Ohshima S, Matsuura O, Takeuchi N, Hattori R, Hashimoto J, Segawa A
Department of Urology, Shakaihoken Chukyou Hospital.
Hinyokika Kiyo. 1989 Aug;35(8):1457-62.
A randomized clinical trial was conducted to determine the optimum does of iohexol (iodine concentration 300 mgI/ml) as a contrast agent for excretory urography in screening outpatients. Cases were divided into two groups, 30 cases in Group A receiving 0.4 ml/kg of iohexol and 29 cases in group B receiving 0.8 ml/kg. Urography was performed at intervals of 5 minutes and 10 minutes following the injection. The diagnostic effectiveness of various X-ray images including nephrograms, the pyelocaliceal system, ureter and bladder were assessed. There was a significant disparity between the two groups during pyelocaliceal urography after 5 minutes, with a fair diagnosis attainable for 73.3% of group A versus 89.6% for group B (P less than 0.05), but after 10 minutes the rates for the two groups had evened out to 93.4% for group A and 96.6% for group B. During urography of the ureter after 5 minutes, only 16.6% of the cases in group A could be easily diagnosed against 51.7% of the cases in group B (P less than 0.05). However, after 10 minutes the rate for group A was up to 56.7% while the rate for group B was 82.8% (P less than 0.1). In the ureter after 5 minutes, non-diagnosable images constituted 26.7% of group A and 10.4% of group B, while after 10 minutes this had dropped to 16.6% for group A and 0% for group B. A comprehensive study of these results suggests that for diagnostic screenings which use iohexol as a contrast agent in excretory urography, optimal results may be obtained using iohexol in amounts of between 0.4 ml/kg and 0.8 ml/kg.
进行了一项随机临床试验，以确定碘海醇（碘浓度300mgI/ml）作为造影剂用于门诊筛查性排泄性尿路造影的最佳剂量。病例分为两组，A组30例接受0.4ml/kg碘海醇，B组29例接受0.8ml/kg。注射后分别于5分钟和10分钟进行尿路造影。评估包括肾图、肾盂肾盏系统、输尿管和膀胱在内的各种X线影像的诊断效果。5分钟后肾盂肾盏造影时两组间存在显著差异，A组诊断成功率为73.3%，B组为89.6%（P<0.05），但10分钟后两组的成功率趋于平衡，A组为93.4%，B组为96.6%。输尿管造影5分钟时，A组仅有16.6%的病例可轻松诊断，而B组为51.7%（P<0.05）。然而，10分钟后A组的诊断率升至56.7%，而B组为82.8%（P<0.1）。输尿管造影5分钟时，A组不可诊断影像占26.7%，B组占10.4%，而10分钟后A组降至16.6%，B组为0%。对这些结果的综合研究表明，在排泄性尿路造影中使用碘海醇作为造影剂进行诊断筛查时，使用0.4ml/kg至0.8ml/kg的碘海醇可能会获得最佳结果。
