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Meei-ling Sheu - One of the best experts on this subject based on the ideXlab platform.
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Iodinated Contrast Medium exposure during computed tomography increase the risk of subsequent development of thyroid disorders in patients without known thyroid disease a nationwide population based propensity score matched longitudinal follow up stu
Medicine, 2015Co-Authors: Ming-shun Hsieh, Chien-shan Chiu, Wen Chi Chen, Jen-huai Chiang, Shih-yi Lin, Meng-yu Lin, Shih-liang Chang, Meei-ling SheuAbstract:To investigate the association between Iodinated Contrast Medium (ICM) exposure during computed tomography (CT) and the subsequent development of thyroid disorders in patients without known thyroid disease in Taiwan, an iodine-sufficient area. We conducted a population-based cohort study by using data from 1996 to 2012 in the Taiwan National Health Insurance Research Database. A total of 33,426 patients who underwent ICM-enhanced CT were included as the study cohort. To avoid selection bias, we used propensity score and matched for the index year (defined as the year of first ICM exposure) to retrieve 33,426 patients as the comparison cohort. No patients in the 2 cohorts had any known thyroid disease before the index year. Patients with a history of amiodarone treatment or coronary angiography and those with 0.5-year post-ICM exposure compared with that during ≤0.5-year post-ICM exposure (HR = 1.26; 95% CI: 1.01-1.58; P 1 time of ICM per year on average compared with those who accepted ≤1 time per year on average (adjusted HR = 3.04; 95% CI: 2.47-3.73; P < 0.001). This study identified ICM exposure during CT as a risk factor for the subsequent development of thyroid disorders in patients without known thyroid disease, particularly in patients with repeated exposure.
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Iodinated Contrast Medium Exposure During Computed Tomography Increase the Risk of Subsequent Development of Thyroid Disorders in Patients Without Known Thyroid Disease: A Nationwide Population-Based, Propensity Score-Matched, Longitudinal Follow-Up
Medicine, 2015Co-Authors: Ming-shun Hsieh, Chien-shan Chiu, Wen Chi Chen, Jen-huai Chiang, Shih-yi Lin, Meng-yu Lin, Shih-liang Chang, Meei-ling SheuAbstract:To investigate the association between Iodinated Contrast Medium (ICM) exposure during computed tomography (CT) and the subsequent development of thyroid disorders in patients without known thyroid disease in Taiwan, an iodine-sufficient area. We conducted a population-based cohort study by using data from 1996 to 2012 in the Taiwan National Health Insurance Research Database. A total of 33,426 patients who underwent ICM-enhanced CT were included as the study cohort. To avoid selection bias, we used propensity score and matched for the index year (defined as the year of first ICM exposure) to retrieve 33,426 patients as the comparison cohort. No patients in the 2 cohorts had any known thyroid disease before the index year. Patients with a history of amiodarone treatment or coronary angiography and those with 0.5-year post-ICM exposure compared with that during ≤0.5-year post-ICM exposure (HR = 1.26; 95% CI: 1.01-1.58; P 1 time of ICM per year on average compared with those who accepted ≤1 time per year on average (adjusted HR = 3.04; 95% CI: 2.47-3.73; P
Ming-shun Hsieh - One of the best experts on this subject based on the ideXlab platform.
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Iodinated Contrast Medium exposure during computed tomography increase the risk of subsequent development of thyroid disorders in patients without known thyroid disease a nationwide population based propensity score matched longitudinal follow up stu
Medicine, 2015Co-Authors: Ming-shun Hsieh, Chien-shan Chiu, Wen Chi Chen, Jen-huai Chiang, Shih-yi Lin, Meng-yu Lin, Shih-liang Chang, Meei-ling SheuAbstract:To investigate the association between Iodinated Contrast Medium (ICM) exposure during computed tomography (CT) and the subsequent development of thyroid disorders in patients without known thyroid disease in Taiwan, an iodine-sufficient area. We conducted a population-based cohort study by using data from 1996 to 2012 in the Taiwan National Health Insurance Research Database. A total of 33,426 patients who underwent ICM-enhanced CT were included as the study cohort. To avoid selection bias, we used propensity score and matched for the index year (defined as the year of first ICM exposure) to retrieve 33,426 patients as the comparison cohort. No patients in the 2 cohorts had any known thyroid disease before the index year. Patients with a history of amiodarone treatment or coronary angiography and those with 0.5-year post-ICM exposure compared with that during ≤0.5-year post-ICM exposure (HR = 1.26; 95% CI: 1.01-1.58; P 1 time of ICM per year on average compared with those who accepted ≤1 time per year on average (adjusted HR = 3.04; 95% CI: 2.47-3.73; P < 0.001). This study identified ICM exposure during CT as a risk factor for the subsequent development of thyroid disorders in patients without known thyroid disease, particularly in patients with repeated exposure.
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Iodinated Contrast Medium Exposure During Computed Tomography Increase the Risk of Subsequent Development of Thyroid Disorders in Patients Without Known Thyroid Disease: A Nationwide Population-Based, Propensity Score-Matched, Longitudinal Follow-Up
Medicine, 2015Co-Authors: Ming-shun Hsieh, Chien-shan Chiu, Wen Chi Chen, Jen-huai Chiang, Shih-yi Lin, Meng-yu Lin, Shih-liang Chang, Meei-ling SheuAbstract:To investigate the association between Iodinated Contrast Medium (ICM) exposure during computed tomography (CT) and the subsequent development of thyroid disorders in patients without known thyroid disease in Taiwan, an iodine-sufficient area. We conducted a population-based cohort study by using data from 1996 to 2012 in the Taiwan National Health Insurance Research Database. A total of 33,426 patients who underwent ICM-enhanced CT were included as the study cohort. To avoid selection bias, we used propensity score and matched for the index year (defined as the year of first ICM exposure) to retrieve 33,426 patients as the comparison cohort. No patients in the 2 cohorts had any known thyroid disease before the index year. Patients with a history of amiodarone treatment or coronary angiography and those with 0.5-year post-ICM exposure compared with that during ≤0.5-year post-ICM exposure (HR = 1.26; 95% CI: 1.01-1.58; P 1 time of ICM per year on average compared with those who accepted ≤1 time per year on average (adjusted HR = 3.04; 95% CI: 2.47-3.73; P
P. Hulek - One of the best experts on this subject based on the ideXlab platform.
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Wedged hepatic venography for targeting the portal vein during TIPS: comparison of carbon dioxide and Iodinated Contrast agents.
Cardiovascular and interventional radiology, 2002Co-Authors: Antonín Krajina, Miroslav Lojík, Vendelín Chovanec, Jan Raupach, P. HulekAbstract:Purpose: Carbon dioxide (CO 2 ) can traverse the hepatic sinusoids better than Iodinated Contrast Medium and has been used by many interventionalists for wedged hepatic venography during transjugular intrahepatic portosystemic shunt (TIPS) procedures. Our study was designed to compare the extent of the portal vein opacification using either CO 2 or Iodinated Contrast Medium. Methods: Wedged hepatic venography for portal vein opacification during TIPS was performed using hand injection through a 6.5 Fr diagnostic catheter. Portograms of 36 patients performed with 10 ml of Iodinated Contrast Medium were retrospectively compared with portograms of 45 patients performed with 30-40 ml of CO 2 . Opacification of the right portal vein branch including the portal vein bifurcation was defined as a successful study. Results: Using CO 2 the right portal vein branch and the portal vein bifurcation were opacified in 87% of patients (39 of 45); only a part of the right portal vein branch was opacified in 6% of patients and no opacification of any portal vein branch was seen in 7% of patients. Using Iodinated Contrast Medium, there was opacification of the portal vein bifurcation in 25% of patients (9 of 36), of a part of the portal vein branch in 36% and no opacification of any branch in 39%. There was one case of hepatic laceration from CO 2 wedged venography which was treated with microcoil embolization. Conclusions: Using CO 2 as a Contrast Medium, opacification of the portal vein bifurcation by wedged hepatic venography was seen in 87% of patients, in comparison with only 25% when Iodinated Contrast Medium was used (p < 0.001). CO 2 is superior to Iodinated Contrast Medium for wedged hepatic venography during TIPS.
Guy Marchal - One of the best experts on this subject based on the ideXlab platform.
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The Use of Carbon Dioxide Wedged Hepatic Venography to Identify the Portal Vein: Comparison with Direct Catheter Portography with Iodinated Contrast Medium and Analysis of Predictive Factors Influencing Level of Opacification
Journal of Vascular and Interventional Radiology, 2006Co-Authors: Geert Maleux, Frederik Nevens, Sam Heye, Chris Verslype, Guy MarchalAbstract:PURPOSE This study was conducted to assess the value of wedged hepatic venography (WHV) with CO 2 as a Contrast agent for identification of the portal venous system in patients with cirrhosis. Additionally, the predictive value of several parameters that potentially influence the level of portal vein opacification by CO 2 WHV was analyzed. MATERIALS AND METHODS In 163 patients, CO 2 WHV was performed before transjugular intrahepatic portosystemic shunt creation to opacify and map the portal vein for subsequent targeting by intrahepatic puncture technique. Concordance between CO 2 WHV and direct catheter portography with Iodinated Contrast Medium was assessed by analysis of sensitivity parameters. Additionally, analysis of factors potentially influencing the opacification of the portal vein with use of CO 2 WHV was assessed. RESULTS CO 2 WHV was successfully performed in all 163 patients. In three patients (1.8%), CO 2 extravasation was noted, but without any clinical consequence. Sensitivity rates of CO 2 WHV for opacification of the right and left portal veins and the portal main trunk were 93.83% and 68.52%, respectively. Positive predictive factors ( P CONCLUSIONS CO 2 WHV is safe, highly efficient, and reliable in the identification of the right and left portal veins. CO 2 WHV is clearly less effective in opacifying the entire portal main trunk. With use of CO 2 WHV, the portal venous system is most distinctly opacified in patients presenting with a high portosystemic gradient, a spontaneous splenorenal shunt, esophageal varices, and reversed portal flow.
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The use of carbon dioxide wedged hepatic venography to identify the portal vein: comparison with direct catheter portography with Iodinated Contrast Medium and analysis of predictive factors influencing level of opacification.
Journal of vascular and interventional radiology : JVIR, 2006Co-Authors: Geert Maleux, Frederik Nevens, Sam Heye, Chris Verslype, Guy MarchalAbstract:This study was conducted to assess the value of wedged hepatic venography (WHV) with CO(2) as a Contrast agent for identification of the portal venous system in patients with cirrhosis. Additionally, the predictive value of several parameters that potentially influence the level of portal vein opacification by CO(2) WHV was analyzed. In 163 patients, CO(2) WHV was performed before transjugular intrahepatic portosystemic shunt creation to opacify and map the portal vein for subsequent targeting by intrahepatic puncture technique. Concordance between CO(2) WHV and direct catheter portography with Iodinated Contrast Medium was assessed by analysis of sensitivity parameters. Additionally, analysis of factors potentially influencing the opacification of the portal vein with use of CO(2) WHV was assessed. CO(2) WHV was successfully performed in all 163 patients. In three patients (1.8%), CO(2) extravasation was noted, but without any clinical consequence. Sensitivity rates of CO(2) WHV for opacification of the right and left portal veins and the portal main trunk were 93.83% and 68.52%, respectively. Positive predictive factors (P < .05, Wilcoxon two-sample test) were high portosystemic gradient, spontaneous splenorenal shunt, esophageal varices, and reversed portal flow. One negative predictive factor was a patent umbilical vein. CO(2) WHV is safe, highly efficient, and reliable in the identification of the right and left portal veins. CO(2) WHV is clearly less effective in opacifying the entire portal main trunk. With use of CO(2) WHV, the portal venous system is most distinctly opacified in patients presenting with a high portosystemic gradient, a spontaneous splenorenal shunt, esophageal varices, and reversed portal flow.
Shee Yen Tay - One of the best experts on this subject based on the ideXlab platform.
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Large-volume Iodinated Contrast Medium extravasation: low frequency and good outcome after conservative management in a single-centre cohort of more than 67,000 patients
European Radiology, 2018Co-Authors: Chih-hsiang Ko, Shee Yen Tay, Hsiu-chin Chang, Wing P ChanAbstract:ObjectivesOur aim was to retrospectively investigate the frequency and outcome of large-volume Iodinated Contrast Medium (CM) extravasation in our institution and to compare our management protocol to current practice.MethodsInstitutional review board approval was obtained, and informed consent was waived because the study was retrospective. From January 2008 to September 2016, radiological examinations with intravenous non-ionic Iodinated CM administration were performed in 67,129 patients. Contrast Medium extravasation events on CT scans and intravenous pyelograms but not on angiograms were included. All data were collected prospectively and stratified according to age, injection method (manual vs auto-injection), prevention of extravasation by various means (including intercom alarm), management of extravasation (routine application of silver sulfadiazine ointment, clobetasol propionate cream, and damp gauze at room temperature), etc.ResultsThe incidence of large-volume CM extravasation was very low (0.04% [27/67,129] overall; 0.03% related to manual injection [age range, 59-92 years; mean, 75.4 years], and 0.045% related to auto-injection [age range, 36-86 years; mean, 65.8 years]). The CM extravasation volume in majority of patients was 20–40 ml in 5 of 9 patients (55.6%) in the manual injection group and 14 of 18 (77.8%) in the auto-injection group. Swelling and pain were the most common symptoms. No patient developed severe signs or needed surgical intervention.ConclusionsResults show a very low incidence of large-volume CM extravasation without severe complications or sequelae. The casual effect between our protocols and good outcome cannot be scrutinised thoroughly because the study lacks a control group and is retrospective.Key Points• The incidence of large-volume Contrast Medium extravasation (≥20 ml) was 0.04%. • No patient needed surgical intervention, and most recovered within 7 days. • Each element of our management protocol contributed to good outcome.
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Large-volume Iodinated Contrast Medium extravasation: low frequency and good outcome after conservative management in a single-centre cohort of more than 67,000 patients.
European radiology, 2018Co-Authors: Shee Yen Tay, Hsiu-chin Chang, P. ChanAbstract:Our aim was to retrospectively investigate the frequency and outcome of large-volume Iodinated Contrast Medium (CM) extravasation in our institution and to compare our management protocol to current practice. Institutional review board approval was obtained, and informed consent was waived because the study was retrospective. From January 2008 to September 2016, radiological examinations with intravenous non-ionic Iodinated CM administration were performed in 67,129 patients. Contrast Medium extravasation events on CT scans and intravenous pyelograms but not on angiograms were included. All data were collected prospectively and stratified according to age, injection method (manual vs auto-injection), prevention of extravasation by various means (including intercom alarm), management of extravasation (routine application of silver sulfadiazine ointment, clobetasol propionate cream, and damp gauze at room temperature), etc. The incidence of large-volume CM extravasation was very low (0.04% [27/67,129] overall; 0.03% related to manual injection [age range, 59-92 years; mean, 75.4 years], and 0.045% related to auto-injection [age range, 36-86 years; mean, 65.8 years]). The CM extravasation volume in majority of patients was 20–40 ml in 5 of 9 patients (55.6%) in the manual injection group and 14 of 18 (77.8%) in the auto-injection group. Swelling and pain were the most common symptoms. No patient developed severe signs or needed surgical intervention. Results show a very low incidence of large-volume CM extravasation without severe complications or sequelae. The casual effect between our protocols and good outcome cannot be scrutinised thoroughly because the study lacks a control group and is retrospective. • The incidence of large-volume Contrast Medium extravasation (≥20 ml) was 0.04%. • No patient needed surgical intervention, and most recovered within 7 days. • Each element of our management protocol contributed to good outcome.
