Radiology, Vol 182, 657-660, Copyright © 1992 by Radiological Society of North America
Diagnostic efficacy of excretory urography with low-dose, nonionic contrast media
ML Gavant, JV Ellis and LM Klesges
Department of Radiology, University of Tennessee, Memphis.
A prospective, randomized, physician-blinded study was conducted to
determine whether a smaller dose of low-osmolar, nonionic contrast medium
can provide diagnostic information on excretory urograms equivalent to that
obtained with higher doses of ionic and nonionic contrast agents. One
hundred fifty adult patients who underwent excretory urography received a
high-dose ionic contrast medium (diatrizoate sodium), high-dose nonionic
contrast medium (iohexol), or low-dose nonionic contrast medium (iohexol).
All urograms were scored for diagnostic quality. No difference in
urographic quality was detected among the different doses of contrast
media. The lower dose of low-osmolar nonionic contrast medium provided
equivalent diagnostic information. The quality of the nephrotomograms,
ureteral image, and overall image was slightly greater with diatrizoate
than with a small dose of iohexol, but the difference was not significant.
This study suggests that excretory urograms obtained in relatively healthy,
well- prepared patients with smaller, less expensive doses of a nonionic
contrast agent are at least diagnostically equivalent to those obtained
with typical higher doses of ionic and nonionic agents.
