Xenetix

No patient preparation was required. CT examinations were performed on either 64-slice (Somatom Definition AS+, Siemens Healthineers, Germany) or 128-slice (Somatom Definition AS+, Siemens Healthineers, Germany) CT scanners with patients in the supine position. The scanning parameters were as follows: tube voltage: 100–120 kVp; automatic tube current modulation: 100–110 mAs); pitch: 1.0–1.3 mm; matrix: 512 × 512; and slice thickness: 0.625–1 mm.
Abdominopelvic CT examinations were performed without contrast, and the arterial and venous phases were obtained after the administration of intravenous (IV) contrast material (Xenetix 300 mgI/ml, Guerbet, France, Ultravist 300 mgI/ml, Bayer, Germany; Omnipaque 300 mgI/ml, GE Healthcare, Ireland). The arterial phase was performed 30–35 seconds after an IV contrast injection, and the venous phase was performed 60–70 seconds after an IV contrast injection. Multiplanar (sagittal, coronal, and axial) images were reconstructed for the diagnosis of intussusception.

Five commercially available iodinated radiographic contrast media are iobitridol (xenetix; Guerbet, France), iodixanol (visipaque; GE Healthcare, Ireland), iohexol (omnipaque; GE Healthcare, China), ioxaglate (hexabrix; Guerbet, France), and isovue (iopamiro; Bracco, Italy). These iodinated radiographic contrast media are mainly used in diagnostic radiology. Di(phenyl)-(2,4,6-trinitrophenyl) iminoazanium (DPPH), ascorbic acid, 2,4,6-tri(2-pyridyl)-s-triazine (TPTZ), Trolox, and 2,2′-azino-bis(3-ethylbenzthiazoline-6-sulphonic acid) (ABTS) were purchased from Sigma–Aldrich (St. Louis, MO, USA).

All participants underwent fluoroscopically guided arthrographic distention of the glenohumeral joint. All injections were performed by the same clinician who performed the sonographic evaluations. Procedures were carried out under strict aseptic conditions. With the patient in the supine position, a local anesthetic agent (2% lidocaine hydrochloride) was infiltrated into the skin and subcutaneous soft tissue. A 22-gauge, 3.5-inch spinal needle (Spinocan; B. Braun Melsungen AG, Melsungen, Germany) was inserted anteriorly into the glenohumeral joint under fluoroscopic guidance, and approximately 3 mL of non-ionic contrast substance (Xenetix; Guerbet, Rome, Italy) was injected. The position of the needle was confirmed by fluoroscopy, and the integrity of the intra-articular structures was verified. This was followed by an injection consisting of 40 mg of triamcinolone (in 1 mL), 9 mL of 0.5% lignocaine, and 10 mL of normal saline. This injection (20 mL total) was given to all the patients to distend the glenohumeral joint [12 (link)].

Various CT protocols involving a 128-slice scanner (SOMATOM Definition Flash, Siemens Healthcare) were used to examine the enrolled patients. All CT scans were performed using one of five types of nonionic low-osmolality ICM: iobitridol 350 (Xenetix®; Guerbet), ioversol 320 (Optiray®; Mallinckrodt Medical), iohexol 350 (Omnipaque®; GE Healthcare), iomeprol 400 (Iomeron®; Bracco), and iopamidol 370 (Pamiray®; Dongkook Pharmaceutical Co., Ltd.). At our institution, each type of ICM was used for a different type of CT examination. The total dose and injection rate of ICM were determined based on the patient's body weight and CT protocol. For multiphasic CT with the arterial phase, a 1.7 mL/kg dose of ICM was administered over 25–30 seconds (minimum injection rate of 0.7 mL/s), followed by a saline chaser of up to 20 mL. For single-venous phase enhanced CT, a 1.7 mL/kg dose of ICM was administered over 50 seconds, followed by a saline chase of up to 20 mL. For cardiac CT, a 1.5–2 mL/kg dose of ICM was administered at a rate of 1–3 mL/s, followed by a saline chase injected at the same rate. We classified multiphasic and cardiac CT examinations as rapid injection rate examinations and single-phase CT examinations as routine injection rate examinations.

All included chest HRCT exams were performed on a 64-row multidetector CT scanner (Discovery HD750, GE Healthcare). Exams were acquired volumetrically with patients in the supine position at the end of full inspiration. The main technical parameters were tube potential, 100-120 kV (according to patient size); tube current modulation range, 150-350 mA; detector configuration, 64 × 0.625 mm; reconstructed slice thickness, 1.25 mm; reconstructed interval, 1.25 mm. Additional end-expiratory volumetric scans, prone scans, and postcontrast (iobitridol 350 mgI/mL, Xenetix, Guerbet or iomeprol 400 mgI/mL, Iomeron, Bracco Imaging) acquisitions were disposable in 28/50, 6/50, and 8/50 patients, respectively. Images were reconstructed using a high-spatial-frequency algorithm and parenchymal windowing (level, −500 HU; width, 1700 HU) for the lungs and a soft tissue algorithm and windowing (level, 50 HU; width, 350 HU) for the mediastinum and chest wall.