Barium Preparations Research Articles

Challenges in Preparing Contrast Media for Videofluoroscopy

We would like to congratulate Popa Nita and colleagues [1] for their article exploring the challenges of matching the rheological (i.e. flow) properties of contrast agents used in videofluoroscopy to thickened liquids used in dysphagia management. This article clearly illustrates the complexities of this challenge; however, there are three additional points that we feel would be clinically relevant and important to bring to the attention of the readers of the Dysphagia journal: The rheological characteristics of barium preparations need to be understood with respect to how they map to clinical categories of liquid consistency; The concentration of barium in commercially available suspensions affects both its visibility on the radiographic image, and the degree to which the suspension leaves a coating on the pharyngeal mucosa; Mixing barium powder into already-thickened liquids may result in further thickening of the liquid. We will provide a brief elaboration on each of these points below.

胃X線検査用造影剤のコントラスト特性と撮影タイミングについて

胃X線検査用造影剤のコントラスト特性と撮影タイミングについて

Evaluation of oral contrast agents for abdominal magnetic resonance imaging

We evaluated the efficacy of six available oral contrast agents in improving visualization of bowel and surrounding structures on magnetic resonance imaging of the abdomen and pelvis. Five volunteers were examined without oral contrast (baseline) and, on separate occasions, after ingestion of 600–900 cc of two positive contrasts [12.5% weight-to-volume (w/v) corn oil emulsion (COE), Redi Cat (EZ-Em Corp., Westbury, NY) mixed with 1% ferric ammonium citrate (FAC)] and four negative contrasts [220%, 105%, 85%, 60% w/v barium sulfate (Liquid HD, Liquid Polybar Plus, HD 85, reconstituted EZ Pake; EZ-Em Corp., Westbury, NY)]. Spin-echo axial and coronal T 1-weighted and axial T 2-weighted images were obtained in the abdomen and pelvis. Three radiologists blindly graded the images for improved visualization of bowel and surrounding structures. Data were analyzed for statistical significance using the General Linear Models algorithm. In the upper abdomen (stomach, duodenum, liver, and pancreas), COE yielded the highest mean scores ( p < .0001), followed by 220% w/v barium. For the lower abdomen (ileum, colon), 220% w/v barium yielded the highest scores ( p < .0001) and COE was much worse. The higher density barium preparations (220% and 105% w/v) yielded higher scores than their lower density counterparts (85% and 60%). All contrasts improved visualization of the retroperitoneum and spleen, but no one agent was best. All agents tested are superior to no agent at all. For visualization of the upper abdomen, 12.5% COE performed best. For visualization of the lower abdomen, 220% w/v barium performed best. For concurrent evaluation of both areas with one agent, 220% w/v barium performed best.

442. 高濃度硫酸バリウムの基礎的検討 : 第 3 報(第 48 回総会学術大会一般研究発表予稿)

442. 高濃度硫酸バリウムの基礎的検討 : 第 3 報(第 48 回総会学術大会一般研究発表予稿)

442. 高濃度硫酸バリウムの基礎的検討第 3 報(X 線透視撮影技術)

442. 高濃度硫酸バリウムの基礎的検討第 3 報(X 線透視撮影技術)

11. 高濃度硫酸バリウムの基礎的検討第 2 報(造影撮影-1 上部消化管)

11. 高濃度硫酸バリウムの基礎的検討第 2 報(造影撮影-1 上部消化管)

Comparison of Kaopectate with barium for negative and positive enteric contrast at MR imaging.

In an evaluation of safe, inexpensive, orally administered contrast agents for use at magnetic resonance imaging, different concentrations of the clay agents kaolin-pectate and attapulgite were compared in an in vitro phantom by performing spin-echo imaging with variable echo times to estimate T2 relaxation time. Additional phantoms containing from 0% to 100% attapulgite or barium preparations were compared by using spin-echo and spoiled-gradient-echo techniques to estimate T1, T2, and T2* relaxation times. In vivo spin-echo and gradient-echo images were obtained of 10 healthy volunteers and of five patients with pancreatic disease after oral administration of 12-16 oz of attapulgite preparation. T1 and T2 relaxation times obtained with use of attapulgite were slightly lower than those obtained with kaolin-pectate at both 50% and 25% concentrations. Compared with barium, attapulgite had shorter T1, T2, and T2* relaxation times, and concentration-dependent relaxivity was greater by nearly an order of magnitude. All subjects were able to drink the attapulgite, and the only complaints were of bad taste and mildly loose stools.

11. 高濃度硫酸バリウムの基礎的検討 第 2 報(第 19 回秋季学術大会一般研究発表予稿)

11. 高濃度硫酸バリウムの基礎的検討 第 2 報(第 19 回秋季学術大会一般研究発表予稿)

6. 高濃度硫酸バリウムの基礎的検討第 1 報(上部消化管撮影技術)

6. 高濃度硫酸バリウムの基礎的検討第 1 報(上部消化管撮影技術)

6. 高濃度硫酸バリウムの基礎的検討第 1 報

6. 高濃度硫酸バリウムの基礎的検討第 1 報

Aspiration of high-density barium contrast medium causing acute pulmonary inflammation — report of two fatal cases in elderly women with disordered swallowing

Two cases are reported in which accidental inhalation of barium contrast medium occurred owing to disordered swallowing in elderly women. In each case there was a pulmonary inflammatory reaction followed within a few hours by death. Experimental and clinical reports of barium inhalation are reviewed and the hazard of aspiration of high density barium preparations in elderly and debilitated patients with dysphagia is emphasised. It is concluded that particular care should be taken in the radiological examination of such patients, and a suggested method for performing a contrast swallow in those who are liable to aspirate is described.

Enteric-coated aspirin bezoar: Elevation of serum salicylate level by barium study

The gastric accumulation of enteric-coated aspirin tables due to peptic ulcer disease or gastric outlet scarring and the impaired gastric emptying that results have been previously reported. In the case reported herein, an unanticipated peaking of plasma salicylate levels occurred following radiographic studies in which barium was used. This phenomenon prompted an in vitro study in which dissolution rates of entericoated aspirin in various barium preparations were determined, suggesting that dissolution is dependent upon effervescent activity of the milieu, as well as pH. The use of barium in diagnosing suspected accumulation of enteric-coated aspirin is discussed, and techniques for tablet removal are reviewed.

Hypersensitivity reactions after barium studies of the upper and lower gastrointestinal tract.

One hundred sixty-seven members of the Society of Gastrointestinal Radiologists, three major commercial suppliers of barium preparations, and the Food and Drug Administration were surveyed about the incidence of hypersensitivity reactions after the administration of barium for stomach or colon examinations. The American literature was also reviewed. Twenty-seven radiologists reported 42 reactions, the companies reported 41 reactions, and the FDA documented 11 cases. An additional 12 cases were found in the literature, giving a total of 106 reactions. Of all the cases, 61% involved the skin, 8% were respiratory in nature, 8% of the patients lost consciousness, and one patient experienced an extraordinary migraine headache. Of the 42 cases reported by the radiologists, half occurred after stomach examination and half after a barium enema examination; the single-contrast technique had been used in only nine of the cases. Glucagon had been used in 11 of the 42 cases. Hypersensitivity reactions can occur after the administration of barium products and are caused by one of the many additives. These reactions are extremely unusual.

The adhesiometer: a simple device to measure adherence of barium sulfate to intestinal mucosa.

A simple, inexpensive device assessing barium sulfate adherence to alimentary tract mucosa was tested in an animal study using pigs and dogs. Interaction of gastric, intestinal, and colonic mucosal lining with three different barium preparations was studied. In both pigs and dogs, barium adherence to gastric mucosa was significantly stronger when compared with colonic mucosa.

Double contrast barium meal examination: A comparison of two high density barium preparations, E-Z-HD and X-Opaque

A clinical trial comparing E-Z-HD and X-Opaque, both high density, low viscosity barium preparations designed for use in double contrast barium meal examinations, found no significant difference in their performance.

Double Contrast Gastrointestinal Radiology With Endoscopic Correlation

Double contrast radiography of the colon has been available to the radiologist for decades. Within the last few years, however, there has been a resurgence in this technique. Improvement in apparatus and barium preparations has resulted in notably superior radiographs. A detailed look at the mucosal lining of gut has been provided. A need then arose for interpretation of these surface patterns as well as a technique to reproduce these images consistently. The author and his collaborators have answered this need with<i>Double Contrast Gastrointestinal Radiology With Endoscopic Correlation</i>. Detailed in 17 chapters is a method for double contrast examination of the entire gastrointestinal tract. Technical and interpretative information is described; radiographic reproductions are excellent. The chapter entitled "Principles of Double Contrast Diagnosis" is particularly useful in presenting basic concepts of interpretation that apply to double contrast examination of any region of the gut. Pathology presented has been limited to

The double contrast meal–new high density barium sulphate powders

I was interested in Dr. James's experiences (James, 1978) with high density barium preparations for double contrast examinations of the oesophagus, stomach and duodenum. The demonstration of the fine mucosal detail, to show small ulcers and scars, etc., is of course the reason for undertaking double contrast examinations. High density barium preparations give a different coating to standard suspensions, that may make it easier to see the fine mucosal detail. The mucosal layer of barium suspension is considerably more frequently. However, from my experience in using both types of suspensions i feel that the higher radiographic density of the large particle suspension makes it easier to see the areae gastricae.

IV.消化管撮影における技術的諸問題 : 硫酸バリウム造影剤の基礎的研究(消化管撮影における技術的諸問題)

The authors investigated the actual conditions of gastrointestinal tract radiography. The problems are as follows. The authors emphasize the point that is the curriculum in school and education after graduation. It is necessary to consider about the radiocontrast media, the particle size of film and intensifying screen and X-ray apparatus. The authors made a comparative studies in vitro using some barium preparations. It is assumed that there is no preparation to satisfy within the limits of these experiments. Furthermore, the mixture method of preparations was performed. The experimental results did not show clearly the satisfactory effect. As the studies in vitro enter a delicate phase, the judgement of barium preparation in vitro is very difficult. Considering such problem, we must understand well about barium contrast media and must handle it with extreme caution.

Assessment of the double contrast barium meal: Method and application

A method of assessing and comparing double contrast barium meals has been devised. The use of the linear analogue scale has been found to be a consistent method of recording and measuring radiological impression of mucosal coating and gaseous distension. By this means the effectiveness of various currently available barium and gas preparations has been assessed in 125 patients. Appreciable differences in mucosal coating achieved by different barium preparations were detected. Satisfactory gaseous distension of the stomach and duodenum was produced in the majority of patients by all of the methods tested, and the following measurements are suggested as an index of good distension: gastric fundus 10 cm, gastric midbody 7 cm, duodenal loop 4 cm. The relationships between mucosal coating, gaseous distension and areae gastricae have been shown to be tenuous. It is suggested that the methods we have used are very suitable for repetition in other centres for the comparison of any of the many barium and gas-producing agents which continue to come on to the market.

Roentgenographic pattern and motility in small bowel studies.

Roentgenographic study of the small intestine often requires three to six hours. In addition, it is frequently noted that there is a lack of uniform filling of the entire small bowel, so that even after several roentgenograms are made the discontinuity of the barium column leads to an inconclusive diagnosis. The ingestion of cold saline (8) has been suggested as a means of hastening small intestinal motility. Some of the familiar barium preparations are said to show flocculation in the presence of mucus, thus producing an unusual small bowel pattern. Colloidal suspensions of barium have been used (1, 2) for obtaining a more uniform pattern. The small bowel enema (6, 7), after intubation of the duodenum, has been proposed as affording more rapid uniform filling of the small intestine. The use of purgatives (3) and parenteral neostigmine (4) have also been suggested, to decrease transit time and improve the diagnostic pattern. In Charity Hospital (New Orleans), several hundred roentgenographic examinations are performed daily by a relatively small staff of radiologists and technicians. It seemed desirable to develop a simple method of outlining the small intestine in a rapid, uniform manner if this could be done without any sacrifice of accuracy in diagnosis. With the oral ingestion of 6 ounces or less of the usual barium suspension, a tendency to segmentation is noted (Fig. 1), and four to six hours, often more, arc required for the study. The question arose whether an increase in the volume of the meal might help overcome these objections. This could be done by increasing the original barium meal or by giving an additional amount of barium suspension, saline, or water after a given interval of time. During routine fluoroscopy of the stomach it was noted that when the patient was in the right lateral recumbent position the stomach emptied at a rapid, uniform rate. It seemed logical that this position might be used to produce a more rapid and uniform filling of the small intestine. Clinical Experiment I The opportunity arose to investigate some of the above possibilities when, in the Spring of 1959, the Department of Physiology requested that the first-year class of Tulane Medical School be divided into small groups to observe fluoroscopy of the upper gastrointestinal tract. These students were asked to report to the Department of Radiology on three successive afternoons, the only preparation required being that they ingest nothing by mouth during the preceding six hours. A total of 106 students were divided into 12 groups of 5 to 12 each. Having been questioned to exclude gastrointestinal symptoms, each subject was given a barium meal and a supine roentgenogram of the abdomen was obtained one hour later. Some of the groups were asked to remain upright and some to assume the right lateral recumbent position. Almost all were given 10 ounces of barium suspension initially. Some received the usual aqueous suspension.