AJR. American journal of roentgenology
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AJR Am J Roentgenol · Mar 1992
Randomized Controlled Trial Comparative Study Clinical TrialComparison of iohexol 300 and diatrizoate meglumine 60 for body CT: image quality, adverse reactions, and aborted/repeated examinations.
Six hundred patients were prospectively randomized and given either diatrizoate meglumine 60 or iohexol 300 during dynamic contrast-enhanced body CT in order to compare image quality, contrast reactions, and the number of aborted studies or studies in which images had to be repeated. Three hundred two patients received iohexol 300, and 298 patients received diatrizoate meglumine 60. Thirty-nine percent (119/302) of the patients given iohexol 300 and 63% (188/298) of the patients given diatrizoate meglumine 60 had at least one adverse reaction thought to be related to contrast material during, or within 24 hr of, the body CT scan. ⋯ The CT study was repeated because of movement during the contrast injection or aborted because of contrast-related reactions in 0.7% of the patients given iohexol 300 and in 3.0% of the patients given diatrizoate meglumine 60. This difference was statistically significant (p = .04). Our results suggest that the difference in image quality, number of adverse reactions, and number of aborted/repeated CT scans performed with iohexol 300 or diatrizoate meglumine 60 are not sufficiently different to warrant conversion to nonionic agents for body CT scans.
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During a 32-month period, adrenal injuries were diagnosed in 20 (2%) of 1120 patients who had abdominal CT for assessment of blunt force trauma. Injuries were unilateral in 17 patients (12 right-sided and five left-sided) and bilateral in three (23 total adrenal injuries) and were accompanied by concurrent ipsilateral thoracic or abdominal injuries in all but one patient. Nineteen (83%) of the adrenal injuries appeared as discrete round to oval hematomas expanding the adrenal gland, two (9%) appeared as diffuse irregular hemorrhage obliterating the gland, and two (9%) appeared as uniform swelling of the adrenal gland. ⋯ In general, these injuries had no significant medical sequelae, but acute adrenal insufficiency developed in one patient with bilateral lesions; in another patient with an adrenal hematoma compressing the inferior vena cava, caval thrombosis developed. The potential for delayed bleeding or infection within the hemorrhagic gland exists, but these did not occur in any of our patients. Our experience indicates that adrenal injury resulting from blunt trauma is more common than suggested by previous reports and emphasizes the importance of careful inspection of the adrenal glands in patients in whom lower thoracic or upper abdominal injuries are detected by CT.
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AJR Am J Roentgenol · Mar 1992
Letter Case ReportsPneumopyopericardium after penetrating chest injury.