ABSTRACT
Gadolinium-based contrast agents are increasingly being used in magnetic resonance imaging. These agents can improve the contrast in images and provide information about function and metabolism, increasing both sensitivity and specificity. We describe the gadolinium-based contrast agents that have been approved for clinical use, detailing their main characteristics based on their chemical structure, stability, and safety. In general terms, these compounds are safe. Nevertheless, adverse reactions, the possibility of nephrotoxicity from these compounds, and the possibility of developing nephrogenic systemic fibrosis will be covered in this article. Lastly, the article will discuss the current guidelines, recommendations, and contraindications for their clinical use, including the management of pregnant and breast-feeding patients.
Subject(s)
Contrast Media , Gadolinium , Magnetic Resonance Imaging , Contrast Media/adverse effects , Humans , Kidney Diseases/chemically induced , Kidney Diseases/prevention & control , Magnetic Resonance Imaging/methods , Nephrogenic Fibrosing Dermopathy/chemically induced , Nephrogenic Fibrosing Dermopathy/prevention & control , Risk FactorsABSTRACT
Los medios de contraste basados en gadolinio son cada vez más utilizados en estudios de resonancia magnética. Son capaces de mejorar el contraste en las imágenes y aportar información sobre la función y el metabolismo, aumentando la sensibilidad así como la especificidad diagnóstica. Se describen los diferentes medios de contraste basados en gadolinio aprobados para uso clínico actualmente, sus características principales en base a su estructura química, estabilidad y seguridad. En términos generales son compuestos seguros. No obstante, las reacciones adversas producidas, la posible nefrotoxicidad inducida por estos compuestos, así como la posibilidad de desarrollar fibrosis sistémica nefrogénica serán temas tratados en la presente publicación. Por último, se mencionarán las actuales guías, recomendaciones y contraindicaciones en cuanto a su utilización en el ámbito clínico, incluyendo el manejo en pacientes gestantes y en la lactancia (AU)
Gadolinium-based contrast agents are increasingly being used in magnetic resonance imaging. These agents can improve the contrast in images and provide information about function and metabolism, increasing both sensitivity and specificity. We describe the gadolinium-based contrast agents that have been approved for clinical use, detailing their main characteristics based on their chemical structure, stability, and safety. In general terms, these compounds are safe. Nevertheless, adverse reactions, the possibility of nephrotoxicity from these compounds, and the possibility of developing nephrogenic systemic fibrosis will be covered in this article. Lastly, the article will discuss the current guidelines, recommendations, and contraindications for their clinical use, including the management of pregnant and breast-feeding patients (AU)
Subject(s)
Adult , Female , Humans , Infant , Male , Pregnancy , Gadolinium/administration & dosage , Gadolinium/adverse effects , Gadolinium , Magnetic Resonance Imaging/trends , Contrast MediaSubject(s)
Echinococcosis, Hepatic/diagnosis , Aged , Animals , Asthenia/complications , Female , Hepatomegaly/complications , HumansABSTRACT
OBJECTIVE: Use of computerized tomography (CT) criteria for the staging of 50 cases of renal trauma diagnosed in the Hospital General Universitario "Gregorio Marañón" over the 1989-1995 period. CT is used as the choice technique to diagnose renal lesions of traumatic etiology in patients haemodynamically stable. MATERIAL AND METHODS: Retrospective study of 50 patients (age range: 16-73 years; sex distribution: 39 male/11 female) with a history of abdominal trauma and CT-confirmed renal injury. Following Hodges-Federle criteria for patients with no underlying renal disease (n = 44), lesions are staged into 4 categories or grades according to CT findings. The traumatic mechanism is correlated to clinical semiology, staging and associated extrarenal lesions. Also, traumatic renal lesions in patients with previously diseased kidneys (n = 6) are analyzed separately. RESULTS AND CONCLUSIONS: Percentile distribution of lesions was as follows: grade I: 50% (n = 22), grade II: 29.5% (n = 13): grade III: 11.4% (n = 5): grade IV: 9.1% (n = 4). Compared to others, our series shows a decreased percentage of mild or grade I lesions. It is confirmed that CT is a very valuable imaging method for an adequate staging of post-traumatic renal lesions, the diagnosis of associated extra-renal lesions and, therefore, for the subsequent therapeutical management.
