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Abdominal Radiology (New York) Nov 2018The "gastrografin challenge" has been used for decades in the evaluation of small bowel obstruction (SBO). This type of study involves enteric administration of a... (Review)
Review
The "gastrografin challenge" has been used for decades in the evaluation of small bowel obstruction (SBO). This type of study involves enteric administration of a water-soluble contrast followed by serial abdominal radiographs. While its diagnostic role is well established, its therapeutic role remains controversial. Following an algorithm for gastrografin challenge cases can help with interpretation. An understanding of the appearance of diluted contrast in the small bowel, the concentrating effect of contrast in the colon, and knowledge of surgical history and anatomy is paramount for diagnosis. In this article, we review the approach to acute SBO and the use of gastrografin along with reviewing image interpretation of cases of partial and complete SBO. Gastrografin use in adynamic ileus along with other potential future uses is also discussed.
Topics: Algorithms; Contrast Media; Diagnosis, Differential; Diatrizoate Meglumine; Humans; Intestinal Obstruction; Intestine, Small; Radiography, Abdominal
PubMed: 29632988
DOI: 10.1007/s00261-018-1591-3 -
Radiography (London, England : 1995) Nov 2020To investigate the impact of two Meglumine-Diatrizoate based bowel preparation regimes for computed tomography colonography (CTC) on the patient experience and image...
INTRODUCTION
To investigate the impact of two Meglumine-Diatrizoate based bowel preparation regimes for computed tomography colonography (CTC) on the patient experience and image quality.
METHODS
100 patients consumed Meglumine-Diatrizoate at 24 h and 12 h prior to the CTC examination. 50 patients followed regime 1 (50:50), 50 ml of Meglumine-Diatrizoate at both 24 and 12 h prior to the examination. 50 patients followed regime 2 (75:25), 75 ml of Meglumine-Diatrizoate at 24 h prior to the examination and 25 ml of Meglumine-Diatrizoate at 12 h prior to the examination. All patients completed a questionnaire to indicate the time of onset of adverse effects and when they were most severe. Five advanced practitioners assessed the image quality in a visual grading study. Visual grading characteristic (VGC) analysis was applied with regime 1 as the reference condition and regime 2 and test condition; test alpha was set at 0.05.
RESULTS
Image quality was assessed with successful bowel cleansing as the scoring criteria for the visual grading study. The bowel cleansing as provided by the two Meglumine-Diatrizoate regimes was revealed not to be statistically different, with the area under the VGC curve and 95% confidence intervals 0.487 (0.287, 0.701), p = 0.887. Patients taking the 75:25 bowel preparation experienced a shorter median time to the onset of adverse effects.
CONCLUSION
There was no observed difference in Image quality criteria score for the two Meglumine-Diatrizoate based bowel preparation with more predictable adverse effects of Meglumine-Diatrizoate with the 75:25 preparation.
IMPLICATIONS FOR PRACTICE
Providing patients with a higher contrast burden 24 h prior to CTC may have a positive impact on the patient experience without compromising image quality.
Topics: Cathartics; Colonography, Computed Tomographic; Contrast Media; Diatrizoate Meglumine; Humans; Tomography
PubMed: 32376192
DOI: 10.1016/j.radi.2020.04.007 -
International Endodontic Journal May 2020To explore in a laboratory setting the feasibility of using Meglumine Diatrizoate (MD) to improve the accuracy of diagnosis of cracked teeth on cone-beam CT (CBCT)...
AIM
To explore in a laboratory setting the feasibility of using Meglumine Diatrizoate (MD) to improve the accuracy of diagnosis of cracked teeth on cone-beam CT (CBCT) images.
METHODOLOGY
Twenty-four teeth were cracked artificially by soaking them cyclically in liquid nitrogen and hot water. The number and position of crack lines were evaluated with a dental operating microscope and used as the gold standard. The artificially cracked teeth were then examined using routine scanning (RS) and enhanced scanning (ES) modes, respectively. For the ES mode, MD was painted on the surface of the crack lines, and then, CBCT scanning with the same parameters was performed after 10 min. A radiological graduate student and an experienced radiologist evaluated the presence or absence of crack lines, respectively. The differences between the RS and ES modes were determined and assessed using McNemar's test. Inter-examiner agreement and intra-examiner agreement were assessed using kappa analysis.
RESULTS
Fifty-seven crack lines were found in the 24 cracked teeth. In the RS mode, the accuracy of detection of crack lines was 23% (radiological graduate student) and 32% (experienced radiologist), whereas in the ES mode, the accuracy was 61% (radiological graduate student) and 65% (experienced radiologist). The inter-examiner agreement was 0.693 in RS mode and 0.849 in ES mode. The intra-examiner agreement was 0.872 and 0.949 for the radiological graduate student in RS and ES mode respectively; and one for the experienced radiologist both in RS and ES mode.
CONCLUSIONS
Compared with routine scanning mode, more crack lines could be detected in enhanced scanning mode using Meglumine Diatrizoate as a contrast medium. MD could be a potential contrast medium to improve the accuracy of detection of crack lines on CBCT images.
Topics: Cone-Beam Computed Tomography; Diatrizoate Meglumine; Humans; Tooth; Tooth Fractures; Tooth Root
PubMed: 31985061
DOI: 10.1111/iej.13270 -
Palliative Medicine Jan 2018Intestinal obstruction and constipation are common conditions in patients with advanced neoplasms. Diatrizoate Meglumine has been used in the management of both these...
BACKGROUND
Intestinal obstruction and constipation are common conditions in patients with advanced neoplasms. Diatrizoate Meglumine has been used in the management of both these conditions without good quality evidence of its effectiveness and safety.
AIM
This audit aimed to assess the usage, effectiveness and adverse effects of Diatrizoate Meglumine for intestinal obstruction and constipation in patients with advanced neoplasms.
DESIGN
A retrospective chart review was undertaken. Descriptive statistics were utilised.
SETTING/PARTICIPANTS
All patients with known advanced neoplasms admitted to Mater Health Services and St Vincent's Private Hospital Brisbane between January 2013 and October 2015; who were administered Diatrizoate Meglumine were included.
RESULTS
Seventy-one patients received Diatrizoate Meglumine. The most common diagnoses were ovarian or primary peritoneal neoplasms (33.8%). Diatrizoate Meglumine was most commonly used for intestinal obstruction (59.2%). The median dose used per patient episode was 50 mL (range: 15-500 mL). Thirty-two patients (45%) had imaging 4-24 h post-dose with Diatrizoate Meglumine being present in the large intestine in 75% of these images. Intestinal obstruction or constipation resolved in 90% of patients post-dose.
CONCLUSION
Most clinicians used 50 mL of Diatrizoate Meglumine as a single dose and repeated imaging after 4-24 h. Diatrizoate Meglumine was well tolerated and may be effective in resolving intestinal obstruction and constipation in patients with advanced neoplasms. Quality controlled studies are needed to further guide the use of Diatrizoate Meglumine in intestinal obstruction and constipation in patients with advanced neoplasms.
Topics: Adult; Aged; Aged, 80 and over; Australia; Constipation; Contrast Media; Diatrizoate Meglumine; Female; Humans; Intestinal Obstruction; Male; Middle Aged; Neoplasms; Prospective Studies; Retrospective Studies
PubMed: 28805119
DOI: 10.1177/0269216317726430 -
Neurosurgery Feb 1983
Topics: Animals; Basilar Artery; Cerebral Angiography; Diatrizoate; Diatrizoate Meglumine; Dose-Response Relationship, Drug; In Vitro Techniques; Male; Potassium; Rats; Rats, Inbred Strains; Vasodilation
PubMed: 6835495
DOI: 10.1227/00006123-198302000-00001 -
AJR. American Journal of Roentgenology Mar 1992Six hundred patients were prospectively randomized and given either diatrizoate meglumine 60 or iohexol 300 during dynamic contrast-enhanced body CT in order to compare... (Clinical Trial)
Clinical Trial Comparative Study Randomized Controlled Trial
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. When reactions of discomfort (heat or warmth, flushing, bad taste) were excluded, 16% (48/302) of the patients who received iohexol and 33% (99/298) of the patients who were given diatrizoate meglumine 60 had at least one adverse reaction. The differences in both types of reactions between the two agents were significant (p less than .001). Among scans evaluated for study quality, 71% (214/302) of the iohexol 300 group and 62% (184/298) of the diatrizoate meglumine 60 group had optimal enhancement (p = .02). However, when the optimal and adequate categories were combined, 301 of 302 patients given iohexol 300 and 292 of 298 patients given diatrizoate meglumine 60 had diagnostic-quality studies (no statistical difference). Studies were not terminated nor were images repeated in 97% (292/302) of the patients given iohexol 300 and in 94% (280/298) of those given diatrizoate meglumine 60. 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.
Topics: Diatrizoate Meglumine; Double-Blind Method; Female; Humans; Iohexol; Male; Middle Aged; Prospective Studies; Radiography, Abdominal; Radiography, Thoracic; Tomography, X-Ray Computed
PubMed: 1739017
DOI: 10.2214/ajr.158.3.1739017 -
The European Journal of Surgery = Acta... Dec 2001To test the use of meglumine and sodium diatrizoate (Gastrografin) as an agent for preoperative mechanical bowel preparation. (Clinical Trial)
Clinical Trial Comparative Study Randomized Controlled Trial
OBJECTIVE
To test the use of meglumine and sodium diatrizoate (Gastrografin) as an agent for preoperative mechanical bowel preparation.
DESIGN
Prospective randomised comparison.
SETTING
County general hospital, Greece.
SUBJECTS
58 patients listed for elective colorectal operations were randomly divided into 2 groups. The first (n = 30) was given Gastrografin 200 ml orally for 2 consecutive days before operation, and the second (n = 28) was given Ringer's solution through a nasogastric tube.
MAIN OUTCOME MEASURES
Tolerability, acceptability, quality of cleansing, and complications.
RESULTS
There were no disturbances in electrolyte concentrations, and other laboratory variables also remained unchanged. Two patients treated with Ringer's solution had appreciable increases in arterial blood pressure, but there were no significant overall changes. About half the patients given Ringer's felt nauseated and a third vomited. Such symptoms were uncommon in patients treated with Gastrografin (p < 0.01). 28/30 and 26/28 (93%) had a clean colonic lumen at operation, whereas in the reminder the lumen was evaluated as containing "slight residue". There were no operation-related complications.
CONCLUSIONS
Gastrografin can be used successfully as an agent for mechanical bowel preparation before elective colorectal surgery, as it gives equally good cleansing results compared with the established method of whole gut irrigation. It also seems to be better tolerated and accepted by patients.
Topics: Aged; Aged, 80 and over; Contrast Media; Diatrizoate Meglumine; Digestive System Surgical Procedures; Female; Humans; Isotonic Solutions; Male; Middle Aged; Preoperative Care; Prospective Studies; Ringer's Solution
PubMed: 11841079
DOI: 10.1080/110241501753361578 -
The Laryngoscope Nov 1977Thirty patients with sudden hearing loss were treated with diatrizoate meglumine (Hypaque) and a vasodilator regimen. Of these patients, 30% had a good response, 23% had...
Thirty patients with sudden hearing loss were treated with diatrizoate meglumine (Hypaque) and a vasodilator regimen. Of these patients, 30% had a good response, 23% had a moderate response, and 47% had no response. These results were superior to the results obtained in a group of patients with sudden hearing loss treated with vasodilators alone. A possible mode of action is discussed and the details of a new study outlined.
Topics: Adult; Aged; Diatrizoate; Diatrizoate Meglumine; Drug Therapy, Combination; Female; Hearing Disorders; Humans; Male; Middle Aged; Time Factors; Vasodilator Agents
PubMed: 916773
DOI: 10.1002/lary.1977.87.11.1809 -
Cardiovascular and Interventional... 1980In an effort to evaluate the "spillover method" of measuring blood flow during angiography, we explored the effects of rapid injection of diatrizoate meglumine and...
In an effort to evaluate the "spillover method" of measuring blood flow during angiography, we explored the effects of rapid injection of diatrizoate meglumine and diatrizoate sodium (Renografin-76) at rates no greater than resting blood flow in the superior mesenteric artery of anesthetized dogs. An increase in mesenteric blood flow and a decrease in mesenteric arterial pressure occurred many seconds after cessation of the injection. The dilation effected by the contrast agent was less marked at elevated blood flow values than at resting flows. The pattern of response to diatrizoate meglumine and diatrizoate sodium resembled that observed with vasodilator drugs. Our findings also suggest that the initial vascular response to a pulsation of the diatrizoate medium is vasodilation.
Topics: Animals; Blood Circulation; Blood Pressure; Diatrizoate; Diatrizoate Meglumine; Dogs; Female; Male; Mesenteric Arteries; Radiography; Technology, Radiologic; Vasodilation
PubMed: 7407811
DOI: 10.1007/BF02551980 -
AJR. American Journal of Roentgenology Apr 1997
Topics: Administration, Oral; Anaphylaxis; Contrast Media; Diatrizoate; Diatrizoate Meglumine; Female; Humans; Middle Aged; Pelvis; Pulmonary Edema; Radiography, Abdominal
PubMed: 9124149
DOI: 10.2214/ajr.168.4.9124149