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A different approach to contrast media, discussed primarily from the point of view of the radiologist. Comprehensive sections are devoted to iodinated contrast media and to the contrast media employed in magnetic resonance imaging and ultrasonography. The latest agents available receive due attention, as do adverse reactions. A final section considers the use of contrast media in nuclear medicine.
Extracellular MRI and X-ray contrast agents are characterized by their phar- cokinetic behaviour.After intravascular injection their plasma-level time curve is characeterized by two phases. The agents are rapidly distributed between plasma and interstitial spaces followed by renal elimination with a terminal half-live of approximatly 1–2 hours. They are excreted via the kidneys in unchanged form by glomerular filtration. Extracellular water-soluble contrast agents to be applied for X-ray imaging were introduced into clinical practice in 1923. Since that time they have proved to be most valuable tools in diagnostics.They contain iodine as the element of choice with a sufficiently high atomic weight difference to organic tissue. As positive contrast agents their attenuation of radiation is higher compared with the attenuation of the surrounding tissue. By this contrast enhancement X-ray diagnostics could be improved dramatically. In 2,4,6-triiodobenzoic acid derivatives iodine is firmly bound. Nowadays diamides of the 2,4,6-triiodo-5-acylamino-isophthalic acid like iopromide (Ultravist, Fig. 1) are used as non-ionic (neutral) X-ray contrast agents in most cases [1].
This volume highlights and broadens our understanding of the correct use and the possible contraindications of contrast agents applied in radiology. Written by experts in the field, it not only focuses on the chemistry, physiochemical properties and pharmacokinetics of both iodinated and gadolinium-containing contrast agents, but also on the relevant safety issues such as frequency of their short- and long-term side effects and ways to avoid them nephrotoxicity risk related to the iodinated contrast agents NSF (nephrogenic systemic fibrosis) accumulation of gadolinium in the brain use of contrast agents in pediatric patients and pregnancy It also includes essential data on the use of contrast agents, such as scanning protocols, in the context of various clinical conditions. This comprehensive manual addresses all professionals involved in radiological imaging and is an invaluable tool for radiologists and technologists, as well as for residents and clinicians.
This book is a comprehensive guide to contrast-enhanced mammography (CEM), a novel advanced mammography technique using dual-energy mammography in combination with intravenous contrast administration in order to increase the diagnostic performance of digital mammography. Readers will find helpful information on the principles of CEM and indications for the technique. Detailed attention is devoted to image interpretation, with presentation of case examples and highlighting of pitfalls and artifacts. Other topics to be addressed include the establishment of a CEM program, the comparative merits of CEM and MRI, and the roles of CEM in screening populations and monitoring of response to neoadjuvant chemotherapy. CEM became commercially available in 2011 and is increasingly being used in clinical practice owing to its superiority over full-field digital mammography. This book will be an ideal source of knowledge and guidance for all who wish to start using the technique or to learn more about it.
Short presentation of aspects important for the application of X-ray contrast media: Composition and properties of contrast media, handling with respect to stability, purity and sterility; applications, interaction, risks; drugs for prophylaxis and treatment of side effects.
Chronic kidney disease (CKD) is a major global public health problem, affecting nearly one in seven adults in the United States alone. It is a disease that integrates chronic illness at several levels, and the progressive condition is associated with high rates of co-morbidity. This text provides a comprehensive, current state-of-the art review of this field, serving as a valuable resource for primary care providers and non-nephrology clinicians that treat patients with CKD. It is comprised of 24 chapters focused on specific aspects of the disease. The first 2 chapters provide a bit of background on the disease, describing the anatomy and physiology of the kidney as well as the definition and epidemiology of the disease. The following 3 chapters discuss the detection, prevention and progression of the disease. The next 6 chapters describe the relationship of the disease with other conditions and most common co-morbidities such as diabetes and hypertension. The chapters, that follow focus on the CKD associated complications and the CKD within special populations such as the elderly and minorities as well as dietary restrictions and drug dosing. The book concludes with discussion on preparation for renal replacement therapy and preemptive organ transplantation as an alternative to dialysis in the management of the advanced CKD. Written by experts in the field, Approach to Chronic Kidney Disease is a comprehensive guide for clinicians, especially primary care providers including residents and fellows in training, who take care of chronic kidney disease patients. It is also a useful tool for researchers dealing with this challenging field.
Diagnostic Ultrasound Imaging provides a unified description of the physical principles of ultrasound imaging, signal processing, systems and measurements. This comprehensive reference is a core resource for both graduate students and engineers in medical ultrasound research and design. With continuing rapid technological development of ultrasound in medical diagnosis, it is a critical subject for biomedical engineers, clinical and healthcare engineers and practitioners, medical physicists, and related professionals in the fields of signal and image processing. The book contains 17 new and updated chapters covering the fundamentals and latest advances in the area, and includes four appendices, 450 figures (60 available in color on the companion website), and almost 1,500 references. In addition to the continual influx of readers entering the field of ultrasound worldwide who need the broad grounding in the core technologies of ultrasound, this book provides those already working in these areas with clear and comprehensive expositions of these key new topics as well as introductions to state-of-the-art innovations in this field. - Enables practicing engineers, students and clinical professionals to understand the essential physics and signal processing techniques behind modern imaging systems as well as introducing the latest developments that will shape medical ultrasound in the future - Suitable for both newcomers and experienced readers, the practical, progressively organized applied approach is supported by hands-on MATLAB® code and worked examples that enable readers to understand the principles underlying diagnostic and therapeutic ultrasound - Covers the new important developments in the use of medical ultrasound: elastography and high-intensity therapeutic ultrasound. Many new developments are comprehensively reviewed and explained, including aberration correction, acoustic measurements, acoustic radiation force imaging, alternate imaging architectures, bioeffects: diagnostic to therapeutic, Fourier transform imaging, multimode imaging, plane wave compounding, research platforms, synthetic aperture, vector Doppler, transient shear wave elastography, ultrafast imaging and Doppler, functional ultrasound and viscoelastic models
Medical Imaging in Clinical Practice is a compendium of the various applications of imaging modalities in specific clinical conditions. It captures in an easy to read manner, the experiences of various experts drawn from across the globe. It explores the conventional techniques, advanced modalities and on going research efforts in the ever widening horizon of medical imaging. The various topics would be relevant to residents, radiologists and specialists who order and interpret various medical imaging procedures. It is an essential for the inquisitive mind, seeking to understand the scope of medical imaging in clinical practice.
This revised edition of Contrast Media: Safety Issues and Guidelines, updates the successful first edition and contains new chapters. It provides an invaluable, unique and unparalleled source of information on the safety issues relating to contrast media.
Journalists, always very direct and in search of sensation, essentially asked me two questions on the occasion of this workshop: What were the goals of the meeting? With the improvement of diagnosis through the development of image techniques, didn't the contrast media already have their future behind them? Many answers were provided during the course of the workshop, and in order to best answer the journalists I proposed the following synopsis. 1. Since the 1979 Colorado Springs workshop organized by E. Lasser, progress has been so rapid and the newly available works so numerous that another meeting on an international level for the purpose of pre senting and discussing these advances appeared indispensable. Why not then in Europe and why not in Lyon? To expand on this progress, by 1981 the new contrast media with less-hyperosmolar molecules, still in the trial stage in 1979, were al most all available commercially for angiography, albeit at prohibitive prices. The advantages of these various media are becoming better known; moreover, in the wake of Lasser's work, our understanding of the pathophysiology of their noxious effects is also advancing rapidly owing to the use of models (for the target organs: heart, vessel wall, nervous system, kidney; and for the more general reactions: blood cells, coagulation, complement system, circulating enzymatic systems). In addition, further new molecules are currently being studied in re search laboratories. 2.