Contrast-enhanced computed tomography of the liver, gall bladder and urogenital tract in female red-eared terrapins (Trachemys scripta elegans)

The aim of the present study was to evaluate the feasibility of contrast-enhanced computed tomography for organ morphology and perfusion in five captive terrapins. Native scans were performed and afterwards an iodinated non-ionic contrast media was manually administered through the jugular vein catheter. Post-contrast CT scans were taken 20 (T20), 60 (T60) and 180 (T180) seconds after the contrast medium administration. Maximum contrast enhancement of the kidneys and the liver was detected at T20 and T60, respectively. The gall bladder content, the urinary bladder content and ovarian follicles were all without contrast enhancement in all five terrapins. Gall bladder wall thickness was 0.9 mm in all terrapins. Enhancement of the gall bladder wall in post-contrast studies was considered excellent, good or poor in two terrapins, two terrapins and one terrapin, respectively, with a mean score of 1.8 ± 0.84 over all contrast studies. Enhancement of the ureters in post-contrast studies was considered excellent in all terrapins in all contrast studies. Peak aortic enhancement was reached 20 seconds after contrast medium administration with the peak enhancement of 213.5 ± 41 HU in four terrapins and 560 HU in one terrapin. Peak hepatic vein enhancement after contrast medium administration was recorded 20 and 60 seconds in two and three terrapins, respectively. In conclusion, contrast-enhanced computed tomography proved to be a valuable method for clinical examination of the liver, gall bladder, kidneys, ureters, urinary bladder and ovarian follicles in red-eared terrapins.

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Oral Hydration as a Safe Prophylactic Measure To Prevent Post-Contrast Acute Kidney Injury in Oncologic Patients with Chronic Kidney Disease (IIIb) Referred for Contrast-Enhanced Computed Tomography: Subanalysis of The Oncological Group of The NICIR Study.

10.21203/rs.3.rs-729538/v1 ◽

2021 ◽

Author(s):

Carmen Sebastia ◽

Alfredo Páez-Carpio ◽

Elena Guillen ◽

Blanca Paño ◽

JoanAlbert Arnaiz ◽

...

Keyword(s):

Computed Tomography ◽

Chronic Kidney Disease ◽

Acute Kidney Injury ◽

Kidney Disease ◽

Kidney Injury ◽

Oral Hydration ◽

Post Contrast ◽

Contrast Enhanced ◽

Enhanced Computed Tomography ◽

Contrast Enhanced Computed Tomography

Abstract Background The objective of this study is to evaluate oral hydration compared to intravenous (i.v.) hydration in the prevention of post-contrast acute kidney injury (PC-AKI) in the oncologic subgroup of patients with stage IIIb chronic kidney disease (CKD) included in the NICIR study referred for elective contrast-enhanced computed tomography (CE-CT). Material and Methods We performed a retrospective subanalysis of the oncological subgroup (174/228 patients, 74%) from a continuous prospective database of patients included in the recently published non-inferiority NICIR study. Patients received prophylaxis against PC-AKI with either oral hydration (500 mL of water two hours before and 2000 mL during the 24 hours after CE-CT) or i.v. hydration (sodium bicarbonate (166 mmol/L)3 mL/kg/h starting one hour before and 1 mL/kg/h during the first hour after CE-CT). The primary outcome was to compare the proportion of PC-AKI in the first 48 to 72 hours after CE-CT in the two hydration groups. Secondary outcomes were to compare persistent PC-AKI, the need for hemodialysis, and the occurrence of adverse events related to prophylaxis in each group. Results Of 174 patients included in the subanalysis, 82 received oral hydration and 92 received i.v. hydration. There were no significant differences in clinical characteristics or risk factors between the two study arms. Overall the PC-AKI rate was 4.6% (8/174 patients), being 3.7% in the oral hydration arm (3/82 patients) and 5.4% (5/92 patients) in the i.v. hydration arm. The persistent PC-AKI rate was 1.8% (1/82 patients) in the oral hydration arm and 3.3% (3/92 patients) in the i.v. hydration arm. No patient required dialysis during the first month after CE-CT or had adverse effects related to the hydration regime. Conclusion In oncological patients with stage IIIb CKD referred for elective CE-CT, the rate of PC-AKI in those receiving oral hydration did not significantly differ from that of patients receiving i.v. hydration.

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