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Trauma
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
Danielle M. Prentice, Lauren A. Plante
Iodinated contrast medium is not known to be harmful to fetuses: it is not teratogenic and does not suppress fetal thyroid function. The American College of Radiology states, “We do not recommend withholding the use of iodinated contrast agents in pregnant or potentially pregnant patients when it is needed for diagnostic purposes” [80].
Laryngeal tumours
Published in Anju Sahdev, Sarah J. Vinnicombe, Husband & Reznek's Imaging in Oncology, 2020
Philip Touska, Steve Connor, Robert Hermans
Image acquisition is carried out from the skull base to the thoracic inlet during quiet respiration with the patient lying supine with the arms down, shoulders dropped and neck in slight extension (17). Injection of iodinated contrast medium is required to aid discrimination of both normal anatomical structures and pathology. A single bolus technique with an injection rate of 1–2 mL/s and a delay of 100 seconds is typically utilized.
Cardiac Diagnostic Testing in Pregnancy
Published in Afshan B. Hameed, Diana S. Wolfe, Cardio-Obstetrics, 2020
Pulmonary CTA is the imaging of choice in the diagnoses of PE due to its high sensitivity and specificity. Disadvantages include maternal breast radiation exposure of up to 10–70 mGy, fetal radiation exposure, and risks related to iodinated contrast material [32,34]. The most common side effects associated with iodinated contrast media include nausea, vomiting, flushing, and anaphylactoid reaction. Iodine contrast media can readily cross the placenta; however, animal studies have not shown any teratogenic or mutagenic effects with its use [8]. The current recommendation is that contrast may be used when needed and when benefits outweigh the risks.
Mastocytosis and related entities: a practical roadmap
Published in Acta Clinica Belgica, 2023
Michiel Beyens, Jessy Elst, Marie-Line van der Poorten, Athina Van Gasse, Alessandro Toscano, Anke Verlinden, Katrien Vermeulen, Marie-Berthe Maes, J. N. G. Hanneke Oude Elberink, Didier Ebo, Vito Sabato
If mastocytosis is diagnosed, it is mandatory to educate the patient to recognize signs of anaphylaxis since their risk of anaphylaxis is higher, particularly in patients without skin lesions [34]. Patients should always carry two epinephrine auto-injectors and be instructed when/how to use these correctly. Triggers for anaphylaxis should be avoided (see table 6) with attention to augmenting factors (e.g. alcohol, infections, exercise, stress). To reduce the risk of anaphylaxis, patients with SM in need of surgery or procedures involving iodinated contrast media, should always undergo a thorough pre-procedural evaluation [35] and, if the intervention were to be scheduled, one can consider a second-generation H1-antihistamine three days prior to the procedure and continue this up until three days after the procedure. Moreover, patients should receive corticosteroids (80 mg methylprednisolone) 24 h and 1 h in advance of the procedure. It is of note that alternative protocols are used worldwide and data concerning efficacy is lacking [36] and one should always remain cautious in these patients. Adrenaline should always be within reach. Finally, if an IgE-mediated HVA is present, lifelong VIT is indicated [37].
Performance of computed tomography and its reliability for the diagnosis of transmural gastrointestional necrosis in a setting of acute ingestion of predominantly strong acid substances in adults
Published in Clinical Toxicology, 2023
Rathachai Kaewlai, Napakadol Noppakunsomboon, Sasima Tongsai, Bandana Tamrakar, Nutnaree Kumthong, Wanwarang Teerasamit, Napaporn Kongkaewpaisan, Arin Pisanuwongse, Ramida Amornsitthiwat, Worapat Maitriwong, Chanikarn Khanutwong, Piyaporn Apisarnthanarak
The CT examinations were performed on the hospital’s multidetector CT scanners. There were two 64-slice scanners (LightSpeed VCT and Discovery CT750 HD, both from GE Healthcare) and two 256-slice scanners (Revolution CT, GE Healthcare). Axial scans were performed with a 1.25-mm slice thickness in an unenhanced phase of the chest, abdomen, and pelvis. This was followed by the intravenous administration of nonionic iodinated contrast media (300–370 mg of iodine/mL; 1.5–2.0 mL/kg) at 2–4 mL/s via injectors. Oral or rectal contrast media were not used. Postcontrast scans of the chest portion were performed in the late arterial phase (approximately 35 s after contrast administration). For the abdomen/pelvis portion, these procedures were performed in a portovenous phase (approximately 80 s after contrast administration). The chest scan parameters were 120 kVp and 250 mAs for the 64-multidetector CT systems and 180 mAs for the 256- multidetector CT systems. The abdominal-pelvic scan parameters were 120 kVp and 300 mAs for the 64-multidetector CT systems and 250 mAs for the 256-multidetector CT systems. Images were sent to a Picture Archiving and Communication System (Synapse, FujiFilm Corporation).
A trial to visualize perforators images from CTA with a tablet device: experience of operating on minipigs
Published in Computer Assisted Surgery, 2022
Hisato Konoeda, Miyuki Uematsu, Nie Jumxiao, Ken Masamune, Hiroyuki Sakurai
Following catheterization of the left jugular vein and the attachment of. CT scanner skin markers (IZI Medical Products Inc., MD, USA), which were placed onto the surface of the skin at 50-mm intervals prior to image acquisition, CTA and the surgical procedure were conducted with the animal in the prone position. CTA was performed using a 16-detector-row CT scanner (BrightSpeed Elite; General Electric, Milwaukee, WI, USA). The scans were performed using the following parameters: 0.37-s gantry rotation speed, 0.50-mm collimator width slice thickness, and 1.37 helical detector pitch. The X-ray tube voltage was 120 kV, and the tube current ranged from 118 to 151 mA. All scanning procedures were performed after intravenous administration of 200 ml of nonionic iodinated contrast medium at a concentration of 370 mg/ml (Iopamilon 370; Bayel, Tokyo, Japan). The contrast material was injected at a rate of 4 ml/s via an 18-g intravenous catheter inserted into the left jugular vein. The scanning delay was 10 s.