Authors: MUTLU SAĞLAM, ŞAHİN UĞUREL, METE KİLCİLER, MEHMET DAKAK, ALİ BUMİN, İBRAHİM SOMUNCU
Abstract: This study was performed to evaluate the feasibility of bone injection gun assisted intraosseous administration of contrast media as an alternative to the intravenous route for urography. Intravenous urographies were obtained in 6 rabbits. Urographic examinations by the intraosseous route were performed in the same animals 48 h later. After adequate anesthesia, the retroauricular vein was punctured for intravenous injection and a bone injection gun was used for intraosseous injections to the distal one-third of the rabbit femur. Direct radiographies of rabbits were obtained following 1200 mg/kg body weight iomeprol (300 mg iodine/ml) administration by both the intravenous and intraosseous routes at 5, 10, and 15 min. Although there was no prominent quality difference among the radiographs obtained by each route at 10 and 15 min, the 5 min radiograph of intraosseous urography showed the calyces more clearly compared to radiographs by intravenous urography. This was attributed to longer lasting high concentrations of iodine in the rabbit circulation after intraosseous injection owing to a longer injection time (mean 240 s) compared to the intravenous route (mean 35 s). Chest radiography and computed tomographic examinations did not reveal any sign of embolus. Bone radiography and magnetic resonance images were also free of any bone or bone marrow complications 48 h after intraosseous application. The success rate for adequate intraosseous insertion by bone injection gun was 100% in all 6 rabbits without any complications. In this study, urographic imaging via bone injection gun assisted intraosseous contrast administration seems to be safe and feasible in rabbits. As a result, we think that bone injection gun assisted intraosseous urography may be an effective and reliable alternative to intravenous urography in pediatric and adult human patients (especially those with ureteral trauma), when emergency urographic examination is necessary and the intraosseous route is the only means of vascular access.
Keywords: Intraosseous urography, intravenous urography, rabbit
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