Preheating the iodinated contrast agent before use is recognized as the best method of application. According to clinical observations, preheating makes the patient more comfortable, and can reduce viscosity and the risk of extravasation of Contrast Media. Limited global data show that heating may reduce the incidence of general adverse events.
Before using the different types of iodinated contrast media, it is recommended to heat the contrast agent to 37 degrees Celsius and place it in a thermostat. Because at 37 degrees Celsius, the viscosity of the iodinated contrast agent decreases with the increase in temperature, which not only facilitates the injection of the contrast agent, but also improves the patient's local tolerance.
There should be a time interval between two injections of iodinated contrast agents:
Patients with normal or moderate renal function (GFR>30ml/min/1.73 m2): 75% of iodine can be eliminated in 4 hours after administration. There should be an interval of 4 hours between two injections.
Patients with severely decreased renal function (GFR<30ml/min/1.73 m2): there should be an interval of 48 hours between two injections.
Dialysis patients: if the patient has residual renal function, there should be an interval of 48 hours between the gadobutrol injection and the other injection.
Time interval between simultaneous use of iodine and gadolinium:
Patients with normal or moderate renal function (GFR>30ml/min/1.73 m2): 75% of iodine and gadolinium can be eliminated in 4 hours after administration. There should be an interval of 4 hours between injections of iodine and gadolinium.
Patients with severely decreased renal function (GFR<30ml/min/1.73 m2) or dialysis patients: There should be an interval of 7 days between injections of iodine and gadolinium.
Order of injection of iodine and gadolinium:
For abdominal examination, enhanced CT should be done first, and then enhanced NMR.
For chest and brain examinations, there is no requirement for the order of CT enhancement and NMR enhancement.
Metformin does not increase the risk of acute kidney injury after the injection of contrast agent, but the injury of acute kidney caused by the iodinated contrast agent will contribute to the accumulation of metformin, which may lead to lactic acidosis.