• Journal of radiological science and technology
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• v.30 no.4
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• pp.305-311
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• 2007

Contrast medium is a useful drug for radiological examinations and usability of it gradually increases while it has some inevitable adverse reaction and it is difficult to predict the occurrence and the degree of adverse reactions. Although the patient consented permission for the use of contrast media, the hospital could not be exempted from the responsibility for the adverse contrast media reaction. During radiological contrast media examination, the radiologist and the contrast media producer have the duty of precaution, prediction and avoid adverse results. In addition, they have reliabi lity of patient remedy for neglecting the duty. Since contrast medium are manufactured or processed as movable properties, the manufacturers are bound to the product liability if damages occur due to the defects in pharmaceuticals. In consideration of the characteristics of product liability, it is necessary to demand high degree of duty of care and diligence from producer or to reduce patient's burden of proof in a product liability lawsuit. For securing compensation ability and liability implementation, products compensation liability insurance is required for contrast medium manufacturers. In conclusion, contrast medium producer has legal liability for adverse reactions and the contract concluded with producer and hospital including legal liability will reduce liability of hospital and radiologist, patient.

• Investigative Magnetic Resonance Imaging
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• v.15 no.2
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• pp.139-145
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• 2011

Purpose : To assess the frequency and severity of acute adverse reactions to intravenous administration of gadolinium-based contrast agents using computerized reporting system at a single large academic institution. Materials and Methods : We assessed data from electronic hospital information system from October 2008 to December 2010. Reactions were classified as mild, moderate, or severe. We compared the frequency of adverse reactions among three contrast agents (Gd-BT-DO3A, Gd-DTPA and Gd-EOB-DTPA). Results : The total number of administrated contrast agents was 33,600, and the number of administration of Gd-BT-DO3A, Gd-DTPA and Gd-EOB-DTPA were 20,824 (62%), 10,417 (31%) and 2,359 (7%), respectively. Total 39 adverse reactions were reported accounting for 0.1161% of all administrations. The incidences of adverse reactions were 0.1248% (26/39, 67%) for Gd-BT-DO3A, 0.0768% (8/39, 21%) for Gd-DTPA, and 0.2120% (5/39, 13%) for Gd-EOB-DTPA. The difference of frequencies of adverse reaction among three contrast agents was not significant. Most cases of the adverse effect were mild (35/39, 89.7%). Moderate and severe adverse reactions were encountered in two patients, respectively. Conclusion : Among Koreans, adverse effects were rare, and especially, moderate to severe adverse reactions were much rarer. There was no difference among the frequencies of adverse reactions caused by three different contrast agents.

• Journal of radiological science and technology
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• v.30 no.1
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• pp.39-46
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• 2007

The purpose of this study is to develop a critical pathway (CP) for the prevention of adverse reactions to contrast media for computed tomography. The CP was developed and implemented by a multidisciplinary group in Seoul National University Hospital. The CP was applied to CT patients. Patients who underwent CT scanning were included in the CP group from March in 2004. The satisfaction of the patients with CP was compared with non-CP groups. We also investigated the degree of satisfaction among the radiological technologists and nurses. The degree of patient satisfaction with the care process increased patient information(24%), prevention of adverse reactions to contrast media(19%), pre-cognitive effect of adverse reactions to contrast media(39%) and information degree of adverse reactions to contrast media(19%). This CP program can be used as one of the patient care tools for reducing the adverse reactions to contrast media and increasing the efficiency of care process in CT examination settings.

• Journal of radiological science and technology
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• v.30 no.2
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• pp.89-93
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• 2007

Contrast medium is a very useful tool for X-ray examinations. But contrast medium has some unavoidable adverse reactions. For those patients who have never received contrast medium before, it is impossible to predict whether they will suffer from certain kinds of adverse reactions. Thus, radiologists should use strategies to minimize adverse events and be prepared to promptly recognize and manage any reactions to the contrast media. If a radiologist commits medical malpractice, he will face civil responsibility. Medical malpractice means a tort or breach of contract that occurs in a medical setting. Medical malpractices happen, despite the efforts of hospital staff. Many courts have applied the traditional doctrine of respondeat superior in actions against organizations for injuries caused by their employees. It is a legal doctrine, which states that an employer is responsible for employee actions performed within the course of the employment. A hospital is an organization for health purposes. An organization may be convicted of an offense committed by an employee of the organization acting in its behalf and within the scope of his office or employment. Organizational liability involves a wide variety of legal issues, including tort liability, wrongful employment practices, personal injury, breach of fiduciary duty, and so on. Many executive directors of organizations are aware of their personal and organizational risks of exposure to legal liabilities. The employer must have the right to control the physical conduct of the employee and must consent to receive the employee's services, while expecting some benefits from the services offered. Therefore, legal liability can be imposed for improper selection, assignment, training, and supervision of employees. In conclusion, the hospital itself has organizational liability for adverse reactions to the contrast medium.

• Journal of the Korean Society of Radiology
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• v.17 no.3
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• pp.423-431
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• 2023

The purpose of this study is to analyze the factors affecting the classification of the severity of contrast media side effects based on the patient's body information using artificial intelligence techniques to be used as basic data to reduce the degree of contrast medium side effects. The data used in this study were 606 examiners who had no contrast medium side effects in the past history survey among 1,235 cases of contrast medium side effects among 58,000 CT scans performed at a general hospital in Seoul. The total data is 606, of which 70% was used as a training set and the remaining 30% was used as a test set for validation. Age, BMI(Body Mass Index), GFR(Glomerular Filtration Rate), BUN(Blood Urea Nitrogen), GGT(Gamma Glutamyl Transgerase), AST(Aspartate Amino Transferase,), and ALT(Alanine Amiono Transferase) features were used as independent variables, and contrast media severity was used as a target variable. AUC(Area under curve), CA(Classification Accuracy), F1, Precision, and Recall were identified through AdaBoost, Tree, Neural network, SVM, and Random foest algorithm. AdaBoost and Random Forest show the highest evaluation index in the classification prediction algorithm. The largest factors in the predictions of all models were GFR, BMI, and GGT. It was found that the difference in the amount of contrast media injected according to renal filtration function and obesity, and the presence or absence of metabolic syndrome affected the severity of contrast medium side effects.

• Journal of radiological science and technology
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• v.35 no.1
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• pp.51-57
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• 2012

In this experiment, we investigated 82 patients who suffered adverse reactions due to contrast medium. We selected the subjects out of 21,178 people who had an intravenous injection of contrast medium to undergo MDCT examination at one university hospital in Busan in 2007. As a result, the largest groups of the patients were as follows. 52.4% of the patients were male when classify by gender; 28.0% of the patients were 50's by age; 45% of the patients got when it was spring(April and March); 75.6% of the patients had a side effects when the speed of injection is 2.5mL/sec; 58.5% of the patients were suffered when the volume of injected contrast medium is over 130mL. Urticaria was the main symptom of side effect as 26.8%. And the main treatment for the effect was alleviating the symptoms before making patients to return home. Thus, practical preventive measures are needed as follows : use the OCS system to observe warning signs at risky patients, secure warming spaces for patients to cope with season changing, prepare enough emergency kits for the patients in danger, and establish CPR call systems, explain the risk of contrast medium and get agree about using contrast medium.

• Proceedings of the Korean Society of Radiological Science
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• 1991.05a
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• pp.8.3-9
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• 1991

• Journal of radiological science and technology
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• v.44 no.1
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• pp.47-52
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• 2021

The incidence of adverse reactions to iodide contrast media was found to have increased owing to their increased use in computed tomography, but the exact reasons were unknown. Based on reported iodide contrast media adverse reactions data, it is recommended to the components of iodide contrast media before use to minimize adverse reactions. It was found that the use of iopromide and iomeprol in iodide contrast media resulted in a higher incidences of death and threat of life resulting from adverse reactions than other ingredients. Patients who are administered iodide contrast media containing iopromide and iomeprol during the computed tomography test should be carefully examined by the relevant medical professional, as the significance of gender and age varies from component to component. As multiple iodide contrast agents are available, the use of an appropriate iodide contrast media will reduce the incidence of iodide contrast media adverse reactions.

• Journal of the Korean Society of Radiology
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• v.17 no.3
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• pp.417-422
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• 2023

In this study, normal saline was diluted with the contrast medium at a certain ratio for the purpose of reducing the image quality poor and side effects caused by the contrast medium during CT examination. At this time, by finding the energy level of DECT that can compensate for the decrease in contrast of the image according to the degree of dilution, the usefulness of applying DECT for compensating the difference in image contrast was investigated through comparative analysis by applying SNR, CNR, and SSIM. As a result, when a dilution ratio of 4 (contrast medium): 6 (normal saline) and the energy level of DECT of 65 keV were applied, the contrast difference was the most similar to that when using the undiluted contrast medium. At this time, SNR was 813.71 ± 37.6, CNR was the highest at 921.87 ± 17.1, and SSIM index was measured at 0.851, which is the most similar to 1. The results of this study are meaningful in providing basic information for finding the appropriate dilution rate and energy level for each examination site through future clinical studies. It is believed that it can be reduced.

• Journal of The Korean Radiological Technologist Association
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• v.29 no.1
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• pp.190-190
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• 2003