조영제 급성 유해반응에 관한 연구

김태은(Tae Eun Kim),정용환(Yong Hwan Jung),김서현(Seo Hyun Kim),박관중(Gwan Jung Park),권순안(Sun Ahn Gwon),민관홍(Kwan Hong Min) 대한CT영상기술학회 2015 대한CT영상기술학회지 Vol.17 No.2

Purpose : The purpose of this study is to find the way to minimize the acute adverse reaction to contrast media by analyzing acute adverse reactions of the patients examined the contrastenhanced CT scan through the acute adverse reaction process. Materials and Methods : The subjects of the experiment are 471,692 patients examined by using contrast media out of 621, 181 who examined the CT scan in June 2007 to December 2014. The number of the patients with acute adverse reactions is presented 4589 (0.99%). Depending on the application of the acute adverse reaction process, rate of the acute adverse reaction was analyzed monthly. The acute adverse reaction process in this study is as follows. In the case of the new patient, they were injected to intravascular fluid. mixed Contrast media with Normal Saline (1:50) by using 10cc syringe. If there was no adverse reactions. examination was progressing. If adverse reactions are found, the patient needs a treatment in Allergy and clinical immunology. We examined the contrast-enhanced CT scan after pre-medication for each condition. Among previous-visited patient those who were found acute adverse reaction may be examined the contrast-enhanced CT scan after pre-medication for each condition. Patients who are taking diabetes medicine such as Metformin should be checked renal function before the contrast-enhanced CT scan. Since 2012, only one Contrast media has been used for the minimization of acute adverse reactions instead of using a variety of Contrast media for each CT scan and the other kinds of Contrast media may be used for the previous-visited patients who were found the acute adverse reaction such as symptom 3. The acute adverse reaction to contrast media can be classified as 3 steps, such as Symptom 1, Symptom 2, Symptom 3 and Analyzing was performed monthly. Results : During the period, the number of contrast-enhanced CT scan for each month increased approximately 44% from 4050 to 5834 in 2007, 2014 respectively. However. in the case of the number of acute adverse reaction, it decreased about 45% from 47 to 26 in 2007, 2014 respectively. Mild cases of acute adverse reactions decreased about 42% from 42 to 23 from 2007 to 2014. Moderate cases of acute adverse reactions decreased about 33% from 4.6 to 3.1 in 2007, 2014 respectively. Severe cases of acute adverse reactions decreased about 25% from 0.4 to 0.3 in 2007, 2014 respectively. Results by dividing the number of contrast-enhanced CT scan into the acute adverse reaction shows the incidence of acute adverse reactions monthly were 47 cases out of average 4050 cases in 2007 (1.17%). in 2014 the cases decreased by approximately 62%, 26 out of 5834 compared to 2007 (0.45%). Conclusions : According to Food and Drug treatment department, as the CT scan is steadily increasing, adverse reactions to contrast media increase annually. However, the results came out conversely in the study of our hospital. Regardless of the antihistamine and corticosteroid IV injection, this applies to prevent adverse reactions to contrast media in many hospitals, if patients have a history of acute adverse reactions, undiluted contrast media tests are performed after pre-medication. And we applied the process in accordance with the GFR (glomerular filtration rate. less than GFR) to prevent the lactic acidosis. which mortality rate shows about 50% when diabetic patients examined the contrast-enhanced CT scan. In addition. put together a variety of contrast media in only one contrast media. Also when severe patients examine the contrast-enhanced CT scan. the other kinds of contrast media was used. As a result. Acute adverse reactions monthly divided by the number of contrast-enhanced CT scan monthly, called Acute adverse reactions incidence, showed a 62% reduction results. It means these processes that applied in our hospital contribute to minimize the acute adverse reaction to contrast media. 목적 : 조영증강 CT 검사를 한 환자를 대상으로 유해반응을 분석하여 본원에서 시행하는 급성 유해반응 process를 통해 조영제 급성 유해반응을 최소화하는 방법을 알아 보고자 하였다. 대상 및 방법 : 2007년 6월부터 2014년 12월까지 내원하여 CT 검사를 한 621,181 명 중 조영제를 사용해 검사한 환자 471,692 명을 대상으로 하였다. 이 중 급성 유해반응이 나타난 환자는 총 4,589명 (0.99%)이었고 본원에서 시행한 급성 유해반응 process의 적용에 따라 월별로 급성 유해반응의 발현 정도를 분석하였다. 본원에서 시행하는 급성 유해반응 process 는 다음과 같다. 신규 환자는 조영제와 Normal saline을 1:50 으로 mixing 한 용액 10cc를 IV Test injection 후 유해반응이 나타나지 않으면 조영증강 CT 검사를 진행하였고, 유해반응이 나타나면 알레르기 내과에서 진료를 보며, 증상의 정도에 따른 전 처치 후 조영증강 CT 검사를 진행하였다. 재진 환자 중 과거력이 있었던 환자의 경우 증상의 정도에 따른 전 처치 후 조영증강 CT 검사를 진행하였다. Metformin 계열의 당뇨약을 복용 중인 환자는 조영증강 CT 검사 전 반드시 신기능을 확인하였다. 또한 2012년 이후로 급성 유해반응을 최소화하기 위해 검사 별로 여러 가지 조영제를 사용하던 것을 한 가지로 통일하여 사용하였고, 이전에 급성 유해반응 중증 반응이 나타났던 환자의 재검사시 기존과 다른 조영제를 사용하였다. 조영제 급성 유해반응은 3가지 증상(symptom 1, symptom 2, symptom 3)으로 분류하여 월 별로 분석하였다. 결과 : 대상 기간 동안 월 별 조영증강 CT 건수는 2007년에는 월 평균 4,050 건에서 2014년에는 월 평균 5,834 건으로 약 44% 증가하였으나, 월 별 급성 유해반응 건수는 오히려 2007년에는 월 평균 47건, 2014년에는 월 평균 26건으로 약 45% 감소하였다. 급성 유해반응 중경증에서는 2007년 월 평균 42건에서 2014년 월 평균 23건g로 약 42% 감소하였고, 중등증에서는 2007년 월 평균 4.6건에서 2014년 월 평균 3.1 건으로 약 33% 감소하였으며, 중증에서는 2007년 월 평균 0.4건에서 2014년 월 평균 0.3건으로 약 25% 감소하였다. 월 별 조영제 급성 유해반응을 월 별 조영증강 CT 건수로 나누어 조영제 급성 유해반응 발현율을 나타낸 결과, 2007년에는 월 평균 4,050건 중 47건 (1.17%) 였으며, 2014년에는 월 평균 5,834건 중 26건 (0.45%)로 2007년에 비해 약 62% 감소하였다. 결론 : 매년 CT 검사가 꾸준히 증가함에 따라 조영제 유해반응도 증가하였다는 식품의약품 안전처의 보고와는 달리 본원에서는 CT 검사가 증가하였지만 조영제 유해반응은 전체적으로 감소하는 추세를 보였다. 본원은 여러 병원에서 조영제 유해반응을 예방하고자 적용하고 있는 항히스타민제와 코르티코스테로이드제 IV injection 처방을 떠나서 급성 유해반응 과거력이 있는 환자의 전 처치 후 다시 한번 조영제 원액 반응 검사를 하였고, 당뇨 환자의 조영 증강 검사 시 치사율이 50%에 이르는 유산산증(lactic acidosis)을 막고자 사구체 여과율(glomerular filtration rate, 이하 GFR)에 따른 검사 process를 적용하였으며, 검사에 쓰이는 여러 가지 조영제를 한 가지로 통일하여 검사하였고, 중증 환자의 재검사 시 기존과 다른 조영제로 검사하도록 하였다. 그 결과 월별 급성 유해반응 건수를 월별 조영증강 CT 건수로 나눈 급성 유해반응 발현율이 62% 감소하는 결과를 보였다. 이는 본원에서 적용하는 여러 가지 process 가조영제 급성 유해반응을 최소화하는데 기여했기 때문이라고 사료된다.

CT조영제 부작용 고위험군에 대한 전처치의 유용성

장양선(Yang seon Jang),이광원(Gwang won Lee),구양수(Yang su Ku),김대현(Dae hyeon Kim) 대한CT영상기술학회 2013 대한CT영상기술학회지 Vol.15 No.1

목적 : 조영제를 사용하는 CT검사에서 조영제 투여 전 병원 내 약물이상 반응 모니터링 팀에서 만든 조영제 부작용 관련 상병코드에 따라 조영제 부작용 고위험군에게 전처치를 시행할 경우 조영제 부작용을 감소시키고 예방할 수 있는 방안을 제공하고자 한다. 대상 및 방법 : 연구대상은 2012년 1월 1일부터 2012년 12월 31일까지 일개 대학병원에 내원한 외래환자 중 정맥내로 조영제를 투여받은 23,317명에서 조영제 부작용 고위험군에게 전처치를 시행한 남녀 118명을 대상으로 하였다. 전처치 방법으로는 스테로이드제인 Prednisolone tab 5mg 10T를 조영제 주입 13시간, 7시간, 1시간 전에 경구 투여하였으며 항히스타민제인 Cetizal tab 5mg 1T를 조영제 주입 1시간 전에 경구 투여 하였다. 또한 검사 당일 전처치가 되지 않은 환자는 마찬가지로 항히스타민제와 스테로이드제인 Chlorpeniramine 4mg/2ml, solu-cortef 250mg/2ml를 조영제 주입 30분 전에 정맥 주입하였다. 결과 : 일반적 특성에서 남자 61명(51.7%) 중 6명(5.09%), 여자 57명(48.3%) 중 3명(2.54%)으로 검사 후 부작용이 나타났으며(p=0.350), 연령에 따라서는 60세 이상에서 60명(50.8%) 중 6명(5.09%)으로 가장 많이 발생하였다(p=0.914). 촬영부위별 부작용 발생 역시 검사 후 증상과는 유의한 차이가 없었고(p=0.830) 전처치 방법으로 정맥 주입을 한 환자는 65명(55.1%) 중 6명(5.09%), 경구 투여를 한 환자는 53명(44.0%) 중 3명(2.54%)으로 유의한 차이가 없었다(p=0.467). 조영제 종류(p=0.670), 조영제 주입량(p=0.695), 주입속도(p=0.468)의 경우 검사후 증상과 유의한 차이를 보이지 않았고 조영제 부작용 기왕력의 경우 36명(30.5%) 중 6명(5.09%)이 검사후 부작용이 다시 발생되어 검사 후 증상과 유의한 차이를 보였다(p=0.001). 결론 : CT검사 후 조영제 부작용은 기왕력에 대해서 높은 관계가 있는 것으로 분석되어 과거의 기왕력을 철저히 파악하고 고위험군에게 전처치를 시행하여 검사 종료 후 세심하게 관찰하고 이를 예방할수 있는 표준화된 지침이 필요하다고 사료된다. Purpose : It is to provide the method to reduce and prevent adverse reactions to contrast media by performing pretreatment to contrast media anaphylaxis high-risk group according to contrast media anaphylaxis related illness code by drug side effect response monitoring team in hospital before the administration of contrast media. Materials and Methods : The subjects were 118 male and female patients who received pretreatment for contrast media anaphylaxis high-risk group out of 23,317 patients who came to the subject hospital and had contrast media in veins. For conditioning, Prednisolone (corticosteroid agent) tab 5 mg 10T were given 13 hours, 7 hours and 1 hour before the administration of contrast media, and Cetizal (anti-histamine) tab 5mg 1T was given orally an hour before the administration contrast media. The patients who did not get pretreatment got injection of anti-histamine agent (Chlorpeniramine 4mg/2ml) and corticosteroid agent (solu-cortef 250mg/2ml) in veins 30 minutes before the administration of contrast media. Results : In general characteristics, 6(5.09%) out of 61 males(51.7%) and 3(2.54%) out of 57 females(48.3%) showed anaphylaxis after the examination(p=0.350). According to age, the group over 60 showed the highest number of anaphylaxis as 6(5.09%) out of 60 (50.8%)(p=0.914). There was no significant difference between anaphylaxis occurrence according to examination part and symptoms after the examination(p=0.830), and there was no significant difference according to pretreatment method. Six(5.09%) out of 65(55.1%) who got intravenous injection showed anaphylaxis, while 3(2.54%) out of 53(44.0%) who got oral administration showed anaphylaxis(p=0.467). There was no significant difference according to contrast media type(p=0.670), contrast media injection volume(p=0.695), and injection speed(p=0.468), while contrast media anaphylaxis history showed significant difference as 6(5.09%) out of 36(30.5%) showed the recurrence of anaphylaxis after the examination(p=0.001). Conclusion : As adverse reactions to contrast media are analyzed to have high correlation with previous history of adverse reactions, it is very important to identify the previous history and a standardized guideline should be in place to administer pretreatment to the high-risk group and to perform close follow-up after the examination.

조영증강 복부 CT 검사에서 조영제 사용량 감소에 관한 연구: 인공지능 기반 조영 증강 부스트 기술

양민재,한현석,이성주,이민수,조명주 대한CT영상기술학회 2024 대한CT영상기술학회지 Vol.26 No.1

본원에서는 일부 조영증강 복부 CT 검사 시 이중-선원 이중 에너지 CT의 저 에너지 가상 단색 영상(Virtual Monochromatic Image; VMI)을 이용하여 조영제 사용량 감소(체중×1.2 mL)를 임상 검사에 적용하고 있다. 이에, 최근 도입된 CE-Boost 기술을 적용해 표준 조영제 사용량(체중×1.6 mL) 120 kV 단일-선원 조영증강 복부 CT 영상과 비교 평가하여 표준 조영제 사용량을 사용하는 조영증강 복부 CT검사에서도 조영제 사용량 감소를 적용할 수 있는지 알아보고자 하였다. 2023년 1월부터 조영제사용량 감소를 적용한 실험군(A), 실험군+CE-Boost(B), 표준 조영제 사용량을 적용한 대조군(C)의 62명을 대상으로 후향적 연구를 진행하였다. 정량적인 평가를 위해 주문맥이 가장 넓게 보이는 영상에서 동맥기의 복부대동맥과 우측 척주기립근, 문맥기의 주문맥과 간실질, 우측 척주기립근에 관심영역(Region of Interest; ROI)을 설정하여 CT Number(HU), 신호 대 잡음비(Signal to Noise Ratio; SNR), 대조도 대 잡음비(Contrast to Noise Ratio; CNR)를 산출하였다. 정성적 평가는 10명의 영상을 표본으로 설정하여 조영증강 정도와 전반적인 영상의 질 평가 항목으로 숙련된 방사선사 5명이 독립적으로 평가하였다. HU 값은 CE-Boost 기술을 적용한 (B) 그룹이 가장 높은 값을 나타내었고,(P<.05) CE-Boost 기술이 적용되지 않은 (A)-(C) 그룹은 통계적으로 유의미한 차이를 보이지 않았다.(P>.05) SNR에서는 CE-Boost가 적용된 (B)그룹이 가장 높은 값을 나타냈으나,(P<.05) 간실질 부위 평가에서 CE-Boost 기술이 없는 (C)그룹과 유의미한 차이를 보이지 않았다.(P>.05) CNR에서도 CE-Boost 기술이 적용된 (B)그룹이 가장 높은 값을 나타냈으나,(P<.05) (B)-(C) 그룹 간에 통계적으로 유의미한 차이를 보이지 않았다.(P>.05) 정성적 평가에서도 CE-Boost가 적용된 (B)그룹이 평가 항목 2문항에서 가장 우수한 것으로 평가되었다.(P<.05) 조영증강 복부 CT 검사 시 인공지능기반의 CE-Boost 기술을 이용한다면 이중-선원 이중 에너지 CT가 아닌 단일-선원 120kV CT 검사에서도 영상의 질을 유지하면서 표준 조영제 사용량의 약 25% 감소를 적용할 수 있어 환자에게 더 안전한 의료 서비스를 제공할 수 있을 것으로 생각된다. In our hospital, we implement a reduction in contrast media dose (calculated as body weight × 1.2 mL) for clinical examinations conducted with dual-source dual-energy CT during contrast-enhanced abdominal CT examinations. Therefore, by applying the CE-Boost technique, the degree of contrast enhancement of blood vessels and tissues was compared with standard contrast media dose (body weight × 1.6 mL) in 120 kV single-source computed tomography images. In contrast-enhanced abdominal CT using the standard contrast media dose, the CE-Boost technique was applied to investigate the feasibility of reducing the contrast media dose. From January 2023, a retrospective study was conducted on 62 subjects. The study included an experimental group (A) that received a reduced contrast media dose, an experimental group + CE-Boost (B), and a control group (C) that received the standard contrast media dose. For quantitative evaluation, in the image where the Main Portal Vein (MPV) is the widest, CT number (HU), Signal-to-Noise Ratio (SNR), and Contrast-to-Noise Ratio (CNR) were calculated. Qualitative evaluation was independently assessed by five experienced radiotechnologists, who evaluated 10 samples as the assessment items for contrast enhancement and overall image quality. In the HU values, the (B) group with CE-Boost technique showed the highest value (P < .05), while the (A)-(C) group without CE-Boost technique showed no statistically significant difference. In the SNR, the group (B) that received the CE-Boost technique exhibited the highest value,(P<.05) but there was no significant difference compared to the group (C) that did not receive the CE-Boost technique in the evaluation of liver parenchyma.(P>.05) In CNR, the (B) group utilizing the CE-Boost technique showed the highest value (P<.05), but there was no statistically significant difference between (B) and (C). In the qualitative evaluation, the group (B) to which CE-Boost was applied was rated the highest in two evaluation items. If an AI-based CE-Boost technique is used for contrast-enhanced abdominal CT, it is believed that safe medical services can be provided to patients by implementing a 25% reduction in the standard contrast media dose while still maintaining image quality, even in a single-source 120kV CT.

Risk Factors for Adverse Reactions to Iodinated Contrast Media in Computed Tomography

강형림,이유정 한국임상약학회 2016 한국임상약학회지 Vol.26 No.1

Objective: The increasing use of imaging examinations such as computed tomography (CT) results in increased contrast media use, which increases contrast media-induced adverse reactions (AR). This study investigated the risk factors of ARs to nonionic iodinated contrast media. Methods: This study evaluated patients who were administered iodinated contrast media during CT scanning in Yeouido St. Mary's Hospital in Seoul, Korea in 2012. Among the subjects, those with contrast media-induced ARs were classified as the AR group. The control group included individuals without ARs who were selected through simple random sampling. The effects of sex, age, contrast media type and dose, CT region, previous contrast media administration, allergy history, and comorbidity were analyzed in the AR and control groups. Results: Multivariate logistic regression analyses were performed to evaluate the identified AR risk factors in 103 subjects in the AR group and 412 subjects in the control group. The results confirmed that the risk of developing ARs was significantly higher in females [odds ratio (OR): 2.206; 95% confidence interval (CI): 1.353- 3.598], in individuals administered Iohexol (OR: 9.981; 95% CI: 2.361-42.193), in individuals with an allergy history (OR: 3.982; 95% CI: 1.742-9.101), and in individuals with comorbid asthma (OR: 6.619; 95% CI: 1.377-31.826). Most of the ARs were mild and immediate. Conclusion: In patients who were administered contrast media during CT scans, female gender, Iohexol use, allergy history, and asthma were risk factors for ARs. Therefore, special care is required for patients with such risk factors to prevent ARs.

컴퓨터 단층촬영을 위한 요오드화 조영제 사용으로 인한 부작용 발생의 위험인자 연구

강형림,이유정 한국임상약학회 2016 한국임상약학회지 Vol.26 No.1

Objective: The increasing use of imaging examinations such as computed tomography (CT) results in increased contrast media use, which increases contrast media-induced adverse reactions (AR). This study investigated the risk factors of ARs to nonionic iodinated contrast media. Methods: This study evaluated patients who were administered iodinated contrast media during CT scanning in Yeouido St. Mary's Hospital in Seoul, Korea in 2012. Among the subjects, those with contrast media-induced ARs were classified as the AR group. The control group included individuals without ARs who were selected through simple random sampling. The effects of sex, age, contrast media type and dose, CT region, previous contrast media administration, allergy history, and comorbidity were analyzed in the AR and control groups. Results: Multivariate logistic regression analyses were performed to evaluate the identified AR risk factors in 103 subjects in the AR group and 412 subjects in the control group. The results confirmed that the risk of developing ARs was significantly higher in females [odds ratio (OR): 2.206; 95% confidence interval (CI): 1.353- 3.598], in individuals administered Iohexol (OR: 9.981; 95% CI: 2.361-42.193), in individuals with an allergy history (OR: 3.982; 95% CI: 1.742-9.101), and in individuals with comorbid asthma (OR: 6.619; 95% CI: 1.377-31.826). Most of the ARs were mild and immediate. Conclusion: In patients who were administered contrast media during CT scans, female gender, Iohexol use, allergy history, and asthma were risk factors for ARs. Therefore, special care is required for patients with such risk factors to prevent ARs.

A Comparison of the Use of Contrast Media with Different Iodine Concentrations for Multidetector CT of the Kidney

정승채,김승협,조정연 대한영상의학회 2011 Korean Journal of Radiology Vol.12 No.6

Objective: To determine the optimal iodine concentration of contrast media for kidney multidetector computed tomography (MDCT) by comparing the degree of renal parenchymal enhancement and the severity of the renal streak artifact with contrast media of different iodine concentrations. Materials and Methods: A 16-row MDCT was performed in 15 sedated rabbits by injection of 2 mL contrast media/kg body weight at a rate of 0.3 mL/sec. Monomeric nonionic contrast media of 250, 300, and 370 mg iodine/mL were injected at 1-week intervals. Mean attenuation values were measured in each renal structure with attenuation differences among the structures. The artifact was evaluated by CT window width/level and three grading methods. The values were compared with iodine concentrations. Results: The 370 mg iodine/mL concentration showed significantly higher cortical enhancement than 250 mg iodine/mL in all phases (p < 0.05). There was however no significant difference in the degree of enhancement between the 300 mg iodine/mL and 370 mg iodine/mL concentrations in all phases. There is a significant difference in attenuation for the cortex-outer medulla between 250 mg iodine/mL and 300 mg iodine/mL (p < 0.05). The artifact was more severe with a medium of 370 mg iodine/mL than with 250 mg iodine/mL by all grading methods (p < 0.05). Conclusion: The 300 mg iodine/mL is considered to be the most appropriate iodine concentration in an aspect of the enhancement and artifact on a kidney MDCT scan. Objective: To determine the optimal iodine concentration of contrast media for kidney multidetector computed tomography (MDCT) by comparing the degree of renal parenchymal enhancement and the severity of the renal streak artifact with contrast media of different iodine concentrations. Materials and Methods: A 16-row MDCT was performed in 15 sedated rabbits by injection of 2 mL contrast media/kg body weight at a rate of 0.3 mL/sec. Monomeric nonionic contrast media of 250, 300, and 370 mg iodine/mL were injected at 1-week intervals. Mean attenuation values were measured in each renal structure with attenuation differences among the structures. The artifact was evaluated by CT window width/level and three grading methods. The values were compared with iodine concentrations. Results: The 370 mg iodine/mL concentration showed significantly higher cortical enhancement than 250 mg iodine/mL in all phases (p < 0.05). There was however no significant difference in the degree of enhancement between the 300 mg iodine/mL and 370 mg iodine/mL concentrations in all phases. There is a significant difference in attenuation for the cortex-outer medulla between 250 mg iodine/mL and 300 mg iodine/mL (p < 0.05). The artifact was more severe with a medium of 370 mg iodine/mL than with 250 mg iodine/mL by all grading methods (p < 0.05). Conclusion: The 300 mg iodine/mL is considered to be the most appropriate iodine concentration in an aspect of the enhancement and artifact on a kidney MDCT scan.

How Computed Tomography Contrast Media and Magnetic Resonance Imaging Contrast Media Affect the Changes of Uptake Counts of <SUP>201</SUP>Tl

Jin-Hyeok Lee,Hae-Kag Lee,Jae-Hwan Cho,Miju Cheon 한국자기학회 2014 Journal of Magnetics Vol.19 No.4

The purpose of the study is to investigate how uptake counts of <SUP>201</SUP>Tl of radioisotopes in the human body could change, when taking computed tomography and magnetic resonance imaging right after injecting contrast media.<SUP> 201</SUP>Tl radioisotope substances of iodine contrast medium, which is a computed tomography contrast medium, and paramagnetic contrast medium, which is an magnetic resonance imaging contrast medium, were used as study materials. First, <SUP>201</SUP>Tl was put into 4 cc of normal saline in test tube, and then a computed tomography contrast medium of Iopamidol<SUP>®</SUP> or Dotarem<SUP>®</SUP>, was put into 2 cc of normal saline in test tube. An magnetic resonance imaging contrast medium of Primovist<SUP>®</SUP> or Gadovist<SUP>®</SUP> was also put into 2 cc of normal saline in test tube. Each contrast medium was distributed to make <SUP>201</SUP>Tl as 3 mCi, with a total of 4 cc. Gamma camera, low energy high resolution collimator, and pinhole collimator were used to obtain images. The uptake count of<SUP> 201</SUP>Tl was measured with 1000 frames of images, and obtained after 10 times of repetition. This study revealed that the use of Gadovist<SUP>®</SUP>, which is an magnetic resonance imaging contrast medium, showed the smallest number of uptake count, after measuring <SUP>201</SUP>Tl uptake count by low energy high resolution collimator. On the other hand, the use of Iopamidol<SUP>®</SUP>, which is a computed tomography contrast medium, showed the biggest difference in uptake count, when measuring <SUP>99m</SUP>Tc uptake count by Pinhole collimator. When examining with gamma camera, using contrast medium and <SUP>201</SUP>Tl, identifying the changes of uptake count is very important for improving the value of diagnosis.

Pre-filled syringe 조영제의 유용성에 대한 고찰

정다희(Da Hyi Jeong),김동주(Dong Joo Kim),안종진(Jong Jin Ahn),유상재(Sang Jae You),김동성(Dong Seang Kim) 대한전산화단층기술학회 2012 대한CT영상기술학회지 Vol.14 No.1

목적 Pre-filled syringe(PFS) 형태의 조영제와 다양한 용량의 제형의 조영제를 여러 가지 사용 상황별로 비교하여 시간 및 비용, 편리성 등에 대한 유용성을 평가고자 한다. 대상 및 방법 본원의 PFS조영제 사용 승인전의 유용성 검사였으며 환자에 대한 직접 주입 상황은 시뮬레이션으로 설정하였다. 실험에 사용한 자동조영제주입기는 Liebel flarsheim사의 Optivantage DH를 사용하였으며 조영제는 125 ml Pre-filled syringe 조영제(Optiray 320, UltrajectTM prefilled syringes, loversol), 150ml, 500ml, 100 ml 제형으로 총 네 가지 타입을 사용하여 pre-filled syringe 형태의 조영제의 사용과 manually filled syringe 형태의 조영제 사용을 비교하였다. 조영제 주입 조건은 40ml/s, saline 4ml/s로 모든 과정에 동일하게 적용하였으며 실험은 먼저 조영제 사용량에 따라 120cc, 90cc 사용 상황과 90cc와 120cc를 불규칙하게 번갈아 사용하는 상황의 3가지 형태의 사용 환경으로 나누어 실험하였다. 각각의 사용 환경별로 PFS형, 150ml 제형 disposable, 500ml 제형 재사용, 100ml 제형 disposable으로 각각 나누어 4명의 방사선사가 각 사용법별 세부적인 준비시간과 버려지는 양 및 주관적인 편리성을 평가하였다. 결과 120ml 사용 환경에서 PFS, 150ml 제형 disposable, 500ml 제형 재사용, 100ml 제형 disposable 방식의 평균 준비시간은 각각 46.3±7.2s, 150.0±9.7s, 64.7±5.5s, 185.7±5.4였으며 평균 버리는 양은 각각 5ml, 30 ml, 10 ml, 80 ml였다. 또한 90ml 사용 환경에서의 평균 준비시간은 각각 45.3±5.0, 139.5±9.0, 64.7±5.5, 103.3±6.3였으며 평균 버리는 양은 각각 35 ml, 60 ml, 10 ml, 10 ml였다. 120ml와 90ml를 번갈아 사용하는 환경에서의 평균 준비시간과 버리는 양은 각각 44.8±6.3, 139.8±9.3, 64.7±5.5, 46.3±±7.2였다(p<0.01). 또한 주관적인 편리성은 모든 사용 환경을 전체로 하여 각각 4점, 2점, 4±0.7점, 1.7±1.0점이였다(p<0.05). 결론 PFS형 조영제는 제형의 조영제에 비하여 시간 및 비용, 편리성 측면에서 효과적이라고 판단되며 많은 용량의 제형으로 된 조영제를 재사용함으로써 나타날 수 있는 교차 감염의 예방 또한 가능하리라 본다. I. Purpose To evaluate of usefulness by using pre-filled type syringe comparing to variety vial types at variable environments of contrast media injection II. Materials & methods This study was usefulness test before approval in the institution; therefore contrasts media injection to patient was replaced by simulation. All contrast media injection condition was 4 ml per second. We made three protocols according to dosage of contrast media (120 cc, 90 cc, irregular 90 cc or 120 cc) to examine by four methods(pre-filled syringe type, 150 cc vial-disposable, 100 cc vial-disposable, 500cc vial-reuse) of injection type and each methods evaluated make-ready time, discarded dose, convenience index by four radio-technologist III. Results At using system of 120 ml protocol PFS, average of setup time 150 ml vial disposable type, 500 ml vial reuse, 100 ml vial disposable was each 46.3±7.2s, 150.0±9. 7s, 64.7±5.5s, 185.7±5.4s. And average of derelict volume was 5ml, 30 ml, 10 ml and 80 ml. respectively. also average of setup time and average of derelict volume in the 90ml protocol were each 각각 45.3±5.0, 139.5±9.0, 64.7±5.5, 103.3±6.3 and 35 ml, 60 ml, 10 ml, 10 ml. average of setup time and average of derelict volume in the 120ml protocol and 90 ml protocol were 44.8±6.3, 139.8±9.3, 64.7±5.5, 46.3±7.2(p<0.01) and 20±15.3, 45±15.1, 10, 30±26.7. Subjective convenience in the all protocol was 4point, 2point, 4±0.7point, 1.7±1.0point (p<0.05). IV. Conclusion We consider that PFS type contrast media is more effectible to saving time, cost and convenience compare with vial type contrast media. And it is also possible to prevent of cross infection which can occur by reusing a lot of capacity of contrast media

IV Catheter Gauge에 따른 PSI 유용성 평가

서윤희(Yun Hee Seo),김경숙(Kyoung Sook Kim),김정훈(Jeong Hoon Kim),김선기(Seon Ki Kim),김영미(Young Mi Kim) 대한CT영상기술학회 2010 대한CT영상기술학회지 Vol.12 No.2

Purpose It aims to confirm the pressure difference between the cases of normal saline injection and contrast media injection using power injector, and to prevent the adverse events such as extravasation and so on, comparing PSI according to each condition like securing the vessel of gauge to meet the exam flow rate, maintenance of temperature, selection of connection tool, etc, and injecting the contrast media with the optimum conditions. Materials and methods 18G, 20G, 22G, and 24G catheter were inserted into 50 cm rubber, and connected with 3-way, MRVLS, 18G needle+ injection cap, directly, and with the coil of injector syringe. Injected the normal saline using power injector with the flow rates of 2.0, 2.5, 3.0, 4.0, and 5.0cc/sec, and inject contrast media, Ultravist 300, Ultravist 370, Iopamiro 300, Optiray320, and Visipaque 320, under the same conditions. And injected the contrast media with the temperature change 25℃ and 37℃. Results PSI during the contrast media injection with power injector was measrned twice to 5 times as high as the one during the normal saline injection. The lower the viscosity of contrast media, the higher the temperature, the thicker the catheter gauge, the lower the flow rate was, the lower PSI was measured. Conclusion 3-way, MRVLS, direct connection in the high flow exam is useful, while 3-way, direct connection is useful in the low flow exam and the cases that the vessel is weak. The vessel stability test for the injection solution should be performed accurately considering the difference of contrast media viscosity and standardized to use the contrast media in the heating cabinet since the viscosity may be varied approximately one-and-a half times according to the temperature of contrast media. Further objective experimental studies are required to anticipating the resistance of blood vessel by the patients’ diseases and IV site based on this study.

Evaluation of Imaging Analysis with the Use of Oral Contrast Media for Abdominal MRI

Kwang Hyun Nam,Kang Min Lee,Jin Hak Kim,Se Keun Park,Yong Dae Kim,Dae Cheol Kweon 한국자기학회 2018 Journal of Magnetics Vol.23 No.3

The purpose of this study was to provide preliminary experimental data on the utility of a new oral contrast media for abdominal MRI contrast imaging examination. In the experimental study, the following oral contrast media were used: Solotop<SUP>®</SUP> (Taejoon Pharmacal, Seoul, Korea), diatrizoate meglumine (Gastrografin<SUP>®</SUP>, Schering, Berlin, Germany), 50 % blueberry juice, 100 % orange juice, 3.5 % blueberry juice. The GE Signa Excite HD 1.5 T MR system and an 8-channel CTL (cervical thoracic lumbar) coil were used to obtain. T1- and T2-weighted images, and the acquired SNR and CNR values of the contrast media were analyzed by multi-way ANOVA. Fruit juice was lower than water in T2-weighted images and showed relatively higher contrast than did chemical contrast media. On the other hand, T1-weighted images showed a relatively low-contrast effect due to the moisture contained in the fruit juice. For the T1-weighted images, Gastrografin<SUP>®</SUP> and Solotop<SUP>®</SUP> had higher CNR and SNR than did the fruit juice contrast media. There was a statistically significant difference between water and oral contrast media (p < .05). Fruit juice having lower absolute water content than water showed lower T2 signal value than did water. Fruit juice having a viscosity higher than that of water had the advantage of being able to get distributed evenly in a desired organ. With further advanced studies based on these experimental results, an alternative oral contrast media could be developed, and abdominal MRI could be expected to be actively applied in clinical practice.