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For the purpose of medical imaging, a certain substance is introduced into the human body to change the image contrast of the body's local tissues. This substance is called "Contrast Media". Iodinated contrast agent is the most commonly used X-ray contrast agent, and it is also the basic diagnostic drug for cardiovascular imaging under X-ray.

1. The development history of iodinated contrast agents
Since its development, the iodinated contrast agent has undergone a development process from ionic to non-ionic, from hypertonic to hypotonic and to isotonic:

(1) Hypertonic contrast agent is an ionic monomer, and its osmotic pressure is as high as 5-7 times of plasma osmotic pressure; due to relatively more adverse reactions, it has been rarely used at present.

(2) The hypotonic contrast agent is named according to that its osmotic pressure is significantly lower than that of the ionic hypertonic contrast agent (such as diatrizoate meglumine), which includes two types of contrast agents: non-ionic monomer and ionic dimer. Its osmotic pressure is about twice that of plasma.

(3) The isotonic contrast agent was developed to further reduce the osmotic pressure after the hypotonic contrast agent. The isotonic contrast agent is a non-ionic dimer whose osmotic pressure is equal to the plasma osmotic pressure.

2.Types of iodinated Contrast Media
The basic structure of the current clinically used iodine-containing contrast agent is 3-acetyl-2,4,6-tribenzoic acid, which is a benzene ring containing 3 iodine. According to different properties, contrast agents can be divided into monomer and dimer contrast agents, ionic and nonionic iodinat contrasts, hypertonic, sub-hypertonic and isotonic contrast agents (Table 1).

Table 1 Classification and physical and chemical properties of commonly used iodine contrast agents
Structure and classificationCommon nameMolecular massIodine content

( mg /ml)Osmotic pressure
(mOsm/kg H20)
The first generation of hypertonic ionic monomermeglumine 
diatrizoate 8093061530
The second generation of sub-hypertonic nonionic monomerIohexol821300 350680 830
Iopamidol777300.370616 796
Iopromide791300 370590 770
Ioverol807320 350710 790
Iomeprol777300 400521 726
Hypotonic ionic dimerioxaglate1270320600
The third generation of isotonic nonionic dimer iodixanol1550320290

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