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For all that new non-X-ray technologies such as MR and ultrasound
and its various manifestations have made an enormous impact in
recent years on the practice of medical imaging, the use of X-rays
and X-ray contrast-enhancing agents has retained an important
position at the heart of the process. Indeed, with its frequent
requirements for high total dose regimes, CT has increased the use
of contrast agents. Even helical/spiral CT which, it was initially
argued, should reduce contrast as well as radiation loads, may
actually require just as much or more of both because of the
potential it offers for multi-phase scanning. Iodinated
intravascular X-ray contrast agents, especially the more recently
developed non-ionic agents, continue therefore to play a pivotal
role in clinical imaging. These succinct and authoritative
articles, originally appearing in the journal Advances in X-ray
Contrast, range sufficiently widely for their compilation in this
volume to be considered a mini-textbook on the water-soluble
iodinated X-ray contrast agents and their applications. Each is
written by an acknowledged and experienced expert in the field.
They usefully cover the developmental history of the agents;
defined risk factors, approaches to prophylaxis and, ultimately, of
the treatment of adverse reactions; the interesting subject of
supposed delayed reactions to contrast agents; the important
organ-specific toxicities, cardiac toxicity, neurotoxicity and
nephrotoxicity and high-dose toxicity as encountered in complex
procedures; the sometimes special circumstances and occasional
extreme conditions to which contrast agents may be exposed in
Interventional Radiology; the special, in several ways, case of
paediatric radiology; the controversial subject of thromboembolic
phenomena in clinical angiography; and the precise role of contrast
agents. As regards the practicalities of contrast administration
regimes and imaging protocols it is really only in the area of CT
that there is debate and controversy, and articles are included
which cover CT of the liver, spleen and pancreas, and protocols for
the new spiral/helical technology and even for the much less widely
available electron-beam CT technology visualization. Pulmonary
embolus diagnosis and protocols for contrast administration with
this technology are also discussed.
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