• Journal of The Korean Radiological Technologist Association
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• v.30 no.1
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• pp.131-142
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• 2004

In this study, when intravenous contrast medium was injected in spiral CT study, the effects of injection volume, injection rate, injection mode, location and lumen of IV catheter on enhancement of contrast medium in aorta, portal vein and liver parenchym

• The Korean Journal of Pain
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• v.28 no.4
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• pp.280-283
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• 2015

Caudal epidural injection is a common intervention in patients with low back pain and sciatica. Even though the complications of fluoroscopically directed epidural injections are less frequent than in blind epidural injections, complications due to contrast media can occur. We report a case of anaphylactic shock immediately after injection of an intravenous nonionic contrast medium (iohexol) during the caudal epidural injection for low back pain and sciatica in a patient without a previous allergic history to ionic contrast media (ioxitalamate). Five minutes after the dye was injected, the patient began to experience dizziness, and the systolic blood pressure dropped to 60 mmHg. Subsequently, the patient exhibited a mild drowsy mental state. About 30 minutes after the subcutaneous injection of 0.2 mg epinephrine, the systolic blood pressure increased to 90 mmHg. The patient recovered without any sequela. Life-threatening complications after injection of intravenous contrast medium require immediate treatment.

• The Korean Journal of Pain
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• v.31 no.2
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• pp.125-131
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• 2018

Background: The thoracic transforaminal epidural block (TTFEB) is usually performed to treat herpes zoster or postherpetic neuralgia (PHN). Especially, multiple segmental involvements and approximate contrast medium spread range, according to volume, help to choose the proper drug volume in the transforaminal epidural block. This study investigated the contrast medium spread patterns of 1-ml to 3-ml TTFEBs. Methods: A total of 26 patients with herpes zoster or PHN were enrolled in this study. All participants received 1 ml, 2 ml, or 3 ml of contrast medium. Results were divided into Groups A, B and C based on the volume (1, 2, or 3 ml), with n = 26 for each group. After the injection of contrast medium, the spread levels were estimated in both the lateral and anteroposterior (AP) images using fluoroscopy. Results: The cephalad spread of contrast medium in the lateral image as expressed by the median (interquartile range) was 2.00 levels (1.00-2.00) for Group A, 2.50 (2.00-3.00) for Group B, and 3.00 (2.00-4.00) for Group C. The caudal spread level of contrast medium was 1.00 (1.00-2.00) for Group A, 2.00 (2.00-3.00) for Group B, and 2.00 (2.00-3.00) for Group C. There was ventral and dorsal spread of the 3-ml contrast medium injection in 88% (23/26) of cases in the lateral image. Conclusions: Injection of 3 ml of contrast medium through the foramina spread 6 levels in a cephalocaudal direction. Spread patterns revealed a cephalad preference. TTFEB resulted in dorsal and ventral spread in a high percentage of cases. This procedure may be useful for transferring drugs to the dorsal and ventral roots.

• The Journal of Internal Korean Medicine
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• v.40 no.5
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• pp.983-989
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• 2019

Objective: Many types of delayed adverse reactions, such as long-term numbness, occur after injecting contrast medium, but few clinical studies have reported effective treatments for these reactions. We report that herbal medicine can have a positive clinical effect in patients who have experienced long-term numbness after contrast medium injection. Method: A patient who had felt numbness in her head and whole limbs presented at Semyung University Korean Medicine hospital. Her numbness had first started 2 days after injection of contrast medium, and she had felt it constantly for almost 2 years. After admission at the hospital, she took "modified Samul-tang" herbal medicine (120 cc three times per day) from 29 January 2019 to 2 February 2019. We measured her numbness using a numeric rating scale (NRS) on 29 January and 2 February and we compared both scores to determine the degree of favorable and clinical effects of herbal medicine. Result: The NRS score for numbness was 5 for her head and limbs on the first day (29 January), but after 4 days (2 February), the NRS score decreased to 0 for her head and both arms and hands, and it decreased from 5 to 2 for both her legs and feet. Conclusion: Korean herbal medicine can have positive clinical effects on treating adverse reactions due to injection of contrast medium.

• Korean Journal of Digital Imaging in Medicine
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• v.10 no.2
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• pp.39-49
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• 2008

Extravasation of contrast material is a not infrequent complication of enhanced imaging studies and large volume extravasation may result in severe damage. Subcutaneous extravasation of the radiographic contrast medium is one of the complications of the contrast medium-enhanced procedures. Automated power injectors enable the contrast material to be delivered at a uniform high-flow-rate and as a nonfragmented bolus, and this is essential for many contrast material enhanced CT(computed tomography) applications. The major risk associated with the use of automated power injectors is the well known complication of contrast material extravasation at the injection site. Automated injection of CT contrast material can produce the compartment syndrome. Selection of the nonionic contrast material after careful evaluation of the intravenous administration site and monitoring of the patient during the use of a mechanical power injector may help minimize or prevent extravasation injuries. Early identification is important and conservative management is effective in most cases. Prevention of these injuries with the education of radiological technologist remains the ultimate aim.

• Journal of the Korean Society of Radiology
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• v.13 no.6
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• pp.879-887
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• 2019

The purpose of this study is to establish a physiological injection protocol according to body weight, in order to minimize amount of contrast medium and optimize contrast enhancement in pediatric patients performing thoracic CT examinations. The 80 pediatric patients under the age of 10 were studied. Intravenous contrast material containing 300 mgI/ml was used. The group A injected with a capacity of 1.5 times its weight, and groups B, C and D added 5 to 15 ml of normal saline with a 10% decrease in each. The physiologic model which can be calculated by weight about amount of injection of contrast medium and normal saline, flow rate and delay time were applied. To assess image quality, measured average HU value and SNR of superior vena cava, pulmonary artery, ascending and descending aorta, right and left atrium, right and left ventricle. CT numbers of subclavian vein and superior vena cava were compared to identify the effects of reducing artifacts due to normal saline. Comparing SNR according to the contrast medium injection protocol, significant differences were found in superior vena cava and pulmonary artery, descending aorta, right and left ventricle, and CT numbers showed significant differences in all organs. In particular, B group with a 10% decrease in contrast medium and an additional injection of saline showed a low degree of contrast enhancement in groups with a decrease of more than 20%. In addition, the group injected with normal saline greatly reduced contrast enhancement of subclavian vein and superior vena cava, and the beam hardening artifact by contrast medium was significantly attenuated. In conclusion, the application of physiological protocol for injection of contrast medium in pediatric thoracic CT examinations was able to reduce artifacts by contrast medium, prevent unnecessary use of contrast medium and improve the effect of contrast enhancement.

• Journal of the Korean Society of Radiology
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• v.15 no.5
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• pp.575-584
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• 2021

The aim of this study was to achieve optimal portal phase while reducing contrast medium by applying weight-based dose protocol compared to standard fixed dose protocol to performing of pediatric abdominal CT examination. Discovery 750HD (General Electric Medical Systems, Milwaukee, USA) was used, and a total of 167 children consisting of 85 men and 82 women under the age of 18 were studied. The group in which the 300 mgI/ml(Xenetix, Guerbet, France) contrast medium was fixedly injected at twice body weight and the group injected with physiological saline while gradually decreasing the injection amount by 10% while applying the weight-based protocol were distinguished. Also, the CT number and SNR of abdominal organs were compared and evaluated while changing the scan delay time. Subjective image quality of enhancement and beam-hardening artifacts of around the heart was assessed with five-point criterion. The group adapted weight-based protocol with 20% reduction in contrast medium was most similar in contrast enhancement in the group with fixed injection at twice body weight. Furthermore, the group with a delay time of 20% had the highest contrast enhancement effect, and the difference in CT attenuation coefficient from the group scanned immediately after injection of the contrast media. Therefore, the appropriate delay time after injection of the contrast agent increased the contrast enhancement of the parenchymal organ. In addition, the weight-based injection protocol with normal saline reduced artifacts around the heart, and the effect of contrast enhancement could be maintained. In conclusion, it is possible to reduce dosage of contrast media through the application of weight-based injection protocols and appropriate latency, and to characterize optimal portal phase imaging on pediatric abdominal CT.

• Imaging Science in Dentistry
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• v.45 no.1
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• pp.31-39
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• 2015

Purpose: This study was performed to evaluate the feasibility of visualizing soft tissue lesions and vascular structures using contrast-enhanced cone-beam computed tomography (CE-CBCT) after the intravenous administration of a contrast medium in an animal model. Materials and Methods: CBCT was performed on six rabbits after a contrast medium was administered using an injection dose of 2 mL/kg body weight and an injection rate of 1 mL/s via the ear vein or femoral vein under general anesthesia. Artificial soft tissue lesions were created through the transplantation of autologous fatty tissue into the salivary gland. Volume rendering reconstruction, maximum intensity projection, and multiplanar reconstruction images were reconstructed and evaluated in order to visualize soft tissue contrast and vascular structures. Results: The contrast enhancement of soft tissue was possible using all contrast medium injection parameters. An adequate contrast medium injection parameter for facilitating effective CE-CBCT was a 5-mL injection before exposure combined with a continuous 5-mL injection during scanning. Artificial soft tissue lesions were successfully created in the animals. The CE-CBCT images demonstrated adequate opacification of the soft tissues and vascular structures. Conclusion: Despite limited soft tissue resolution, the opacification of vascular structures was observed and artificial soft tissue lesions were visualized with sufficient contrast to the surrounding structures. The vascular structures and soft tissue lesions appeared well delineated in the CE-CBCT images, which was probably due to the superior spatial resolution of CE-CBCT compared to other techniques, such as multislice computed tomography.

• Korean Journal of Radiology
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• v.2 no.1
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• pp.28-36
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• 2001

Objective: To provide a systematic overview of the effects of various parameters on contrast enhancement within the same population, an animal experiment as well as a computer-aided simulation study was performed. Materials and Methods: In an animal experiment, single-level dynamic CT through the liver was performed at 5-second intervals just after the injection of contrast medium for 3 minutes. Combinations of three different amounts (1, 2, 3 mL/kg), concentrations (150, 200, 300 mgI/mL), and injection rates (0.5, 1, 2 mL/sec) were used. The CT number of the aorta (A), portal vein (P) and liver (L) was measured in each image, and time-attenuation curves for A, P and L were thus obtained. The degree of maximum enhancement (Imax) and time to reach peak enhancement (Tmax) of A, P and L were determined, and times to equilibrium (Teq) were analyzed. In the computed-aided simulation model, a program based on the amount, flow, and diffusion coefficient of body fluid in various compartments of the human body was designed. The input variables were the concentrations, volumes and injection rates of the contrast media used. The program generated the time-attenuation curves of A, P and L, as well as liver-to-hepatocellular carcinoma (HCC) contrast curves. On each curve, we calculated and plotted the optimal temporal window (time period above the lower threshold, which in this experiment was 10 Hounsfield units), the total area under the curve above the lower threshold, and the area within the optimal range. Results: A. Animal Experiment: At a given concentration and injection rate, an increased volume of contrast medium led to increases in Imax A, P and L. In addition, Tmax A, P, L and Teq were prolonged in parallel with increases in injection time The time-attenuation curve shifted upward and to the right. For a given volume and injection rate, an increased concentration of contrast medium increased the degree of aortic, portal and hepatic enhancement, though Tmax A, P and L remained the same. The time-attenuation curve shifted upward. For a given volume and concentration of contrast medium, changes in the injection rate had a prominent effect on aortic enhancement, and that of the portal vein and hepatic parenchyma also showed some increase, though the effect was less prominent. A increased in the rate of contrast injection led to shifting of the time enhancement curve to the left and upward. B. Computer Simulation: At a faster injection rate, there was minimal change in the degree of hepatic attenuation, though the duration of the optimal temporal window decreased. The area between 10 and 30 HU was greatest when contrast media was delivered at a rate of 2 3 mL/sec. Although the total area under the curve increased in proportion to the injection rate, most of this increase was above the upper threshould and thus the temporal window was narrow and the optimal area decreased. Conclusion: Increases in volume, concentration and injection rate all resulted in improved arterial enhancement. If cost was disregarded, increasing the injection volume was the most reliable way of obtaining good quality enhancement. The optimal way of delivering a given amount of contrast medium can be calculated using a computer-based mathematical model.

• The Korean Journal of Nuclear Medicine Technology
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• v.28 no.1
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• pp.23-29
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• 2024

Purpose: 99mTc-mebrofenin hepatobiliary scintigraphy (HBS) is an important and clinically useful diagnostic imaging study for detecting complications after liver transplantation. CT contrast agents due to their high atomic numbers, lead to a decrease in gamma ray count rates. This study investigated the impact of CT contrast agents on the uptake of 99mTc-mebrofenin in the liver. Materials and Methods: The quantitative HBS was performed on sixty-two liver transplantation patients (male:female=36:26), with a mean age of 59.4±6.4 years. Statistical comparison of hepatic uptake reduction ratio (HURR%) before and after the injection of CT contrast agents was performed using a paired t-test. Results: Hepatic uptake of the reduction ratio was 94.47±3.65% for the pre-CT contrast agents and 92.17±4.00% for the post-CT contrast agents. HURR% after CT contrast agent injection showed a statistically significant difference compared to before the injection (t=11.09, P<0.001). Conclusion: It will be necessary to pay attention when examining the HBS of patients with liver transplantation after the injection of CT contrast medium. It is advisable to schedule the examination on a different day to prevent residual contrast medium in the body from interfering with the quantitative evaluation of the nuclear medicine examination.