1 General Fundamentals.- 1.1 A Historical Overview of the Development of Contrast Media for Diagnostic Imaging Procedures in Radiology.- 1.2 Chemistry of Positive X-Ray Contrast Media.- 1.3 Structure - Toxicity Relationships and Molecule Design.- 1.4 Relevant Results of Toxicity Studies of Non-Ionic X-Ray Contrast Media for Estimating the Risk to Man.- 1.5 Physicochemical Properties of Contrast Media: Osmotic Pressure, Viscosity, Solubility, Lipophilicity, Hydrophylicity, Electrical Charge.- 1.6 Pharmacokinetics of Contrast Media.- 1.7 Clinical Documentation of the Tolerance, Safety and Efficacy of X-Ray Contrast Media.- 1.8 Statistical Considerations in the Design and Analysis of Clinical Trials.- 2 Pharmaceutical Quality and Stability of lodinated X-Ray Contrast Media.- 2.1 What are the Steps in the Production of X-Ray Contrast Media?.- 2.2 Which Chemical Degradation Products are Formed?.- 2.3 What Additives do X-Ray Contrast Media Solutions Contain?.- 2.4 What is the Importance of Additives in Contrast Medium Formulations?.- 2.5 How is the Sterility of X-Ray Contrast Media Assured?.- 2.6 How is the Chemical Stability of Contrast Media Checked?.- 2.7 How are X-Ray Contrast Media Checked for Freedom from Pyrogens?.- 2.8 To What are Colour Changes of Contrast Media Attributable?.- 2.9 Does Particulate Contamination Occur in X-Ray Contrast Media, and How Important Is It?.- 2.10 Which Factors Reduce the Stability of X-Ray Contrast Media, and What Are the Implications of Storage Recommendations?.- 2.11 What Precautions Are Necessary in Drawing Up X-Ray Contrast Media into Syringes and in Administering Them Using Infusion Devices and Motorised Pumps?.- 2.12 How Long Do X-Ray Contrast Media Remain Usable After the Original Container Has Been Opened?.- D. Herrmann.- 2.13 May X-Ray Contrast Media be Resterilised, Diluted or Mixed with Other Drugs?.- 2.14 Can the Re-Use of Disposable Catheters for Angiography be Justified?.- 3 Influence of Contrast Media on Organs and Vessels.- 3.1 What are the Mechanisms of Toxicity Associated with Contrast Media?.- 3.2 Do Contrast Media Affect the Viscosity of Blood?.- 3.3 Are there any Differences Between Ionic and Nonionic Contrast Media in Their Effect on Coagulation?.- 3.4 Do Contrast Media Affect Cardiovascular Function?.- 3.5 Do Contrast Media Affect Pulmonary Function?.- 3.6 Do Contrast Media Affect Hepatic Function?.- 3.7 Do Contrast Media Lead to Impaired Kidney Function?.- 3.8 Do Iodinated X-Ray Contrast Media Affect Thyroid Function?.- 3.9 What Is the Relationship Between Iodinated Contrast Media and the Blood-Brain Barrier?.- 3.10 Do Contrast Media Affect the Central Nervous System?.- 3.11 Do Contrast Media Affect Blood Vessel Walls?.- 3.12 Can X-Ray Contrast Media Affect the Results of Laboratory Tests?.- 4 Determination of Risk Factors Regarding the Administration of Contrast Media.- 4.1 In Which Patients is the Administration of X-Ray Contrast Media Associated with an Increased Risk?.- 4.2 How Big is the Risk of an Examination with X-Ray Contrast Media of Patients with Known Hypersensitivity to CM and for Allergic Patients?.- 4.3 Does an Existing Allergy to Iodine Mean an Increased Risk for an X-Ray Contrast Medium Examination?.- 4.4 Why does the Administration of Iodinated Contrast Media to Patients with Manifest or Latent Hyperthyroidism Represent a Risk?.- 4.5 Why does the Administration of Iodinated Contrast Media Represent a Risk to Patients with Non-Toxic Nodular Goitre?.- 4.6 How Do I Recognise Hyperthyroidism or the Presence of Non-Toxic Nodular Goitre?.- 4.7 Does Underlying Cardiovascular Disease Constitute an Increased Risk in Contrast Media Administration?.- 4.8 Why is Pre-Existing Lung Disease a Risk for the Administration of Contrast Media?.- 4.9 Why Does Previous Renal Failure Represent a Risk?.- 4.10 Why Does Previous Diabetes Mellitus Represent a Risk?.- 4.11 Why Does Previous Paraproteinaemia Represent a Risk?.- 4.12 How Can the Risk of Provoking a Hypertensive Crisis in Patients with Phaeochromocytoma be Reduced?.- 4.13 Does the Examination of Dehydrated Patients Represent an Increased Risk?.- 4.14 Are Patients with Autoimmune Disorders at Any Particular Risk on Contrast Media Administration?.- 4.15 Does the Administration of Iodinated Contrast Media to Patients with Sickle Cell Anaemia Result in Further Change in Erythrocytic Shape?.- 4.16 Are Contrast Media-Induced Side Effects Dependent on Age?.- 4.17 Can Contrast Media Procedures Be Carried Out Despite Defined Risks?.- 4.18 What Interactions are Known Between Contrast Media and Other Medications?.- 4.19 What Effects Do Iodinated Contrast Media Have When Administered During Pregnancy or Lactation?.- 5 Prophylactic Measures.- 5.1 What Is the Place of Fasting and Dehydration Before Contrast Media Administration?.- 5.2 Can Hypersensitivity Reactions to Contrast Media be Predicted Through Preliminary Testing?.- 5.3 Is Sedation Indicated Before Administering Contrast Media?.- 5.4 Does General Anaesthesia Prevent the Occurrence of Contrast Media-Induced Side Effects?.- 5.5 Can the Rate of Contrast Media-Induced Side Effects be Lowered by Premedication with Antihistamines?.- 5.6 Can the Adverse Reaction Rate Be Reduced by Administration of Corticosteroids?.- 5.7 How Important is Pharmacoprophylaxis of Hyperthyroidism and How Can it Be Performed?.- 6 Informing the Patient Prior to Contrast Media Administration.- 6.1 What is the Patient’s “Right to Know” Prior to an X-Ray Examination Using Contrast Media?.- 6.2 What Special Information Should a Healthy Volunteer/Patient Receive Who is Participating in a Clinical Study of a New Drug?.- 7 Administration of Contrast Media.- 7.1 Are Contrast Media Heated to Body Temperature Better Tolerated?.- 7.2 Are There Any Guidelines for Maximum Doses in Angiography?.- 7.3 Are There Any Guidelines for Maximum Doses in Myelography?.- 7.4 Are There Any Guidelines for Maximum Doses in Cholegraphy?.- 7.5 Can “Maximum” Doses be Exceeded?.- 7.6 Does the Injection Rate Affect the Tolerance?.- 7.7 What Fluids Can Be Recommended for Flushing Catheters?.- 7.8 Are Contrast Media Dialysable?.- 7.9 What are the Sequelae of Inadverted Paravascular Administration of Iodinated Contrast Media?.- 8 Adverse Reactions and Their Pathophysiology and Management.- 8.1 What Adverse Reactions Can Be Expected After Intravascular Administration of Iodial Containing Contrast Media?.- 8.2 Do Late-Occuring Adverse Reaction to Contrast Media Necessitate Longer Supervision of the Patient?.- 8.3 What Adverse Reactions to Contrast Media are Dose Independent or Dependent?.- 8.4 What Are the Mediators of Anaphylactoid Reactions to Iodinated Contrast Media?.- 8.5 How Often Can Late Reactions be Expected After Administration of Radiographic Contrast Media.- 8.6 Which Are the Clinical Manifestations of Late Reactions to Radiographic Contrast Media?.- 8.7 What Is the Pathophysiology of Late Reactions to Radiographic Contrast Media?.- 8.8 Are Antibodies to Radiographic Contrast Media Known?.- 8.9 Are There Allergies to Contrast Media?.- 8.10 Can Sensitization Due to Frequent Contrast Media Administration be Observed?.- 8.11 Can Epileptogenicity and Arachnoiditis be Observed After Myelography with Nonionic Contrast Media?.- 9 Clinical Use of Iodinated Contrast Media for the Visualization of Vessels, Organs and Organ Systems.- 9.1 Cerebral Angiography.- 9.2 Spinal Angiography and Phlebography.- 9.3 Angiography of the Extremities.- 9.4 Phlebography.- 9.5 Direct Lymphography and Indirect Lymphangiography.- 9.6 Angiocardiography.- 9.7 Angiographic Procedures for the Liver, Spleen, Pancreas and Portal Venous System.- 9.8 Computed Tomography in the Liver, Pancreas and Spleen.- 9.9 Visualization of the Gastrointestinal Tract.- 9.10 Cholecystography and Cholangiography.- 9.11 Intravenous Urography.- 9.12 Urethrography and Micturating Cystrography, Cavernosography, and Seminal Vesiculography and Vasography.- 9.13 Visualization of the Kidneys and the Adrenal Gla
