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Contrast media safety: what do we know and how do we know it?
1Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania 19107.
The American Journal of Cardiology
|October 26, 1990
Summary
Iodinated contrast media have evolved since 1923, with newer agents offering improved safety profiles. Studies show reduced adverse reactions with low-osmolar nonionic agents, though cost remains a factor.
Area of Science:
- Radiology
- Medical Imaging
- Pharmacology
Background:
- Intravenous iodinated contrast agents, first used in 1923, have undergone significant development.
- Early agents like sodium iodide had high side effect rates and poor image quality.
- Adverse reactions to contrast media have been extensively studied since the 1970s.
Purpose of the Study:
- To review the historical development and safety of iodinated contrast agents for urinary tract visualization.
- To compare the incidence of adverse reactions between different types of contrast media.
- To evaluate factors influencing the risk of adverse reactions.
Main Methods:
- Review of historical literature and large-scale prospective studies on contrast agent reactions.
- Comparison of adverse event rates for ionic versus nonionic contrast agents.
- Analysis of risk factors such as patient history of allergy or previous reactions.
Main Results:
- Early contrast agents had high incidences of side effects.
- Large studies reported overall adverse reaction rates of 5.65% for older agents.
- Low-osmolar nonionic agents demonstrate significantly fewer adverse reactions but are more expensive.
Conclusions:
- Modern contrast agents offer improved safety compared to older formulations.
- Pretreatment with steroids may enhance the safety of ionic agents.
- Ongoing research compares the safety and efficacy of various contrast media.