• The Korean Journal of Pain
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• v.34 no.3
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• pp.339-345
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• 2021

Background: Ultrasound-guided caudal epidural injection (CEI) is limited in that it cannot confirm drug distribution at the target site without fluoroscopy. We hypothesized that visualization of solution flow through the inter-laminar space of the lumbosacral spine using color Doppler ultrasound alone would allow for confirmation of drug distribution. Therefore, we aimed to prospectively evaluate the usefulness of this method by comparing the color Doppler image in the paramedian sagittal oblique view of the lumbosacral spine (LS-PSOV) with the distribution of the contrast medium observed during fluoroscopy. Methods: Sixty-five patients received a 10-mL CEI of solution containing contrast medium under ultrasound guidance. During injection, flow was observed in the LSPSOV using color Doppler ultrasonography, following which it was confirmed using fluoroscopy. The presence of contrast image at L5-S1 on fluoroscopy was defined as "successful CEI." We then calculated prediction accuracy for successful CEI using color Doppler ultrasonography in the LS-PSOV. We also investigated the correlation between the distribution levels measured via color Doppler and fluoroscopy. Results: Prediction accuracy with color Doppler ultrasonography was 96.9%. The sensitivity, specificity, positive predictive value, and negative predictive value were 96.7%, 100%, 100%, and 60.0%, respectively. In 52 of 65 patients (80%), the highest level at which contrast image was observed was the same for both color Doppler ultrasonography and fluoroscopy. Conclusions: Our findings demonstrate that color Doppler ultrasonography in the LS-PSOV is a new method for determining whether a drug solution reaches the lumbosacral region (i.e., the main target level) without the need for fluoroscopy.

• Journal of Korean Biological Nursing Science
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• v.6 no.2
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• pp.57-68
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• 2004

The contrast medium is very commonly used in more than 90% of computed tomography(CT) scans. It is difficult to predict the occurrence of adverse reactions and the degree of adverse reactions are diverse from mild urticaria, itching, nausea, vomiting to even cardiopulmonary arrest. The purpose of this study was to evaluate the symptoms, occurrence rate and risk factors of the adverse reactions in patients after contrast injection during CT examinations. Two hundreds sixty-five patients showed symptoms of adverse reactions out of 71,117 adult patients who received intravenous contrast administration during CT scans from January 2003 to December 2003 at a general hospital. Data was collected by reviewing adverse reaction records and electronic medical record. The results of this study were as follows; 1. Adverse reactions occurred in 265 out of a total of 71,117 patients(0.37%). Clinical symptoms of adverse reactions were most commonly dermatologic problems such as urticaria(69.81%) and itching(63.02%), followed by dyspnea(14.34%), dizziness(11.70%), nausea(6.79%), and vomiting(7.17%). 2. Anaphylactoid reactions occurred in 47 out of a total of 265 patients, and their pattern of symptoms were most commonly related to cardiovascular system(90.91%), followed by respiratory system(82.22%), gastrointestinal system(51.72%), and dermatologic system(16.51%). Eleven patients were transferred to emergency room for further treatment and two patients needed cardiopulmonary resuscitation. 3. The adverse reactions were significantly more common in women than in men(0.46% vs.0.32%, p=.003) and in type D contrast medium than the others(p<.001). The occurrence rate of adverse reactions was not significantly different according to the age and infusion speed of the contrast medium.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.2
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• pp.786-792
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• 2013

In this study was explored minimize side effects due to the additional injection of contrast medium and maintaining a high resolution imaging applied to the inspection and analysis of the contrast medium that affect the peak time biomechanics factors. Included 48 patients using the test bolus method, after measuring a patient's biomechanics factors of inspection before and during the test, correlation between contrast medium peak time and learn, matches the regression equation calculated and measured contrast medium peak time was assessed by the Bland Altman plot. Research result, inspections of SBP, HR contrast medium peak time and a significant negative correlation was, step 1, every increase, the contrast medium peak time significantly to -0.018 and -0.159 decreased, a fairly high concordance no difference between the two method. In conclusion, the regression equation using the existing methods, while maintaining excellent image quality that contrast medium is reduced to a patient, it can conclude that the alternative to the existing methods.

• The Journal of the Korea Contents Association
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• v.6 no.5
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• pp.145-152
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• 2006

Radiographic contrast medium may cause tissue injury by extravasation during intravenous automated injection during CT examination. A large - volume extravasation (140 mL) occurred in an adult during contrast-enhanced CT The patient had a swelling and injury on the dorsum right hand of intravenous catheter region. The extravasation injury site was determined by CT scanning. The extavasation compartment syndrome case was examined using four separate display techniques. These 3D MDCT findings might help to determine the best course of treatment for patient with contrast extravasation. 3D image reconstructions provide accurate views of high-resolution and soft-tissue imaging. This paper introduces extravasation with the radiography and 3D MDCT findings.

• Journal of the Korean Society of Radiology
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• v.18 no.1
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• pp.53-63
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• 2024

The purpose of this study was to analyze radiological technologists' (RT) task perceptions of intravenous injection behavior of contrast medium and use it as basic data for future workforce response plans. We surveyed a total of 172 RT using questionnaire terms consisting of demographic characteristics, job priorities, and RT' task perceptions of intravenous injection behavior. Statistical analysis was performed using descriptive statistics, frequency analysis, independent samples T-test, and ANOVA analysis. As a result, first, current clinical RT were highly aware of the need for intravenous injection behavior as a response to the future workforce of them, and the workload burden resulting from this was evaluated as low. Second, the fear of intravenous injection behavior was found to be significant, so it is judged to be useful to perform them as selective job actions rather than all RT' task. Third, the need for training courses and certification for RT' intravenous injection behavior is being raised, and additional specific research on this is required. Last, RT' positive perception of intravenous injection behavior could be expected as a foundation for improving national medical services, strengthening RT expertise, and expanding tasks.

• 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.

• Journal of Biomedical Engineering Research
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• v.30 no.5
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• pp.412-417
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• 2009

The purpose of this study was to assess the ability of this device during clinically important episodes of extravasation. The extravasation detection accessory (EDA) system was based of infrared ray with detection sensor, an amplifier, alarm device, receiver, cable and a computer based system. This study was a prospective, observational study in which the EDA system was used to monitor the automated mechanical injection of contrast media. Three hundred patients referred for contrast media enhanced body computed tomography studied in a prospective, observation study in which the EDA system was used to identify and interrupt any injection associated with clinically important extravasation. There were 8 true-positive cases, 276 true-negative cases, 15 false-positive cases and 1 false-negative cases. The EDA system had a sensitivity of 88.8% and a specificity of 94.8% for the detection of clinically important extravasation. The EDA system had good sensitivity for the detection of clinically important extravasation and the EDA system has the clinical potential for the early detection of extravasation of the contrast medium that is administered with power injectors.

• Journal of the Korean Society of Radiology
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• v.8 no.6
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• pp.279-285
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• 2014

This study is to have dose reduction and minimization of excessive use of contrast medium in the pediatric cardiac computed tomography and to suggest the optimization plan to acquire the enhancement image of the 4 chambers at the same time by formulating scan delay time in empirical method with considering variables such as contrast medium injection velocity and cardiac approaching time. Quantitative, qualitative and dose assessment were carried out for 30 pediatric patients who had taken the cardiac examination. In conclusion, image enhancement in 4 chambers of the cardiac shows over 300 HU which is proper to pediatric cardiac reading by applying the empirical method with calculating scan delay time according to weight and contrast medium volume and injection velocity. Qualitative image assessments in confidence sharpness and noise have excellence qualitatively. Exposure dose to pediatrics also decreases precisely. Therefore this study is judged to take a important role of making optimization images with advantages of dose reduction and less side effects caused by it's excessive use in clinic.

• Proceedings of the KOSOMBE Conference
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• v.1998 no.11
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• pp.271-272
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• 1998

Contrast-enhanced CT has an important role in the assessment of liver lesions. However, the optimal protocol to get most effective result is not clear. The main principle for deciding injection protocol is to optimize lesion detectability by rapid scanning when lesion-to-liver contrast is maximum. For this purpose, we developed a physiological model of contrast medium enhancement based on the compartment modeling and pharmacokinetics. Blood supply to liver was modeled in two paths. This dual supply character distinguishes the CT enhancement of liver from that of the other organs. The first path is by hepatic artery and the second is by portal vein. It is assumed that only hepatic artery can supply blood to hepatocellular carcinoma (HCC) compartment. It is known that this causes the difference of contrast enhancement between normal liver tissue and hepatic tumor. By solving differential equations for each compartment simultaneously using computer program Matlab, CT contrast-enhancement curves were simulated. Simulated enhancement curves for aortic, hepatic, portal vein, and HCC compartments were compared with mean enhancement curves from 24 patients exposed to the same protocols as simulation. These enhancement curves were in a good agreement. Furthermore, we simulated lesion-to-liver curves for various injection protocols, and analyzed the effects. These may help to optimize the scanning protocols for good diagnosis.

• Journal of Biomedical Engineering Research
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• v.20 no.2
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• pp.173-182
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• 1999

Contrast-enhanced CT has an important role in assessing liver lesions, the optimal protocol to get most effective result is not clear. The mein goal when deciding injention protocol is to optimize lesion detectability with rapid scanning when lesion to liver contrast is maximum. For this purpose, we developed a physiological model of the contrast medium enhancement based on the compartment modeling and pharmacokinetics. Blood supply to liver is achieved in two paths. This dual supply characteristic distinguishes the CT enhancement of liver from that of the other organs. The first path is by hepatic artery and to second, by portal vein. However, it is assumed that only gepatic artery can supply blood to hepatocellular carcinoma(HCC) compartment, thus, the difference of contrast enhancement is resulted between normal liver tissue and hepatic tumor. By solving differential equations for each compartment simultaneously using the computer program Matlab, CT contrast-enhancement curves were simulated. The simulated enhancement curves for aortic, hepatic, portal vein, and HCC compartments were compared with the mean enhancement curves from 24 patients exposed to the same protocols as the simulation. These enhancement curves showed a good agreement. Furthermore, we simulated lesion-to-liver curves for various injection protocols, and the effects were analyzed. The variables to be considered in the injection protocol were injection rate, dose, and concentration of contrast material. These data may help to optimize scanning protocols for better diagnosis.