Kaplan P A, Lieberman R P, Chu W K
Department of Radiology, University of Nebraska Medical Center, Omaha 68105.
AJR Am J Roentgenol. 1989 Dec;153(6):1225-7. doi: 10.2214/ajr.153.6.1225.
Decreasing or alleviating pain experienced by some patients during or after temporomandibular arthrography would make this relatively inexpensive and highly accurate technique more attractive. This is particularly true for those patients without access to MR or those whose referring physicians prefer arthrography to other techniques for diagnosing internal derangements. Ionic and nonionic contrast agents were compared in a randomized, double-blind trial to determine if pain could be decreased by using a nonionic contrast material. Forty patients received either Omnipaque 300 (nonionic, iohexol) or Hypaque 60 (ionic, diatrizoate meglumine). Radiographs were assessed for diagnostic quality, and patients were asked to note their level of discomfort. No significant differences between the agents were detected. Maximal discomfort was noted at 24 hr. Discomfort was classified as none, mild, or moderate, with no patients describing marked discomfort. This study does not support the use of nonionic contrast agents over the less expensive ionic agents for decreasing pain or improving film quality in temporomandibular joint arthrography.
减轻或缓解一些患者在颞下颌关节造影期间或之后所经历的疼痛，会使这项相对廉价且高度准确的技术更具吸引力。对于那些无法进行磁共振成像（MR）检查的患者，或者其转诊医生更倾向于使用关节造影而非其他技术来诊断关节内紊乱的患者而言，情况尤其如此。在一项随机双盲试验中，对离子型和非离子型造影剂进行了比较，以确定使用非离子型造影剂是否能够减轻疼痛。40名患者分别接受了欧乃派克300（非离子型，碘海醇）或泛影葡胺60（离子型，泛影葡胺）。对X线片的诊断质量进行了评估，并要求患者记录他们的不适程度。未发现两种造影剂之间存在显著差异。最大不适在24小时时被记录到。不适被分类为无、轻度或中度，没有患者描述有明显不适。这项研究不支持在颞下颌关节造影中使用非离子型造影剂而非价格较低的离子型造影剂来减轻疼痛或提高影像质量。
