Hall F M, Goldberg R P, Wyshak G, Kilcoyne R F
Radiology. 1985 Feb;154(2):339-41. doi: 10.1148/radiology.154.2.3966120.
This prospective study compares immediate and delayed patient discomfort in 177 patients following shoulder arthrography using intraarticular combinations of metrizamide, meglumine/sodium diatrizoate, meglumine diatrizoate, lidocaine, epinephrine, and air. Patients receiving conventional ionic monomeric positive contrast media had a 60% (90/150) incidence of moderate or severe delayed exacerbation of their baseline symptoms; only 14% (3/21) of patients receiving metrizamide, a nonionic contrast medium, had similar levels of postprocedural discomfort. Morbidity was somewhat diminished with the use of double-contrast (45%, 34/75) rather than single-contrast (75%, 56/75) examinations, and with avoidance of sodium-containing contrast agents or epinephrine. Nonionic or monovalent polymeric contrast media, despite their present high cost, may be the agents of choice if single-contrast arthrography is performed in joints (such as the shoulder, hip, and temporomandibular) associated with a high incidence of post-procedural pain.
这项前瞻性研究比较了177例接受肩关节造影术的患者在使用甲泛葡胺、葡甲胺/泛影葡胺钠、葡甲胺泛影葡胺、利多卡因、肾上腺素和空气进行关节内联合注射后的即时和延迟患者不适情况。接受传统离子型单体阳性造影剂的患者基线症状中度或重度延迟加重的发生率为60%（90/150）；而接受非离子型造影剂甲泛葡胺的患者中，只有14%（3/21）出现了类似程度的术后不适。使用双重造影（45%，34/75）而非单一造影（75%，56/75）检查，以及避免使用含钠造影剂或肾上腺素，发病率有所降低。非离子型或单价聚合型造影剂，尽管目前成本高昂，但如果在与术后疼痛高发相关的关节（如肩部、髋部和颞下颌关节）进行单一造影关节造影，可能是首选药物。
