Contrast Media: Safety Issues and ESUR Guidelines

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Springer Science & Business Media, Mar 23, 2009 - Medical - 254 pages
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In 1994 the European Society of Urogenital Radiology (ESUR) set up a committee to consider the safety of contrast media used for diagnostic imaging. Subsequently the committee questioned members, reviewed the literature, proposed guidelines and discussed these proposals with participants at the annual symposia of the society. The end result of this work was the successful first edition of this book, published in 2006. This second edition not only updates the previous edition, but also contains some completely new chapters, for example on gadolinium-based contrast agents, meta-analyses in contrast media research and various regulatory issues. Comprehensive consideration is given to the many different safety issues relating to iodinated, MR, ultrasound and barium contrast media. The text includes chapters on both acute and delayed non-renal adverse reactions and on renal adverse reactions. All those questions frequently raised in radiological practice are addressed, and the well-known ESUR guidelines on contrast media are included. This book, presented in a handy, easy to use format, provides an invaluable, unique and unparalleled source of information on the safety issues relating to contrast media.
 

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Contents

Classification and Terminology
3
Requests for Imaging Using Contrast Agents What Information Must be Provided
10
OffLabel Use of Medicines Legal Aspects
15
Pharmacovigilance When to Report Adverse Reactions
21
What is Required in Order to Get the Authorities to Approve a New Contrast Agent?
24
A Critical Review of MetaAnalysis of Adverse Events After Contrast Agents
31
Iodinated and Gadolinium Contrast Media
40
Prevention of Acute Reactions
43
Pulmonary Effects
147
MRContrast Media
153
Chelates and Stability
154
Diagnostic Efficacy
161
Radiography with Gadolinium Contrast Agents
171
GadoliniumBased Contrast Agents
178
Acute Adverse Reactions
181
Delayed Reactions Nephrogenic Systemic Fibrosis
186

Management of Acute Adverse Reactions
52
Renal Adverse Effects
61
Contrast MediumInduced Nephropathy
63
Dialysis and Contrast Media
81
NonInsulinDependent Diabetes and Contrast Media
86
Other Adverse Effects
93
Pregnancy and Lactation
95
Phaeochromocytoma
102
Interactions with Other Drugs and Clinical Tests
107
Extravasation Injury
114
Iodinated Contrast Media
120
Late Adverse Reactions
121
Effects on the Blood and Endothelium
129
Effect on Thyroid Function
139
OrganSpecific MR Contrast Agents
197
GadoliniumBased Contrast Agents
199
NonGadoliniumBased Contrast Agents
205
Ultrasonographic Contrast Media
213
Safety of Ultrasonographic Agents
214
Barium Preparations
220
Barium Preparations Safety Issues
221
Appendix
227
ESUR Guidelines on Contrast Media
229
Official Publications from the European Society of Urogenital Radiology
243
Subject Index
244
List of Contributors
253
Copyright

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About the author (2009)

Short CURRICULUM VITAE for HENRIK S. THOMSEN Born: April 29th 1953 M.D.: University of Copenhagen, June 1979 Dr. Med. (dissertation): University of Copenhagen November 1984 Certified Radiologist: April 1993 (National Health Authorities) Consultant: April 1996, Department of Diagnostic Radiology, Copenhagen University Hospital at Herlev Chair: January 2002-2008, Department of Diagnostic Radiology, Copenhagen University Hospital at Herlev Professor: April 1999, Radiology, University of Copenhagen Director: 2000, Department of Diagnostic Sciences, Faculty of Health Sciences, University of Copenhagen (renominated for 2007-2012) Research: Author or co-author of approx. 340 manuscripts (original paper, reviews, book chapters) mainly dealing with radiological topics within the fields of uroradiology, muscleskeletal radiology, contrast media et c. Editor: Member of the editorial board of 4 international journals (Abdominal Imaging, European Radiology, Academic Radiology, Acta Radiologica); has edited in cooperation with colleagues 8 books in English. Sole editor of one book: Contrast Media: Safety issues and ESUR Guidelines. Guest editor of two issues of Abdominal imaging (2003 & 2006). Referee: European Journal of Radiology, Scandinavian Journal of Clinical and Laboratory Investigations, Acta Radiologica, Acta Oncologica, Current Opinion in Radiology (USA), Pharmacology & Toxicology, Investigative Radiology (USA), CardioVascular and Interventional Radiology, Annals of Medicine, Academic Radiology (USA), Kidney International (USA), Journal of Clinical Ultrasonography (USA), British Journal of Radiology, European Radiology, Lancet, American Journal of Kidney Diseases, New England Journal of Medicine, Nephrology Dialysis Transplantation, American Journal of Kidney Diseases. Has evaluated > 200 publications. Advisor: Main advisor for 10 PhD-students Evaluation: Dissertations and PhD on behalf of University of Copenhagen, University of Southern Denmark, University of Århus, University of Mamö. Appointment (committee member) of professors and lecturers: University of California Los Angeles, University of Alabama Birmingham, University of Manchester, UK, University of Sheffield, UK, University of Copenhagen, Yale University. Congresses: Member of organization and/or program committee at more than 20 international congresses and symposia (e.g. European Congress of Radiology, European Symposia on Urogenital Radiology, Radionuclides in Nephro-urology, Mangement in Radiology, Contrast Media Research) ESUR Contrast Media Safety Committee: Chairman since 1996 ECR Evaluation Committee: Chairman 1993-2002 Committes: ECR Urogential 1995-2001 ECR Contrast Media 2007-2008 Management in Radiology 2003- ISMRM Committee of NSF 2007- ESMRMB Safety Committee 2007- ESUR: Secretary 1990-1996 President-Elect 1996-1998 President 1998-2000 CMR: Convenor 2007-2009 Awards President's AWARD, Society for Uroradiology, September 1990, for best scientific presentation. December 1990, Jytte Mommsen, født Købler's legat til fremme af den lægevidenskabelige forskning af nyresygdomme. April 1992 Eyvind Mosekildes Rejselegat, Danish Society of Radiology Price for cooperation with industry 2004, Copenhagen County March 2004, Ulrik Brinch og hustru Marie Brinchs legat, (Technical University of Denmark). Honorary member European Society of Urogenital Radiology Pacific Northwestern Radiological Society Member of: The Danish Society of Nephrology The Danish Society of Clinical Physiology and Nuclear Medicine Danish Society of Uroradiology Danish Society for GCP ('Good Clinical Practice') Society of Uroradiology (USA) Danish Society of Radiology Radiological Society of North America (USA) European Congress of Radiology (Austria) European Society for Magnetic Resonance in Medicine and Biology Publications: Thomsen HS, Bonnevie A, Thomsen G. Pleuraforkalkninger - Asbestudsættelse? Ugeskr Læger 1977; 139: 2777-2780.Thomsen HS, Gottlieb J, Madsen JK, Rasmussen SG, Jensen KB, Christensen JJ, Christensen V: Rutinemæssig røntgenundersøgelse af thorax inden kirurgiske indgreb i universel anæstesi. Ugeskr Læger 1978; 140: 765-768.Thomsen HS, Dorph S. Pyelorenal backflow during retrograde pyelography after renal transplantation. Scand J Urol Nephrol 1978; 12: 175-179.Thomsen HS, Dorph S, Olsen S. Pyelorenal backflow in normal and ischemic rabbit kidneys. Invest Radiol 1981; 16: 206-214.Thomsen HS, Dorph S. Pyelorenal backflow during retrograde pyelography in adult patients. Scand J Urol Nephrol 1981; 15: 65-68.Thomsen HS, Dorph S, Olsen S. Pyelorenal backflow: Experimental studies in rabbits. - Evalueret abstract. Amer J Roentgenol 1981; 137: 198.Thomsen HS, Madsen JK, Thaysen JH, Damgaard Pedersen K. Volume of polycystic kidneys during reduction of renal function. Urol Radiol 1981; 3: 85-89. Abstr.: Radiology 1982; 144: 720.Thomsen HS, Dorph S, Olsen S. Pyelorenal backflow in rabbits following clamping of the renal vein and artery. Radiologic and microscopic investigation. Acta Radiol Diagn 1982; 23: 143-148.Thomsen HS, Taylor Jr. A. Evaluation of renal ischemia with 99mTc-pyrophosphate. Eur J Nucl Med 1982; 7: 147-149. Abstr.: Radiology 1982; 145: 590.Thomsen HS, Larsen S, Talner LB. Pyelorenal backflow during retrograde pyelography in normal and ischemic porcine kidneys. A radiologic and pathoanatomic study. Eur Urol 1982; 8: 291-297.Thomsen HS. Rapport fra klinisk fysiologisk udvalg. DBCG's informationsblad 1982; 9: 12-13.Thomsen HS, Talner LB, Higgins CB. Intrarenal backflow during retrograde pyelography with graded intrapelvic pressure. Invest Radiol 1982; 17: 593-603.Thaysen JH, Thomsen HS. Involution of polycystic kidneys during replacement therapy of terminal renal failure. Acta Med Scand 1982; 212: 389-394.Thomsen HS, Larsen S, Talner LB. Papillary morphology in adult human kidneys and in baby and adult pig kidneys. Eur Urol 1983; 9: 170-180.Thomsen HS, Hartelius H, Jensen R, Flindt-Nielsen N, Ohlhues L. Excretory urography with glucagon: A randomized trial. Radiology 1983; 147: 335-338.Thomsen HS, Larsen S. Intrarenal backflow during retrograde pyelography with graded intrapelvic pressure. A pathoanatomic study. Acta path microbiol immunol scand Sect A 1983; 91: 245-252.Thomsen HS. Pressures during retrograde pyelography. Acta Radiol Diagn 1983; 24: 171-175. Thomsen HS. Refluxnefropati på basis af vesikoureteral refluks. (oversigtsartikel). Ugeskr Læger 1983; 145: 3334-3338.Thomsen HS, Larsen S. Refluksnefropati. (kasuistik). Ugeskr Læger 1983; 145: 3339-3340.Thomsen HS, Dorph S, Larsen S, Talner LB. Intrarenal backflow and renal perfusion during increased intrapelvic pressure in excised porcine kidneys. Acta Radiol Diagn 1983; 24: 327-336.Dorph S, Mygind T, Thomsen HS. The early nephrogram during urography in kidney transplants. - Evalueret abstract. Amer J Roentgenol 1984; 142: 239.Thomsen HS. Excretory urography with glucagon: A randomized trial. (specielt udarbejdet abstract af artikel 15 efter anmodning). Postgraduate Radiol 1984; 4: 206-207.Thomsen HS, Løkkegaard H, Munck O. Evaluation of kidney grafts with 99mTc-methylene diphosphonate within 36 hours after transplantation: A marker of ischemic damage. Eur J Nucl Med 1984; 9: 115-120.Thomsen HS. Intrarenal backflow during retrograde pyelography following kidney transplantation. Acta Radiol Diagn 1984; 25: 113-120. Thomsen HS, Munck O, Andersen KW. Værdien af rutinemæssig knoglescintigrafi ved primær operabel cancer mammae. Ugeskr Læger 1984; 146: 1915-1918.Thomsen HS, Lund JO, Munck O, Andersen KW, Støckel M, Rossing N. Bone metastases in primary operabel breast cancer. The role of serial scintigraphy. Eur J Cancer Clin Oncol 1984; 8: 1019-1023.Thomsen HS. PYELORENAL BACKFLOW. CLINICAL AND EXPERIMENTAL INVESTIGATIONS. RADIOLOGIC, NUCLEAR MEDICAL AND PATHOANATOMIC STUDIES. (disputats). Lægeforeningens Forlag, København 1984; 1-24. Dan Med Bull 1984; 31: 438-457.Thomsen HS. Pyelorenal backflow. Clinical and experimental investigations. Radiologic, nuclear medical and pathoanatomic studies. (specielt udarbejdet abstract af artikel 27 efter anmodning). Ugeskr Læger 1984; 146: 3379-3380.Thomsen HS, Dorph S, Mygind T. Subtraction nephrotomography during urography of transplanted kidneys. Acta Radiol Diagn 1984; 25: 495-500.Munck O, Thomsen HS, Lund JO, Støckel M, Andersen KW, Rossing N. Bone metastases in primary operable breast cancer. The role of serial scintigraphy. I: Schmidt HAE, Varumo DE (eds.) Nuklearmedizin (Nuclear Medicine in Research and Practice). Schattauer Verlag, Stuttgart; 1984: 536-539.Thomsen HS. Vesioureteral reflux and reflux nephropathy. (oversigtsartikel). Acta Radiol Diagn 1985; 26: 3-13.Thomsen HS. Filling of the central intrarenal veins during retrograde pyelography following a recent kidney transplantation (kasuistik). Acta Radiol Diagn 1985; 26: 206-211.Thaysen JH, Thomsen HS, Sass A, Kristensen JK.Volume changes of polycystic kidneys during chronic dialysis and after renal transplantation. Acta Med Scand 1985; 217: 197-204.Thomsen HS, Dorph S, Mygind T, Holm HH, Munck O, Damgaard Pedersen K. The transplanted kidney. Diagnostic and interventional radiology (oversigtsartikel). Acta Radiol Diagn 1985; 26: 353-367. Thomsen HS, Rygaard H, Strandberg C. Micturating cystourethrography and vesicoureteral reflux. Variations in technique. Eur J Radiol 1985; 5: 318-320.Thomsen HS. Vesicoureteral reflux and reflux nephropathy. (specielt udarbejdet abstract af artikel 31 efter anmodning). Postgraduate Radiol 1986; 6: 139-140.Vyberg M, Miskowiak J, Nielsen SL, Fahrenkrug L, Thomsen HS. Cecal angiodysplasia localized by 99mTechnetium blood pool scintigraphy and specimen venography. (kasuistik). Cardiovasc Interv Radiol 1986; 9: 28-32.Zobbe VB, Rygaard H, Rasmussen D, Strandberg C, Krause S, Hartsen SH, Thomsen HS. Glucagon in acute ureteral colic. A randomized trial. Eur Urol 1986; 12: 28-31.Thomsen HS, Dorph S. Caliceal clubbing and adjacent parenchymal scarring (always reflux nephropathy?) as a cause of end-stage renal failure. Acta Radiol Diagn 1986; 27: 705-710.Thomsen HS, Munck O, Løkkegaard H. 90-min 99mTc-MDP scintigraphy and 131I-Hippuran renography in recently allotransplanted kidneys: Evaluation of renal ischemia. Eur J Nucl Med 1986; 12: 110-114.Thomsen HS, Nielsen SL, Larsen S, Løkkegaard H. Renography and biopsy-verified acute rejection in renal allotransplanted patients receiving cyclosporin A. Eur J Nucl Med 1987; 12: 473-476.Thomsen HS. Opdigtet videnskabeligt arbejde. (leder). Ugeskr Læger 1987; 149: 539-540.Thomsen HS, Munck O. Use of 99Tcm radionuclides to show nephrotoxicity of cyclosporin A in transplanted kidneys. Acta Radiol 1987; 28: 59-61.Thomsen HS, Dorph S. The upper urinary tract. Pyelography and interventional procedures. (oversigtsartikel). Acta Radiol 1987; 28: 129-137.Thomsen HS, Munck O. Nephrotoxicity of ciclosporin in transplanted kidneys demonstrated with 99mTc perfusion studies. Contrib Nephrol 1987; 56: 159-162. Nielsen SL, Hvid-Jacobsen K, Thomsen HS, Munck O. Renal washout and vascular resistance (kasuistik). Eur J Nucl 1987; 12: 629-630.Thomsen HS, Hvid-Jacobsen K, Pedersen T, Nielsen SL. Radionuclide techniques in renal/renovascular hypertension. (oversigtsartikel). IM-Internal Medicine for the Specialist 1987; 8: 231-246.Munck O, Thomsen HS. Nephrotoxicity of cyclosporin A in transplanted kidneys demonstrated with Tc-99m perfusion technique. In: Schmidt HAE, Emrich D (eds.). Nuklearmedizin (Clinical Demands on Nuclear Medicine). Schattauer Verlag, Stuttgart; 1987: 287-289.Thomsen HS, Rasmussen D, Munck O, Dombernowsky P. Knoglescintigrafi ved nydiagnosticeret cancer mammae; en overflødig rutine? Ugeskr Læger 1987; 149: 1453-1455.Thomsen HS, Dombernowsky P. Knogleskintigrafi ved cancer mammae. (leder). Ugeskr Læger 1987; 149: 1480.Thomsen HS, Rygaard H, Nielsen SL, Larsen S, Løkkegaard H. Angiography in non-functioning renal allografts receiving cyclosporin A. Acta Radiol 1987; 28: 313-317.Thomsen HS, Løkkegaard H, Munck O. Influence of normal central venous pressure on onset of function in renal allografts. Scand J Urol Nephrol 1987; 21: 143-145.Thomsen HS, Hvid-Jacobsen K, Nielsen SL. Alternating use of 123I and 131I hippuran for routine postoperative monitoring of transplanted kidneys is impracticable. Acta Radiol 1987; 28: 365-367.Thomsen HS, Rasmussen D, Munck O, Lund JO, Nielsen VG, Terkildsen T, Dombernowsky P, Andersen KW. Bone metastases in primary operable breast cancer. The role of a yearly scintigraphy. Eur J Cancer Clin Oncol 1987; 11: 779-781.Skaarup P, Thomsen HS. Urinary protein profiles following urography with iothalamate: A preliminary report. Acta Radiol 1987; 28: 335-338. Thomsen HS, Nielsen SL, Munck O. Prægraduat ikke obligatorisk undervisning i specialer uden eksamen. Klinisk fysiologi og nuklearmedicin som eksempel. Ugeskr Læger 1987; 149: 3014-3015.Thomsen HS. Knoglescintigrafi ved cancer mammae. DBCG's informationsblad 1987; 19: 24-27.Thomsen HS, Hvid-Jacobsen K, Meyhoff H-H, Nielsen SL. Combination of DMSA scintigraphy and hippuran renography in unilateral obstructive nephropathy: Improved prediction of recovery after intervention. Acta Radiol 1987; 28: 653-655.Hvid-Jacobsen K, Nielsen SL, Jensen VJ, Thomsen HS. Demonstration of the thoracic duct by 123I heptadecanoic acid. (kasuistik). Acta Radiol 1987; 28: 783-784. Strandberg C, Falkenløve P, Dorph S, Jakobsen S, Thomsen HS. Effect of glucagon-(1-21)-peptide on gastroduodenal motility during upper gastrointestinal examination. Randomized trials. Acta Radiol 1988; 29: 49-52.Thomsen HS, Rasmussen K, Burcharth F, Nielsen SL. Monitoring of pancreatic graft perfusion by first passage radionuclide angiography. Acta Radiol 1988; 29: 138-140.Thomsen HS, Dorph S, Mygind T, Sovak M, Nielsen H, Rygaard H, Larsen S, Skaarup P, Hemmingsen L, Holm J. Intravenous injection of ioxilan, iohexol, and diatrizoate. Effects on urine profiles in the rat. Acta Radiol 1988; 29: 131-136.Thomsen HS, Hvid-Jacobsen K, Nielsen SL. Validity of renal split function by single probe renography in hypertensive patients. A comparison with gamma-camera scintigraphy. Acta Radiol 1988, 29. 377-378. Rygaard H, Dorph S, Thomsen HS, Mygind T, Nielsen H, Larsen S, Skaarup P, Hemmingsen L, Holm J. Effects of intravenous injection of diatrizoate, iohexol, or ioxilan on renal size, urine profiles and blood profiles in the rabbit. Acta Radiol 1988; 28: 491-494.Thomsen HS, Dorph S, Mygind T, Nielsen H, Rygaard H, Larsen S, Skaarup P, Hemmingsen L, Holm J. Do contrast media aggravate Fanconi's syndrome in rats? A comparison of diatrizoate, iohexol, and ioxilan. Invest Radiol 1988; 23 (Suppl. 1): S168-S170. Thomsen HS, Dorph S, Mygind T, Hemmingsen L, Holm J, Larsen S, Nielsen H, Rygaard H, Skaarup P. Urine profiles following intravenous diatrzoate, iohexol, or ioxilan in rats. Invest Radiol 1988; 23 (Suppl. 1): S168-S170.Hvid-Jacobsen K, Fogh J, Nielsen SL, Thomsen HS, Dyrbye M. Skintigrafisk efterkontrol af lungeemboli. Ugeskr Læger 1988; 150: 94-95.Thomsen HS, Hvid-Jacobsen K, Nielsen SL. Asymptomatisk ren mobile i en hypertensiv population. Ugeskr Læger 1988; 150: 358-359.Thomsen HS, Nielsen SL. Triple therapy and initial renal graft perfusion. Dan Med Bull 1988; 35: 393-395. Abstr.: Cyclosporin Quarterly 1988; 3: 10.Thomsen HS, Løkkegaard H, Nielsen SL, Larsen S. Postoperative radionuclide monitoring of renal allografts on triple therapy. Dan Med Bull 1988; 35: 395-397.Thomsen HS. Nefropati af ukendt årsag. Uroradiologiske undersøgelser. (oversigtsartikel). Ugeskr Læger 1988; 150: 1331-1334.Hvid-Jacobsen K, Fogh J, Nielsen SL, Thomsen HS, Hartling OJ. Scintigraphic control of pulmonary embolism. Eur J Nucl Med 1988; 14: 71-72.Thomsen HS, Hemmingsen L, Dorph S, Skaarup P. Effects of urine profiles of diatrizoate in hydrated and dehydrated rats. A double cross-over study. Acta Radiol 1988; 29: 731-735.Thomsen HS, Thaysen JH. Frequency of hepatic cysts in adult polycystic kidney disease. Acta Med Scand 1988; 224: 381-384.Larsen S, Brun C, Dunn S, Løkkegaard H, Thomsen HS. Early arteriolopathy following "high-dose" cyclosporine in kidney transplantation. APMIS 1988; Suppl. 4: 66-73. Abstr.: Cyclosporin Quaterly 1990; 4: 13.Thomsen HS, Lund JO, Munck O, Rossing N. The value of pre-scheduled bone scintigraphies in breast cancer. Acta Oncol 1988; 27: 617-620.Rasmussen K, Burcharth F, Thomsen HS, Rygaard H. Monitoring of pancreas-graft perfusion by radionuclide and digital subtraction angiography. Diabetes 1989; 38 (Suppl. 1): 21-23.Thomsen HS, Nielsen SL. Renal parenchymal scars in adults: Split function and extent of scars at urography and DMSA scintigraphy. Dan Med Bull 1989; 36: 185-188.Thomsen HS, Lund JO, Munck O, Andersen KW. Experience with 7,604 bone scintigraphies at time of operation for breast cancer 1977-1987. Dan Med Bull 1989; 36: 481-486.Hvid-Jacobsen K, Thomsen HS, Nielsen SL, Kamper A-L, Vestbo J. Scintigraphic demonstration of the thoracic duct following oral ingestion of 123I-heptadecanoic acid. Gastrointestinal Radiol 1989; 14: 212-214.Thomsen HS, Nielsen SL. Triple therapy and initial graft perfusion. (specielt udarbejdet abstract af artikel 69 efter anmodning). Urology/Nephrology Digest 1989; 3: 22-23.Thomsen HS, Larsen S, Hemmingsen L, Holm J, Skaarup P. Nephropathy induced by intramuscularly administered glycerol and contrast media in rats. A comparison between diatrizoate, iohexol and ioxilan. Acta Radiol 1989; 30: 217-222.Thomsen HS, Løkkegaard H, Nielsen SL, Larsen S. Postoperative radionuclide monitoring of renal allografts on triple therapy. (specielt udarbejdet abstract af artikel 70 efter anmodning). Urology/Nephrology Digest 1989; 3: 23-24.Thomsen HS, Sos TA, Nielsen SL. Renovascular hypertension. Diagnosis and intervention. (oversigtsartikel). Acta Radiol 1989; 30: 113-120.Petronijevic L, Bucharth F, Rasmussen K, Thomsen HS, Rygaard H. Monitoring of pancreatic graft rejection by measurement of exocrine secretion and graft perfusion by intravenous radionuclide angiography. Gastroenterol Arh 1989; 8: 47-52.Thomsen HS, Nielsen SL. Imaging in renal transplantation (oversigtsartikel). Current Opinion in Radiology 1989; 1: 297-305.Vestergaard A, Herrstedt J, Thomsen HS, Dombernowsky P, Zedeler K. The value of yearly chest X-ray in patients with stage I breast cancer. Eur J Cancer Clin Oncol 1989; 24: 687-689.Thomsen HS, Larsen S, Skaarup P, Hemmingsen L, Dieperink H, Golman K. Nephrotoxicity of cyclosporin A and contrast media. A comparison between diatrizoate and iohexol in rats. Acta Radiol 1989; 30: 647-653.Vestergaard AS, Thomsen HS. Urografi og renal clearance af røntgenkontraststof. En randomiseret undersøgelse af et ionisk højosmolært og et ikke ionisk lavosmolært røntgenkontraststof. Ugeskr Læger 1990; 152: 154-157.Kamper A-L, Thomsen HS, Nielsen SL, Strandgaard S. Initial effect of enalapril on kidney function in patients with severe chronic nephropathy. Scand J Urol Nephrol 1990; 24: 69-73.Thomsen HS, Bartram P, Hvid-Jacobsen K, Nielsen SL. Prospective evaluation of radionuclide monitoring in renal transplantation. Contrib Nephrol 1990; 79: 108-112.Hvid-Jacobsen K, Thomsen HS, Nielsen SL. Diuresis renography. A simultaneous comparison between 131I-hippuran and 99Tcm-MAG3. Acta Radiol 1990; 31: 83-86Thomsen HS, Golman K, Hemmingsen L, Larsen S, Skaarup P. Adriamycin nephrosis and contrast media. A comparison between diatrizoate and iohexol in rats. Acta Radiol 1990; 31: 93-98.Brynskov J, Thomsen HS, Nielsen SL. Renographic monitoring of renal function in patients with Crohn's disease treated with low dose cyclosporin A. Brit Med J 1990; 300: 1438-1439.Thomsen HS. Contrast media- and pharmacologic-induced nephropathies. Effects of diatrizoate and iohexol on urine profiles in rats. Invest Radiol 1990; 25 (suppl. 1): S129-S132.Kamper A-L, Thomsen HS, Nielsen SL, Strandgaard S. Renal uptake of dimercaptosuccinic acid and glomerular filtration rate in chronic nephropathy at angiotensin converting enzyme inhibition. Eur J Nucl Med 1990; 16: 85-88.Løgager VB, Vestergaard A, Herrstedt J, Thomsen HS, Zedeler K, Dombernowsky P. The limited value of routine chest X-ray in the follow-up of stage II breast cancer. Eur J Cancer 1990; 26: 553-555.Thomsen HS. (redaktør + forfatter af forord). Uroradiology Copenhagen'90. FADL Publishers, Copenhagen, and Field & Wood Inc, Philadelphia; 1990.Thomsen HS. Isotope or radiologic MCU for reflux. In: Thomsen HS (ed.). Uroradiology Copenhagen'90. FADL Publishers, Copenhagen, and Field & Wood Inc, Philadelphia; 1990: 75-78.Thomsen HS. CM and drug induced nephropathies. In: Thomsen HS (ed.). Uroradiology Copenhagen'90. FADL Publishers, Copenhagen, and Field & Wood Inc, Philadelphia; 1990: 99-101.Thomsen HS, Skaarup P, Larsen S, Golman K, Hemmingsen L. Gentamicin nephropathy and contrast media. A comparison between diatrizoate and iohexol in rats. Acta Radiol 1990; 31: 401-407.Thomsen HS. Contrast nephropathy (oversigtsartikel). Current Opinion in Radiology 1990; 2: 793-802.Thomsen HS, Larsen S, Skaarup P, Hemmingsen L, Dieperink H. Nephrotoxicity of cyclosporin A and contrast media (specielt udarbejdet abstract af artikel 88 efter anmodning). Postgraduate Radiol 1990; 10: 290-291.Thomsen HS. Værdien af røntgen af thorax ved recidivopsporing. DBCG's informationsblad 1990; 23: 18-21.Thomsen HS, Hemmingsen L, Golman K, Skaarup P, Larsen S. Low sodium diet, indomethacin and contrast media. A comparison between renal effects of diatrizoate and iohexol in rats. Acta Radiol 1990; 31: 613-618.Dorph S, Larsen JK, Mygind T, Thomsen HS. Radiology of the transplant kidney. In: Lang EK (ed.). Radiology of the upper urinary tract. (Volume of Brady LW, Donner MW, Heilman H-P, Heuck F: Medical Radiology - Diagnostic Imaging and Radiation Oncology). Springer Verlag, Berlin; 1991: 311-338.Thomsen HS, Golman K, Svendsen O. Muscle toxicity of diatrizoate and iohexol in rabbits. A model of local tissue damage. Acta Radiol 1991; 32: 182-183.Thomsen HS, Hvid-Jacobsen K. Estimation of glomerular filtration rate from a low dose injection of iohexol and a single blood sample. Invest Radiol 1991; 26: 332-336.Thomsen HS, Vestergaard A, Nielsen SL, Fogh-Andersen N, Golman K, Dorph S. Renal clearance of an ionic high-osmolar and a non-ionic low-osmolar contrast medium. Invest Radiol 1991; 26: 564-568.Aspelin P, Thomsen HS. New tools reshape uroradiology terrain. Diagnostic Imaging International 1991; 7: 41-42. Thomsen HS, Golman K, Larsen S, Hemmingsen L, Skaarup P. Urine profiles and kidney histology following intravenous diatrizoate and iohexol in the degeneration phase of gentamicin nephropathy in rats. Invest Radiol 1991; 26: 951-959. Thomsen HS, Golman K, Svendsen O, Skaarup P, Hemmingsen L, Larsen S. Pretreatment with steroids before intravnous injection of diatrizoate or iohexol. Effects on urine and serum profiles in rats. Invest Radiol 1991; 26: 1083-1086.Thomsen HS. Røntgenundersøgelse af thorax. DBCG's informationsblad 1991; 24: 21-24.Thomsen HS, Andersen J, Andersen KW, Axelsson CK, Blichert-Toft M, Dombernowsky P, Hansen M, Krag C, Mouridsen HT, Overgaard M, Rasmussen BB, Rose C, Zedeler K. Rationaliseringsgevinster inden for billeddiagnostik ved systematiske opfølgningsprogrammer i DBCG's regi. 1 Ugeskr Læger 1991; 153: 2270-2272.Danish Breast Cancer Cooperative Group (DBCG). En randomiseret undersøgelse af tumerektomi versus mastektomi ved cancer mammae. 2. DBCG-82TM protokollens 6-års resultater. Ugeskr Læger 1991; 153: 2272-2276.Axelsson CK, Andersen JA, Andersen KW, Blichert-Toft M, Dombernowsky P, Hansen M, Krag C, Mouridsen HT, Overgaard M, Rasmussen BB, Rose C, Thomsen HS, Zedeler K. Prognosen efter kirurgisk behandling af cancer mammae. 3. DBCG's lavrisikogruppe. Ugeskr Læger 1991; 153: 2276-2279.Dombernowsky P, Andersen JA, Andersen KW, Axelsson CK, Blichert-Toft M, Hansen M, Krag C, Mouridsen HT, Overgaard M, Rasmussen BB, Rose C, Thomsen HS, Zedeler K. Adjuverende behandling and præmenopausale og menopausale højrisiko patienter med cancer mammae. 4. Resultater fra DBCG 77B undersøgelsen. Ugeskr Læger 1991; 153: 2280-2283.Rose C, Andersen JM, Andersen KW, Axelsson CK, Blichert-Toft M, Dombernowsky P, Hansen M, Krag C, Mouridsen HT, Overgaard M, Rasmussen BB, Thomsen HS, Zedeler K. Adjuverende endokrin behandling af postmenopausale brystkræftpatienter med høj risiko for recidiv. 5. Resultater fra DBCG 77 C, en randomiseret undersøgelse. Ugeskr Læger 1991; 153: 2283-2287.Thomsen HS, Vestergaard A, Dorph S. Quality of urography and renal clearance of ionic and non-ionic contrast media. Invest Radiol 1992; 27: 40-44. Munck O, Gerquari I, Møller JT, Jensen LI, Thomsen HS. Plain radiography, renography and 99mTc-DMSA renal scintigraphy before and after extracorporeal shock wave lithotripsy for urolithiasis. Acta Radiol 1992; 33: 569-572.Andersen M, Thomsen HS. Indberettede bivirkninger ved vandopløselige røntgenkontraststoffer. Ugeskr Læger 1992; 154: 946-948.Thomsen HS, Dorph S. Interventional uroradiology today (oversigtsartikel). Annals of Medicine 1992; 24: 167-169. Mouridsen HT, Andersen J, Andersen KW, Axelsson C, Blichert-Toft M, Dombernowsky P, Hansen M, Krag C, Overgård M, Rasmussen BB, Rose C, Thomsen H, Zedeler K. Classical prognostic factors in node negative breast cancer patients. The DBCG experience. J Natl Cancer Inst Monogr 1992; 11: 163-166.Thomsen HS. (redaktør + forfatter af forord). European Uroradiology'92. FADL Publishers, Copenhagen; 1992: 1-268.Thomsen HS. Quality of urography and contrast medium clearance. In: Thomsen HS (ed.). European Uroradiology'92. FADL Publishers, Copenhagen; 1992: 32-35.Thomsen HS. Reflux nephropathy. In: Thomsen HS (ed.). European Uroradiology'92. FADL Publishers, Copenhagen; 1992: 133-138. Andersen M, Thomsen HS. Bivirkninger ved vandopløselige røntgenkontraststoffer (svar på læserbrev). Ugeskr Læger 1992: 154: 2216-2217.Thomsen HS. Uronephrologic nuclear medicine (oversigtsartikel). Current Opinion Nephrol Hypertension 1992; 1: 269-279.Thomsen HS, Dorph S. Symposium spotlights European uroradiology Diagn Imaging Int 1992; 8: 65+68.Thomsen HS, Vestergaard A, Golman K, Dorph S. One or two samples for determination of total plasma clearance of a nonionic contrast medium in patients undergoing

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