Abstract

BackgroundThe aim of this study was to compare the safety and intra-individual contrast enhancement of low-osmolar monomeric iohexol and the iso-osmolar dimeric iodixanol in body computed tomography (CT) scanning.MethodsIn this single center, double-blind, prospective study, a total of 2000 consecutive patients undergoing adult body CT scanning were prospectively enrolled, with 1000 patients assigned to iodixanol and 1000 patients assigned to iohexol. In both groups, the contrast medium was injected at the rate of 3.5 ml/s. Subjective assessment of image quality for each image was determined using a 3-grading scale by three reviewers. Patients were monitored with questioning and vital signs before injection, immediately after injection, and at 24 and 48 h. Extensive laboratory evaluation also was performed.ResultsLaboratory results showed no significant difference across groups. There were also no detectable differences in image quality between the two contrast groups in this study. The total adverse reactions occurred in less than 1 % of individuals receiving iodixanol comparing to 2.5 % in iohexol group (P < 0.05). Among them, only 0.7 % patients injecting iodixanol suffered immediate events, comparing to 2 % patients in iohexol group. In all, 0.2 % patients with iodixanol and 0.5 % with iohexol had late allergic reaction. Further, No deaths occurred in any of the two groups.ConclusionsThe iso-osmolar iodixanol provides image quality compared with that of iohexol, with lower incidence of adverse events.

Highlights

  • The aim of this study was to compare the safety and intra-individual contrast enhancement of lowosmolar monomeric iohexol and the iso-osmolar dimeric iodixanol in body computed tomography (CT) scanning

  • Subjects allocated to the experimental arm underwent body computed tomography scanning using the contrast medium of iodixanol, whereas iohexol was used in the controlled arm of the trial

  • The diagnostic images in iodixanol group was evaluated as Grade 1 for 80.9 % (809/1000) of the individuals and 82.6 % (826/1000) of the patients in the iohexol group

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Summary

Introduction

The aim of this study was to compare the safety and intra-individual contrast enhancement of lowosmolar monomeric iohexol and the iso-osmolar dimeric iodixanol in body computed tomography (CT) scanning. The hyper-osmolality is believed to be an important factor for systemic adverse reactions of contrast agents and responsible for local symptom from contrast media extravasations (Lee et al 1996). A latter double blind, randomized, prospective, multi-center study has concluded that iohexol was more nephrotoxic among high risk groups, compared with the iso-osmolar, agent iodixanol (Doerfler et al 1999). Numerous clinical trials demonstrated comparable safety and efficacy in body computed tomography usage (Lee et al 1996). Iohexol is another extensively used low-osmolar monomer non-ionic contrast medium, which is considered to safe, efficient and be

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