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Surgery

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Urology

Question
37 out of 129
 

Non-ionic contrast media used for urography is



A Diatrizoate
B Iodixanol

C Meglumine
D M. Sodium

Ans. B Iodixanol (REF. RADIOLOGY TECHNIQUES ADAMS 8TH EDITION. PG 245)

a. Contrast media is primarily divided into two categories, high osmolar contrast media (HOCM) and low osmolar contrast media (LOCM).

b. Most non-ionic agents are placed into the LOCM category while all ionic agents are in the HOCM category.

c. The introduction of contrast media into the vascular system causes water from body tissue (cells) to move into the vascular system in an attempt to equalize concentrations.

d. The contrast media particles draw plasma water towards them therefore, water from body tissue (cells) rapidly moves into the vascular system via the capillary membranes to balance or equalize the situation.

e. The blood vessels dilate in an attempt to compensate from the increased fluid volume.

f. Sometimes the fluid shift may be too dramatic for the vessels to handle therefore, fluid actually extravasates into the surrounding tissues.

g. The rapid fluid movement, especially water, throughout the vascular system is believed to contribute to pain associated with vessel dilation, flushing, damage to the vascular endothelium, red cell changes, nausea, vomiting, and dehydration.

h. The osmotic effect can cause the arteries of the kidneys to expand.

i. When the arteries expand vasoconstrictors are released to compensate for the artery expansion.

j. The vasoconstrictors constrict the arteries resulting in a rapid opening and closing action of the arteries.

k. The result of this action is a diminished blood supply to kidneys which can lead to total shut down of the kidneys.

High osmolar (ionic)

Ionic contrast media have higher osmolarity and more side-effects, such as diatrizoic acid, Telebrix, etc.

Commonly used iodinated contrast agents

Compound

Name

Type

Iodine content

Osmolality

Level

Ionic

Diatrizoate (Hypaque 50)

Monomer

300 mgI/ml

1550

High osmolar

Ionic

Metrizoate (Isopaque 370)

Monomer

370 mgI/ml

2100

High osmolar

Ionic

Ioxaglate (Hexabrix)

Dimer

320 mgI/ml

580

High osmolar

Low osmolar (non-ionic)

Non-ionic contrast media, have lower osmolarity and tend to have fewer side-effects, such as iohexol, iopromide, iodixanol, etc.

Commonly used iodinated contrast agents

Compound

Name

Type

Iodine content

Osmolality

Level

Non-ionic

Iopamidol (Isovue 370)

Monomer

370 mgI/ml

796

Low osmolar

Non-ionic

Iohexol (Omnipaque 350)

Monomer

350 mgI/ml

884

Low osmolar

Non-ionic

Ioxilan (Oxilan 350)

Monomer

350 mgI/ml

695

Low osmolar

Non-ionic

Iopromide (Ultravist 370)

Monomer

370 mgI/ml

774

Low osmolar

Non-ionic

Iodixanol (Visipaque 320)

Dimer

320 mgI/ml

290

Low osmola

Urology Flashcard List

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