In the literature, data is mostly available from retrospective magnetic resonance imaging (MRI) studies, where gadolinium deposition may be indirectly measured by evaluating changes in T1 signal intensity in the brain tissues, particularly in the deep gray matter such as the dentate nucleus and/or globus pallidus. Patients with renal insufficiency cannot filter gadolinium efficiently however, gadolinium is also retained in the brain of some adults and pediatrics with no renal impairment. Over the past five years, several studies have reported deposition and retention of gadolinium in the brain after administration of gadolinium-based contrast agents (GBCAs) during radiological procedures.
INTRAVENOUS REQUIREMENTS FOR MR CONTRAST AGENTS SKIN
The most common adverse reactions were not severe, consisting in skin rash and hives. Acute adverse reactions are generally rare with the overall adverse reaction rate of 0.3%. The most severe reactions were seen associated with use of Gd-BOPTA, with 3 severe reactions in 32 total reactions. Twenty-four reactions (75.0%) were mild, four (12.5%) moderate, and four (12.5%) severe. Twelve reactions were associated with Gd-DOTA injection (0.11%), 9 with Gd-BOPTA injection (0.08%), 6 with Gd-BTDO3A (0.056%), 3 with Gd-EOB-DTPA (0.028%), and 2 with Gd-DTPA (0.018%). 32 acute adverse reactions occurred, accounting for 0.3% of all administration. At our center 10608 MRI examinations with CM were performed using five different GBCAs: Gd-BOPTA (MultiHance), Gd-DTPA (Magnevist), Gd-EOBDTPA (Primovist), Gd-DOTA (Dotarem), and Gd-BTDO3A (Gadovist). Objective was to retrospectively assess the frequency and severity of adverse reactions associated with gadolinium-based contrast agents (GBCAs) injection in patients who underwent MRI. Contrast media (CM) for magnetic resonance imaging (MRI) may determine the development of acute adverse reactions. This review discusses the safety issues involved with administration of intravenous contrast media in MR imaging, focusing on the six agents (four gadolinium chelates, one manganese chelate, and the last a large iron particle) with widespread use world-wide.īackground and Purpose. These latter two agents are considered to be very safe but have a higher percentage of associated adverse reactions (7%-17% with mangafodipir trisodium and 15% with ferumoxides). Far fewer patients have been examined to date with the two other agents that have widespread approval, mangafodipir trisodium and ferumoxides. The four gadolinium chelates currently available worldwide, gadopentetate dimeglumine, gadoteridol, gadodiamide, and gadoterate meglumine, cannot be differentiated on the basis of adverse reactions. Health care personnel should be aware of the (extremely uncommon) potential for severe anaphylactoid reactions in association with the use of MR contrast media and be prepared should complications arise. Minor adverse reactions, including nausea (1%-2% for all agents) and hives (<1% for all agents), occur in a very low percent of cases. Unlike x-ray agents, the gadolinium chelates are not nephrotoxic. These agents are thought to be safer than nonionic iodinated contrast agents. The gadolinium chelates constitute the largest group of MR contrast media and are considered to be very safe. Contrast media provide critical additional diagnostic information in many instances. In the last 10 years, the use of intravenous contrast media in magnetic resonance (MR) has become well-established clinical practice.
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