CN101791413A - Anus injecting iodine intestinal tract contrast agent and application thereof in CT virtual colon-proctoscope - Google Patents
Anus injecting iodine intestinal tract contrast agent and application thereof in CT virtual colon-proctoscope Download PDFInfo
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- CN101791413A CN101791413A CN201010019421A CN201010019421A CN101791413A CN 101791413 A CN101791413 A CN 101791413A CN 201010019421 A CN201010019421 A CN 201010019421A CN 201010019421 A CN201010019421 A CN 201010019421A CN 101791413 A CN101791413 A CN 101791413A
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Abstract
The invention relates to an anus injecting iodine intestinal tract contrast agent and application thereof in a CT virtual colon-proctoscope contrast agent. The iodine contrast agent is an iodine water preparation and comprises an inorganic iodine agent, an organic iodine agent, other iodine compounds and an iodine-contained food; and the iodine-contained concentration is between 5g/L and 180g/L. By adding water for dissolving the iodine contrast agent and adding or not adding an isoosmotic adjusting agent and an antiallergic medicine, the contrast agent is prepared. The application of the anus injecting iodine intestinal tract contrast agent in preparing the CT virtual colon-proctoscope contrast agent does not need to clean the intestinal tract in advance and has the advantages of reduction of pain of an examined person, lowering of pain and side effects on a patient probably caused by injection twice, improvement of effect and accuracy of virtual colon-proctoscope inspection and effective separation of residues in the intestinal tract and the intestinal wall under the condition of excrement residual, and a preparation method of the iodine contrast agent is simple.
Description
[technical field]
The present invention relates to the contrast agent of CT (x-ray computer tomoscan) technical field, in particular diodone and the application in the virtual knot rectoscope of CT contrast medium thereof.
[background technology]
X ray CT is the large-scale medical imaging devices that develops rapidly nearest decades, for the diagnosis of disease plays an important role.
Lack under the correlated situation of nature in human organ and structure, usually we artificially certain material is introduced organ inner or its around to increase its contrast in medical images such as CT, the contrast material of being introduced is called as contrast agent (or contrast medium).Use the CT scan of carrying out behind the contrast agent to be called as enhanced ct scans.The diagnosis of some diseases can not obtain to clarify a diagnosis without enhanced ct scans, so enhanced ct scans has the value of its uniqueness.Handle and the three-dimensional reconstruction technology based on effective contrast agent and corresponding image segmentation, just can be effectively the content and the intestinal wall of enteral be separated, thereby develop the virtual knot rectoscope of better CT technology.
Contrast agent mainly can be divided into two big classes, i.e. atomic weight height, heavy high density contrast medium and atomic weight is low, proportion is little low-density contrast medium.Because most of high density contrast medium is difficult for by intestinal absorption, so safety and be considered to more be applicable to that intestinal is according to shadow relatively more.High density contrast agent commonly used has barium sulfate and Operand.
Barium sulfate generally is used for the inspection of X line gastrointestinal image, adds water by purified medicinal barium sulfate powder and is modulated into suspension.Different with purpose according to the position of checking, the concentration of used barium sulfate is also different.But, because barium is a kind of metallic atom of thick atom amount, because the overlapped and stage of small intestinal is full, thus when CT scan, also can produce obvious metal artifacts even be diluted to low concentration, so generally not as the intracavity contrast agent of intestinal CT scan.
Diodone is the contrast agent that present CT examination is mainly used, and is mainly used in angiography, urography, CT and strengthens inspection.CT strengthen to check the inspection that comprises each systemic disease of whole body, is mainly used in the radiography (liver, gallbladder, pancreas), urinary system radiography of nervous system radiography, abdominal part parenchymal viscera etc.The importing of contrast agent mainly is to annotate (promptly disposable at short notice whole contrast medium are injected vein blood vessel rapidly) by intravenous group.After the vein injection 30 minutes, contrast agent about 90% was excreted by glomerular filtration, and a small amount of contrast agent can be drained through other organ, and promptly so-called vicarious excretion wherein mainly passes through bile excretion by liver.
The inspection of knot rectal tissue is in order to understand the pathological change of colon intestinal wall and mucosa, a kind of mode of CT tomoscan is to annotate the capable enhancing of nonionic diodone through vein group to check at present, by to the dabbling observation of blood vessel interimage agent, thereby understand the pathological change of colon intestinal wall and mucosa.But owing to be to adopt the agent of blood vessel interimage, can not reach effect intuitively fully, particularly for the observation of early lesion and focal lesion to the observing effect of intestinal wall and mucosa.Simultaneously, adopt vein group to annotate diodone, its untoward reaction is higher as incidence rate irritated, blood clotting.
The another kind of mode of the CT scan of knot rectal tissue is the virtual knot examination per rectum of CT.The virtual knot rectoscope of existing C T prepares to require patient to eat at an influent stream that a few days ago begins of checking, begin fasting evening before that day, check and emptied intestinal with cathartic morning on the same day, before CT scan, need further intestinal lavage, insert anal canal then, squeeze into about 2 litres of air or carbon dioxide with hand-held air-inflating tools or similar peritoneoscope aeration machine, scanning is at last lain, two kinds of postures for sleeping in, and then rebuild virtual knot rectum, so that browse the change of observing knot mucous membrane of rectum structure.Here, air or carbon dioxide play a part contrast medium.
The greatest drawback of the virtual knot rectoscope of existing C T technology is to be difficult for being accepted by the people.Though with respect to conventional intestinal mirror, intestinal does not have invader and is subjected to the inspection time short during inspection, but fasting for a long time, cathartic, the inflation of intestinal lavage and anus still brings a lot of miseries to the person under inspection for 2 liters, and this also is this technology one of the reason popularized into the routine physical examination project of failing in China.Simultaneously, gas agent is as a comparison having under the situation of presence of residual feces, can not be effectively the residue of enteral be separated with intestinal wall.Make to be prone to false positive and false-negative result, influenced accurate rate of diagnosis, further limited this The Application of Technology by virtual knot proctoscopy.
[summary of the invention]
Purpose of the present invention is exactly in order to overcome the above-mentioned shortcoming of the virtual knot rectoscope of present CT technology, a kind of intestinal lavage of need not going ahead of the rest is provided, reduce person under inspection's misery, reduce misery and side effect that the patient may cause because of twice perfusion, improve the effect and the accuracy rate of virtual knot proctoscopy, still effective contrast agent and application in the CT virtual coloscope thereof that the residue and the intestinal wall of enteral are distinguished particularly arranged under the residual situation of feces.What the present invention especially endeavoured is the application of anus perfusion iodine intestinal tract contrast agent in the virtual knot rectoscope of preparation CT contrast medium.
Further purpose of the present invention also is to provide the virtual knot rectoscope of CT diodone and preparation method thereof.Diodone preparation method of the present invention is simple.
Purpose of the present invention is achieved by following technical proposals:
Contrast agent of the present invention adopts conventional diodone, and conventional diodone comprises oils and water formulation two classes, but the oils iodine preparation comprises iodized oil and iofendylate etc., owing in the knot rectum, can't behind radiography, in time remove smoothly, inapplicable in the present invention; Anus perfusion diodone of the present invention is the iodine water formulation, the iodine water formulation is divided into inorganic iodine preparation (as sodium iodide) and organic iodine preparation, organic iodine preparation is according to having or not ionizing to be divided into two kinds of ion-type and nonionics in the water, ionic contrast agent such as triiodo-benzene cycle compound, as cardiografin, meglumine iothalamate, bis-conray etc., the nonionic diodone, as iohexol, Iopromide, iotrolan, Ultravist (Ultravist), Metrizamide (Amipaque) etc., also can be other safe handling contain iodine compound, as iodoform etc., can also be to contain iodine food, as iodated salt etc.
The iodine concentration that contains of anus perfusion diodone of the present invention is 5g/L～180g/L
Though the absorbance of nonionic diodone is lower, but because ion-type diodone price is lower, add for the knot rectum, it only absorbs moisture in theory, the ion-type nonionic is little from absorbing the angle difference, not as intravenous injection, anus perfusion diodone therefore of the present invention is preferably the ion-type iodine preparation in the organic iodine contrast medium.
Bypass price factor, the present invention also can adopt the nonionic diodone.
The iodine concentration that preferably contains of various diodones of the present invention is 20～120g/L.
The solvent of diodone of the present invention (promptly dissolving the liquid of diodone) can be a water for injection, also can use pure water, deionized water, distilled water, distilled water.
Anus of the present invention perfusion iodine intestinal tract contrast agent can be made etc. and to ooze preparation, as being normal saline (0.9% weight percent sodium chloride solution), 5.07% (or claims about 5%, 5.1% volume/volume ratio) mannitol aqueous solvent, 5% glucose (percentage by weight) aqueous solution, this be because, straight colon has the physiological action that absorbs moisture, adopt the isotonic solution coloclysis, the moisture content of contrast agent is absorbed, can not make the power and water of blood plasma separate matter again runs off in a large number, contrast agent keeps its concentration and osmotic pressure constant at straight colonic, thereby the fluid properties that has kept contrast agent reduces contrast agent by intestinal absorption.
The volume that the present invention injects human colorectal diodone is 200～2500ml.Be preferably 500～1500ml, the best is 1000～1500ml.
Antiallergic agent be can add in the diodone of the present invention, as the dexamethasone of 5～20mg or chlorphenamine 4mg～20mg or diphenhydramine 4mg～20mg added to reduce anaphylactoid incidence rate.
In the diodone of the present invention even can add a small amount of barium sulfate and make suspension, preferably make etc. and to ooze suspension.The adjuvant of suspendible can adopt sodium carboxymethyl cellulose, Polyethylene Glycol etc.
PROCTO inspection of the virtual knot of CT of the present invention and preparation method are:
1, intestinal is prepared:
1.1 check the few slag of lunch feed the previous day or do not have slag diet (as medicated porridge, bread, the flesh of fish, Carnis Gallus domesticus, the peeling melon and fruit, milk etc. are not eaten the vegetable of fibre-enrich).
1.2 check the semi-fluid or liquid diet of dinner feed the previous day (as Amylum Nelumbinis Rhizomatis etc.), fasting after 8 of evenings, but drink water or fruit juice more.Decoction (or hot water is taken after mixing it with water) Folium Sennae 20mg is advised in dinner after half an hour, or 1～2 of oral phenolphthalein tablet, or 250ml concentration is 20% mannitol, or other short gastrointestinal peristalsis medicines promote defecations.
1.3 check fasting on the same day, but can't help water, suggestion is drunk water or fruit juice more, drains behind the feces to hospital's row CT examination.
2, prepare before the scanning:
Preceding 10 minutes intramuscular injection 654-2 injection 20mg of suggestion scanning reduce intestinal peristalsis promoting, but need to get rid of contraindication (glaucoma, prostate hyperplasia, core function abnormality).The above machine of 16 rows can not medication (but still suggestion with), and the following machine of 16 rows is advised medication strongly.Scan preceding 5 minutes and contain diodone 200～2500ml through anal canal anus perfusion configuration, preferred 500～1500ml, the best is 1000ml～1500ml.For children's, the corresponding minimizing of its consumption.
3, CT scan and virtual knot rectoscope date processing.
The preparation method of anus perfusion iodine intestinal tract contrast agent of the present invention is:
1, preparation water for injection;
2, take by weighing diodone isoosmotic adjusting agent (as sodium chloride, glucose, mannitol), the Claritin (as dexamethasone, chlorphenamine, diphenhydramine) of dosage;
3, diodone, Claritin is water-soluble, filter;
4, isoosmotic adjusting agent is water-soluble, filters;
5, merge two filtrates, add water to standardize solution, sterilization, promptly.
As be to prepare the same day same day to use, need not sterilization.
The preparation method of diodone of the present invention also can be that all each medicine is directly used water dissolution (need not use water dissolution respectively), standardize solution, filters or does not filter promptly.
The also available pure water of diodone of the present invention, deionized water, distilled water, dissolved in distilled water.
Anus perfusion iodine intestinal tract contrast agent of the present invention is compared with intravenous bolus injection technique, has safety preferably:
1, at first, coloclysis is a kind of medical procedure of routine, is widely used in before the operation and before the art of various intestinal inspections to prepare.The present invention adopts the method for this coloclysis just.
2, the conventional use of the diodone of coloclysis use of the present invention is mainly used in phlebography, is a kind of high density contrast agent, pours into colon and do not absorbed by intestinal mucosa substantially.
3,3～15 times as the coloclysis working concentration of the concentration used are annotated by intravenous group, coloclysis working concentration working concentration in the blood vessel, even might minute quantity be entered blood circulation by intestinal absorption, its concentration is still
Be far smaller than the contrast concentration of intravenous injection, add the use of isotonic solution, can further reduce the absorption of contrast agent.
4, the contrast agent of intravenous injection circulates through blood, and most of at last the discharge through renal metabolism needs about 30 minutes, and discharge also is about 90% of total amount.The used contrast agent of coloclysis is checking that finishing back (about 10 minutes) can discharge from anus, does not exist the problem of discharging through metabolism.
5, the used contrast agent of coloclysis of the present invention only stays in straight colonic, and the time is short, and concentration is low.And now CT will arrive all human body major organs (comprising colon) through intravenous similar contrast agent through the blood circulation, and in human body the time of staying long, the concentration height.The used contrast agent of coloclysis of the present invention obviously is difficult for producing untoward reaction, anaphylaxis etc.
Anus perfusion iodine intestinal tract contrast agent of the present invention is compared with the virtual interior enteroscopy of routine, for the person under inspection, has toleration preferably, has reduced patient's misery and side effect:
1, need before the Chang Gui virtual endoscopy need pour into the about 2000ml of air more then before inspection through cleansing enema, promptly the person under inspection needs through 2 coloclysis processes.And the virtual endoscopy of high density contrast enema of the present invention does not need special cleansing enema.
What 2, Chang Gui virtual endoscopy poured into is gas, is unstable material, and mobility is bigger, easily causes senses of discomfort such as abdominal distention to the person under inspection.And the virtual endoscopy of high density contrast enema of the present invention pours into for containing the liquid of iodine, and degree of stability is apparently higher than gas, and the immoderation that causes to the person under inspection is lower than extremely significantly and pours into gas.
The virtual knot rectoscope of the virtual knot rectoscope of CT of the present invention contrast agent and routine with gas as a comparison the inspection method of agent compare, because the effect of diodone, and the result of Computer Processing, can be effectively the residue of enteral be separated with intestinal wall, improve the accuracy rate of the virtual intestinal mirror of CT, this will further promote the clinical practice of the virtual intestinal mirror of CT.
Diodone rule of origin of the present invention is simple, and preparation method technology is simple, and is lower to the production equipment requirement, also can produce voluntarily in the general hospital, prepare.
[specific embodiment]
The present invention is described in further detail below in conjunction with embodiment, but the invention is not restricted to following embodiment.
Embodiment one
Take by weighing sodium iodide 11.8g, dexamethasone 10mg (also can use 2 replacements of dexamethasone injection), other takes by weighing sodium chloride 18g, and sodium iodide, dexamethasone are dissolved in about 100ml water for injection, filters; Sodium chloride is dissolved in about 100ml water for injection, filters; Merge two filtrates, add the injection water to 2000ml, sterilization promptly makes 2000ml etc. and oozes the sodium iodide enema.
As be to prepare the same day same day to use, need not sterilization.
To patient's intestinal prepare and CT enhanced ct scans and virtual knot rectoscope Computer Processing step with the summary of the invention part.
Embodiment two
Take by weighing cardiografin 360g, chlorphenamine 10mg (available 2 chlorphenamine injections replace), other takes by weighing glucose 100g, and cardiografin, chlorphenamine are dissolved in about 400ml water for injection, filters; Glucose is dissolved in about 200mg water for injection, filters; Merge two filtrates, add the injection water to 2000ml, sterilization promptly makes 2000ml etc. and oozes the cardiografin enema.
As be to prepare the same day same day to use, need not sterilization.
Embodiment three
Take by weighing iohexol 86.28g, diphenhydramine 20mg, measure mannitol 5.1ml, iohexol, diphenhydramine are dissolved in an amount of water for injection, and mannitol is dissolved in an amount of water for injection separately, filter, merge two filtrates, add the injection water to 1000ml, sterilization promptly makes 1000ml etc. and oozes the iohexol enema.
Embodiment four
Take by weighing Ultravist (Ultravist) 374g and be dissolved in the water for injection, filter, add water to 1500ml, promptly make anisosmotic Ultravist enema 1500ml.
Embodiment five
Take by weighing iodoform 223g and be dissolved in the water for injection, filter, add water to 1200ml, promptly make anisosmotic enema 1200ml.
During use, can be before coloclysis, dexamethasone injection Polyglucan of first intramuscular injection.
Embodiment six
Take by weighing iodated salt 30.35g, add the injection water, promptly make the iodic salt enema of isotonic solution to 2000ml.
Embodiment seven
Take by weighing bis-conray 419.8g, be dissolved in the 400ml water for injection, add 2 of dexamethasone injection, filter; Other gets 18g sodium chloride, is dissolved in the 500ml water for injection, filters; Merge two filtrates, add the injection water to 2000ml, sterilization promptly makes 2000ml bis-conray enema.
Embodiment eight
Take by weighing medicine and dose with embodiment one, each medicine directly is dissolved in deionized water, need not to dissolve respectively, need not to filter, add deionized water to 2000ml.
The foregoing description is a preferred embodiment of the present invention; real saving length; no longer repeat the embodiment of meglumine iothalamate similar to the above embodiments, Iopromide, iotrolan, Metrizamide etc. and other medicines and adjuvant; but embodiments of the invention are not restricted to the described embodiments; other are any not to deviate from change, the modification done under spirit of the present invention and the principle, substitute, combination, simplify; all should be the substitute mode of equivalence, be included in protection scope of the present invention.
Claims (10)
1. anus perfusion iodine intestinal tract contrast agent is the iodine water formulation, comprises inorganic iodine preparation, organic iodine preparation, other iodine compounds and contain iodine food; Containing iodine concentration is 5g/L～180g/L.
2. anus perfusion iodine intestinal tract contrast agent according to claim 1, it is characterized in that containing iodine concentration is 20～120g/L.
3. anus perfusion iodine intestinal tract contrast agent according to claim 1 is characterized in that solvent is selected from water for injection, pure water, deionized water, distilled water, distilled water.
4. anus according to claim 1 perfusion iodine intestinal tract contrast agent, it is characterized in that diodone is adjusted to etc. oozes preparation, selects for use normal saline, about 5% Osmitrol or 5% D/W adjusting etc. to ooze.
5. anus perfusion iodine intestinal tract contrast agent according to claim 1 is characterized in that adding in the diodone antiallergic agent.
6. anus perfusion iodine intestinal tract contrast agent according to claim 1 or 5 is characterized in that antiallergic agent selects dexamethasone for use.
7. anus perfusion iodine intestinal tract contrast agent according to claim 1 is characterized in that diodone is an organic ion type diodone.
8. the preparation method of the described anus perfusion of claim 1 iodine intestinal tract contrast agent may further comprise the steps: 1. prepare water for injection; 2. take by weighing diodone, isoosmotic adjusting agent, the Claritin of dosage; 3. diodone, Claritin is water-soluble, filter; 4. isoosmotic adjusting agent is water-soluble, filters; 5. merge two filtrates, add water to standardize solution, sterilization, promptly.
9. the preparation method of the described anus perfusion of claim 1 iodine intestinal tract contrast agent the steps include: that all each medicine is directly used water dissolution, standardize solution, filters or does not filter promptly.
10. the application of the anus of claim 1 perfusion iodine intestinal tract contrast agent in the virtual knot rectoscope of preparation CT contrast medium.
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| Application Number | Priority Date | Filing Date | Title |
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| CN201010019421A CN101791413A (en) | 2010-01-15 | 2010-01-15 | Anus injecting iodine intestinal tract contrast agent and application thereof in CT virtual colon-proctoscope |
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| Application Number | Priority Date | Filing Date | Title |
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| CN201010019421A CN101791413A (en) | 2010-01-15 | 2010-01-15 | Anus injecting iodine intestinal tract contrast agent and application thereof in CT virtual colon-proctoscope |
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| CN101791413A true CN101791413A (en) | 2010-08-04 |
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| CN201010019421A Pending CN101791413A (en) | 2010-01-15 | 2010-01-15 | Anus injecting iodine intestinal tract contrast agent and application thereof in CT virtual colon-proctoscope |
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Application publication date: 20100804 |