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碘海醇在心血管造影中的初步研究及临床评估方法——安全性评估参数的建立及影像学质量评估的可靠性

[Preliminary study and clinical evaluation method of ioversol in angiocardiography--establishment of safety evaluation parameters and reliability of radiographic quality evaluation].

作者信息

Matsuyama S, Kuribayashi S, Ide M, Shigeta A, Umemura J, Harada J, Yamada T, Himi K, Takemoto A, Morimoto S

机构信息

Department of Radiology, Tokai University School of Medicine.

出版信息

Nihon Igaku Hoshasen Gakkai Zasshi. 1990 Jun 25;50(6):620-36.

PMID:2235313
Abstract

A multi-center clinical study of a new nonionic iodinated contrast medium (ioversol) was performed in 26 patients undergoing left ventriculography (LVG) and coronary angiography (CAG) at four centers. The aims of this study were to try to establish a clinical evaluation method on contrast media in angiocardiography and to determine radiographic efficacy and safety of ioversol. The reliability of the method evaluating the radiographic quality of the contrast medium was also examined with statistical analysis. Excellent radiographic efficacy was observed with ioversol and morphological diagnosis was possible in all cases. The electrocardiograms (ST-segment deflection, T-wave amplitude, QT interval, corrected QT interval, arrhythmia and heart rate) and the hemodynamic parameters (left ventricular systolic and end diastolic pressures, left ventricular dp/dt max, aortic systolic and diastolic pressures) indicated no clinically significant changes. This study suggested that the monitoring of the ECGs and hemodynamic parameters for up to three minutes after injection of the contrast medium is sufficient for the evaluation in LVG and CAG, and that the monitoring in CAG during the first injection into each left and right coronary artery is also sufficient for the purpose. Heat sensation during injection was mild. A patient had a symptom of nausea after ioversol administration, but it was mild and transient and resolved spontaneously. There were no abnormal clinical laboratory data related to ioversol. The reliability of the radiographic quality evaluated by the individual clinical investigators was considered to be high and adaptable. However, the evaluation in the blinded cinefilms by the committee members involving all investigators would be more preferable for the higher objectivity. The study results suggest that ioversol is considered to be the efficacious and safe contrast medium for the cardiovascular angiography.

摘要

一项针对新型非离子型碘化造影剂(碘佛醇)的多中心临床研究在四个中心的26例接受左心室造影(LVG)和冠状动脉造影(CAG)的患者中进行。本研究的目的是尝试建立一种用于心血管造影中造影剂的临床评估方法,并确定碘佛醇的放射学有效性和安全性。还通过统计分析检验了评估造影剂放射学质量的方法的可靠性。使用碘佛醇观察到了出色的放射学效果,并且在所有病例中都能够进行形态学诊断。心电图(ST段偏移、T波振幅、QT间期、校正QT间期、心律失常和心率)和血流动力学参数(左心室收缩压和舒张末期压力、左心室dp/dt max、主动脉收缩压和舒张压)均未显示出临床上的显著变化。本研究表明,在注射造影剂后长达三分钟监测心电图和血流动力学参数足以用于LVG和CAG评估,并且在首次向左右冠状动脉各注射一次造影剂期间对CAG进行监测也足以达到该目的。注射过程中的热感较轻。一名患者在使用碘佛醇后出现恶心症状,但症状较轻且短暂,可自行缓解。没有与碘佛醇相关的异常临床实验室数据。由个别临床研究人员评估的放射学质量的可靠性被认为较高且适用。然而,由涉及所有研究人员的委员会成员对盲法电影胶片进行评估会更具客观性。研究结果表明,碘佛醇被认为是用于心血管造影的有效且安全的造影剂。

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