Gavant M L, Ellis J V, Klesges L M
Department of Radiology, University of Tennessee, College of Medicine, Memphis 38163.
Can Assoc Radiol J. 1992 Apr;43(2):111-5.
Because of improved patient tolerance and decreased risks of idiosyncratic reaction, low-osmolarity contrast media are increasingly used for excretory urography. However, physiologic differences among patients may affect the optimal time for acquiring diagnostic radiographs during the pyelographic phase of the examination. A prospective, randomized, physician-blinded comparative study of 60 adult patients was undertaken to determine if the time to peak opacification of the pyelocaliceal systems differs with different doses of nonionic and ionic contrast media. Three doses of contrast media were used: a high dose (based on body weight) of a high-osmolarity ionic contrast medium, a high dose (based on body weight) of a low-osmolarity non-ionic contrast medium and a lower, fixed dose of a low-osmolarity nonionic contrast medium. The diagnostic quality of the radiographs did not differ statistically with the dose or the contrast medium. However, acquiring an additional radiograph during abdominal compression greatly increased the chance of obtaining at least one radiograph with maximal diagnostic information during the pyelographic phase. Despite potential differences among contrast media in the degree of pyelocaliceal opacification or distension and diuresis, it is not necessary to modify the timing of film acquisitions during excretory urography when lower doses of low-osmolarity agents are administered.
由于患者耐受性提高且特异反应风险降低，低渗性造影剂越来越多地用于排泄性尿路造影。然而，患者之间的生理差异可能会影响在检查肾盂造影阶段获取诊断性X光片的最佳时间。对60名成年患者进行了一项前瞻性、随机、医生盲法比较研究，以确定肾盂肾盏系统造影剂峰值显影时间是否因非离子型和离子型造影剂剂量不同而有所差异。使用了三种造影剂剂量：基于体重的高渗性离子型造影剂高剂量、基于体重的低渗性非离子型造影剂高剂量以及较低的固定剂量低渗性非离子型造影剂。X光片的诊断质量在剂量或造影剂方面无统计学差异。然而，在腹部加压期间额外拍摄一张X光片极大地增加了在肾盂造影阶段获得至少一张具有最大诊断信息的X光片的机会。尽管造影剂在肾盂肾盏显影程度或扩张及利尿方面可能存在潜在差异，但当给予较低剂量的低渗性造影剂时，在排泄性尿路造影期间无需改变拍片时间。
