Tervahartiala P
Department of Diagnostic Radiology, Helsinki University Central Hospital, Finland.
Invest Radiol. 1992 Feb;27(2):114-8. doi: 10.1097/00004424-199202000-00003.
Morphologic studies on the effect of dehydration on contrast media (CM)-induced renal changes were done. Sixty-six healthy Wistar rats were deprived of water for 24 hours before the intravenous (i.v.) injection of 1.0 or 3.0 g iodine (I)/kg of high-osmolal diatrizoate, low-osmolal iopromide or iohexol, iso-osmolal iotrolan, or 0.2 or 0.6 g/kg of high-osmolal magnetic contrast agent, gadolinium-DTPA (Gd-DTPA). Control animals received physiologic saline. After 2 hours, the kidneys were fixed by perfusion for light and electron microscopy, and the morphologic changes were semi-quantitatively reviewed by two independent observers blinded to the treatment. The smaller dose of iohexol or iotrolan and the larger dose of all the CM induced in the proximal convoluted tubule (PCT) cells a statistically highly significant (P less than .001) or significant (Gd-DTPA; P less than .01) cytoplasmic vacuolization. The changes were most prominent (P less than .001) after treatment with iohexol and iotrolan. The results might be related to the higher urinary CM concentration after low- and iso-osmolal agents. Dehydration further potentiates higher CM concentration. The morphologic injury, when compared with the author's earlier findings on normal rats, was clearly intensified by dehydration.
开展了脱水对造影剂（CM）所致肾脏改变影响的形态学研究。66只健康的Wistar大鼠在静脉注射1.0或3.0克碘（I）/千克高渗泛影葡胺、低渗碘普罗胺或碘海醇、等渗碘曲仑，或0.2或0.6克/千克高渗磁性造影剂钆喷酸葡胺（Gd-DTPA）之前24小时禁水。对照动物接受生理盐水。2小时后，通过灌注固定肾脏用于光镜和电镜检查，由两名对治疗不知情的独立观察者对形态学改变进行半定量评估。较小剂量的碘海醇或碘曲仑以及所有造影剂的较大剂量均在近端小管（PCT）细胞中诱导出具有统计学高度显著性（P<0.001）或显著性（Gd-DTPA；P<0.01）的细胞质空泡化。在用碘海醇和碘曲仑治疗后，这些改变最为显著（P<0.001）。结果可能与低渗和等渗造影剂后较高的尿造影剂浓度有关。脱水进一步增强了较高的造影剂浓度。与作者早期对正常大鼠的研究结果相比，脱水明显加剧了形态学损伤。
