CH T T NG PH N TRONG C HA

BS NGUY N T N QU C BV C P C U TR NG V NG

CC LO I CH T T
 B t(nh t

NG PH N

 Kh , trong siu m (harmonic)

ng) bary sunphat  Ch t t ng ph n t  D ch c ch a iod ( water-soluble contrast media)

W.C.Roentgen (1845-1923)

WATER SOLUBLE CONTRAST MEDIA

 IONIC

p th m th u th p p th m th u cao  NONIONIC

CHAT CAN QUANG AP THAM CAO 1500 mOsm/Kg H2O

L I  Khuech tan gian bao tot  -> o can quang cao  Bai tiet tot  -> can quang nieu qua tnh mach BAT LI
 Tang the tch mau  -> t ng cam giac

nong, au  -> nguy hiem cho tim  -> nguy hiem cho than

CHAT CAN QUANG AP THAM THAP 500-800 mOsm/Kg H2O

L I  Hoa lan noi mach cao:  -> chup mach mau  -> khong nong, au  -> bm ong mach tot BAT LI
 Tang the tch

mau  Bai tiet cham

CHAT CAN QUANG ION HOA



L I Chong ong mau tot:

BAT LI
ch nh: ->tuy o  Hoa tan nc giam ->tac dung ngoai y
 Chong

-> giam nguy c tao huyet khoi  Giam s un t c noi m ch -> than dung nap tot  o nht thap: -> d chch -> tang quang tot cac mach mau nho  Co Na: -> t loan nhp

CHAT CAN QUANG KHONG ION HOA

L I
 Giam tnh tham thau

BAT LI

 Chong tao

-> Giam tang the tch mau  Hoa tan nc tot hn -> Giam tac dung ngoai y.

huyet khoi kem -> De tao huyet khoi khi nong vanh (PTCA)

AP THAM THAU (mOsm/Kg

H2O)

ng d ng
 CT-scan:

-Li u s d ng 1-2ml/kg -T c b m: +thng th ng 1,5-2ml/s +dynamic, m ch mu 3-4ml/s, c bi t k thu t 2 pha: u 5-10ml/s, sau 12ml/s - Li u s d ng 1-2ml/kg -T c b m 0,5-1ml/s

 UIV:

TC D NG PH
 Chong ph n v  Khng

c ng (nonidiosyncratic : direct chemotoxic/hyperosmolar effect) -bu n nn, i -lo n nh p tim -suy th n -ph ph i -tr y tim m ch

TC D NG PH
 Qu m n(idiosyncratic)

-pht ban,ng a -ph m t v thanh qu n -co th t ph qu n, suy h h p -tr y tim m ch  Ph n ng mu n -n i m ay , ng a -s t, n l nh, h i ch ng cm - au kh p -chn n, r i lo n v gic - au u, m t, tr m c m - au b ng, to bn, tiu ch y

CH

NH

 IONIC cas thng th

ng.Hi n nay c xu h ng s d ng lo i p th m th u th p t gy tc d ng ph h n  NONIONIC -ti n s d ng thu c c n quang -ti n s hen suy n d ng -suy tim - aut y -tr em < 12 thng -creatinin> 2mg/dl -CT m ch mu

CH NG CH
M tn

NH

c(*)  Ti u ng  Suy th n n ng  Cao HA  Suy tim n ng  B nh huy t h c

TI LI U THAM KH O
 DHNERTS ELECTRONIC RADIOLOGY

REVIEW Wolfgang Dhnert