Kaiser A M, Grady T, Gerdes D, Saluja M, Steer M L
Department of Surgery, Beth Israel Hospital, Harvard Medical School, Harvard Digestive Diseases Center, Boston, Massachusetts 02215, USA.
Dig Dis Sci. 1995 Jul;40(7):1547-53. doi: 10.1007/BF02285207.
Contrast-enhanced computed tomography provides diagnostic and prognostic information in patients with acute pancreatitis. To evaluate whether contrast medium may worsen the severity of acute pancreatitis, we have used a model of necrotizing pancreatitis induced by ligating the common bile-pancreatic duct in opossums. Animals were infused with either saline or an ionic contrast agent 48 and 96 hr after induction of pancreatitis. Hyperamylasemia, pancreatic edema, acinar cell fragility, and macroscopic evidence of pancreatitis were comparable in both experimental groups. The microscopic extent of inflammation was similar in both groups, whereas acinar cell injury/necrosis was less in the contrast group. We conclude that administration of this ionic contrast agent during early stages of necrotizing pancreatitis in the opossum does not worsen the disease severity. The concept that administration of contrast medium during early stages of pancreatitis is dangerous should not be accepted until additional experimental and clinical studies support its validity.
对比增强计算机断层扫描可为急性胰腺炎患者提供诊断和预后信息。为评估造影剂是否会加重急性胰腺炎的严重程度，我们采用了通过结扎负鼠胆总管诱导坏死性胰腺炎的模型。在胰腺炎诱导后48小时和96小时，给动物输注生理盐水或离子型造影剂。两个实验组的高淀粉酶血症、胰腺水肿、腺泡细胞脆性和胰腺炎的宏观表现相当。两组炎症的微观程度相似，而造影剂组的腺泡细胞损伤/坏死较少。我们得出结论，在负鼠坏死性胰腺炎早期给予这种离子型造影剂不会加重疾病严重程度。在有更多实验和临床研究支持其有效性之前，不应接受胰腺炎早期给予造影剂是危险的这一观念。
