An experimental study on tissue damage following subcutaneous injection of water soluble contrast media

Kim, S H; Park, J H; Kang, H S; Kim, C W; Han, M C; Kim, Y I

Abstract

The water soluble contrast media cause tissue necrosis infrequentely by extravasation during intravenousinjection in various radiological examinations. However, it has not been well documented that what kind and whatconcentration of contrast media can cause tissue necrosis. And also, the mechanism of tissue necrosis byextravasated contrast media has not been well known. The purpose of this experimental study was to evaluate thefrequency and severity of tissue damage following subcutaneous injection of various water soluble contrast media,to investigate the characteristics of the contrast media acting on the tissue damage, and to provide the basicdata for the clinical application. Meglumine ioxithalamate, sodium and meglumine ioxithalamate, iopromide,iopamidol, ioxaglate, meglumine diatrizoate and sodium diatrizoate of various iodine content and osmolality wereinjected into subcutaneous tissue of the dorsum of 970 feet of 485 rats. The tissue reaction of injection siteswere grossly examined with period from 1 day to 8 weeks after the injection. Representative gross changes werecorrelated with histologic findings. The results were as follows; 1. The basic tissue damage by extravasatedcontrast media was acute and chronic inflammatory reaction of the soft tissue with subsequent progress into thehemorrhagic and necrotizing lesion. 2. Larger volume of contrast media caused more severe tissue damage. 3.Contrast media of higher osmolality caused more severe tissue damage. 4. At same osmolality, contrast media ofhigher iodine content caused more severe tissue damage. 5. Ionic contrast media of meglumine salt caused moresevere tissue damage than those of sodium salt. 6. There was no significant difference of tissue damage betweenionic and non-ionic contrast media under the same or similar osmolality and iodine content. 7. The younger ratsshowed more severe tissue damage by contrast media of high osmolality. It is, therefore, recommended to use thecontrast media of lower osmolality and lower iodine content, regardless of ionic or non-ionic, and to use thecontrast media contanining sodium salt rather than meglumine salt in case of high risk of extravasation inclinical practice.

An experimental study on tissue damage following subcutaneous injection of water soluble contrast media

Abstract

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