scanned after both intravenous and intra-arterial injection of contrast media. Contrast enhancement and cancer CT numbers were highest after intra-arterial administration.
A neonate with herpes simplex encephalitis type 2 manifested progressively increasing density of the gray matter on serial computed tomographic scans. Postmortem examination of the brain proved the cause of the increased density to be a high concentration of iodine that had been retained following the intravenous administration of sodium diatrizoate 25 and 16 days previously. This demonstrates that a water-soluble iodinated contrast agent or its iodine component may be retained in the brain for a prolonged period of time. It is recommended that such agents be avoided when possible in neonates with herpes simplex encephalitis.
Enhancement of normal functioning myocardium was quantitated in 15 dogs by serial computed transmission tomographic (CT) images during the bolus (10 ml/sec.) or slow (1 ml/sec.) intravenous injection of diatrizoate contrast media (1 ml/kg body weight) in concentrations of 37, 18.5, or 9.25 g iodine (I)/dl. Homogenous images of myocardial enhancement were obtained. However, major streak artifacts were observed frequently when contrast material was injected as a bolus, and myocardial edges were not defined clearly when contrast material with a concentration of 9.25 g I/dl was injected slowly. Time-attenuation curves of normal myocardial enhancement constructed from serial CT images demonstrated a peak in contrast enhancement (delta Hounsfield units, 22-45) followed by a period of deterioration that lasted two to three minutes. These results can be applied to make optimal use of both single (static) and serial (dynamic) myocardial CT images.
Ten percent sodium diatrizoate, which is approximately isotonic with plasma, can be used with 60 kV radiography/fluoroscopy to visualize the stomach, small intestines, and colon of young infants.
Percutaneous ultrasound-guided puncture of the gallbladder (PUPG) is a new method for antegrade study of the gallbladder and the common bile duct. All procedures were scheduled immediately prior to planned surgery. Under ultrasound guidance, a 22-gauge sheathed needle was placed into the gallbladder lumen, and dilute (25% to 30%) diatrizoate meglumine (Hypaque) was injected. Indications in five patients included: evaluation of the common bile duct for calculi and/or obstruction, specifically in one patient who had hypersensitivity to intravenous contrast material; aspiration of bile for gram stain, crystal analysis, and cytology; evaluation of the gallbladder lumen for intraluminal masses; and to establish the anatomic site of an occult abscess. A small bile leak occurred in one patient who had no obstruction, and a more significant leak occurred in a patient who had obstructive jaundice and ampullary carcinoma. PUPG obviated the need for surgical intervention in three patients. Although the method has limited indications, we feel that it has great diagnostic potential in conditions related to the gallbladder and biliary ducts.
Investigations into the nature of severe and fatal reactions to contrast media have been severely limited by their unpredictable occurrence in the clinical setting and the absence of suitable laboratory models. The authors report their experience with a canine dehydration model. Intravenous administration of 2 ml/kg of 76% sodium methylglucamine diatrizoate resulted in vomiting, shock, inappropriate slowing of the heart rate, and death. ECG findings indicated suppression of sinoatrial node automaticity, a decrease in the rate of atrioventricular conduction, and depression of myocardial contractility. These results suggest two possible mechanisms: (a) enhanced vagal tone as the result of stimulation of the vasomotor center of the medulla or (b) accentuation of direct contrast-induced myocardial toxicity.
The effect of diatrizoate, ioxitalamate, metrizamide, and ioxaglate on the aortic endothelium of the rat was investigated using transmission electron microscopy and DNA synthesis autoradiography. One milliliter of each contrast medium, containing 300 mg iodine per ml, was injected into the aorta. The types of lesions seen on electron microscopy and the rate of DNA synthesis seen on autoradiography established the degree of endothelial damage that had been produced. Of the four contrast agents tested, ioxaglate produced the least amount of cellular change.
Hemodynamic effects of pulmonary arterial injections of ionic (sodium methylglucamine diatrizoate) and non-ionic contrast media (iohexol) were compared in 9 anesthetized dogs which were maintained with an open thorax in a resting control state. Both were found to increase pulmonary arterial pressure and cardiac output. In addition, both resulted in decreased systemic vascular resistance, though the effect was significantly less with the non-ionic agent. Aortic pressure did not change with the non-ionic agent but fell drastically with the ionic agent. Contrary to prevailing beliefs, the predominant response of the pulmonary circulation to contrast media was a fall rather than a rise in pulmonary vascular resistance.
The effects of right atrial injections of Renografin 76 (meglumine diatrizoate), hypertonic (5%) sodium chloride, and iohexol, a new nonionic contrast medium, on sequential measures of left atrial pressure and extravascular lung water in anesthetized dogs were studied. Renografin 76 caused significant transient elevations of extravascular lung water; control levels were reestablished at 15-20 minutes after injection. These changes occurred in the absence of significant changes in left atrial pressure. Iohexol reduced extravascular lung water slightly while hypertonic saline transiently increased it. The increased extravascular lung water after right atrial injections of ionic contrast medium can only partially be explained by the tonicity of the medium. This increase was not observed with nonionic medium, suggesting that nonionic media may be preferable imaging agents in patients with underlying lung or heart disease, and may be more suitable for digital intravenous examinations.
The computed tomographic (CT) appearance of splenic infarction has classically been described as peripheral, wedge-shaped, and low in density. Two investigations were designed to determine the appearance of splenic infarcts: (a) a clinical study of 12 patients and (b) a canine experimental model. In the clinical study, two previously undescribed patterns of splenic infarction were found. The classic peripheral, wedge-shaped defects were seen in four patients; multiple, heterogeneous lesions were seen in five; and massive hypodense lesions were noted in three. In three of the nine patients who had both precontrast and postcontrast CT scans, the unenhanced images alone would not have permitted the diagnosis. Contrast enhancement markedly improved infarct visualization in the remaining six. The experimental study of splenic infarction in dogs indicated that CT images can accurately depict the various phases of an infarct as it evolves through stages of congestion, hemorrhage, inflammation, organization, and fibrosis. In addition, a new contrast material--liposome-encapsulated diatrizoate--was used in one of the dogs and was found to produce greater and more sustained differences between normal and abnormal tissue than did conventional contrast material.