RESUMO
Superior soft tissue and contrast resolution of MR imaging benefits sensitivity to kidney cyst features and classification, which may have an impact on patient management and outcomes. Contrast-enhanced ultrasound (CEUS) may have nearly similar sensitivity for detection of cyst features yet is dependent on patient body habitus and adequacy of visualization windows for the kidneys, which does not have the same impact on MR imaging results. Both MR imaging and CEUS may provide superior kidney cyst assessment compared with contrast-enhanced CT; however, further research is needed, particularly for the identification of role of CEUS.
Assuntos
Meios de Contraste , Aumento da Imagem/métodos , Doenças Renais Císticas/diagnóstico por imagem , Neoplasias Renais/diagnóstico por imagem , Imageamento por Ressonância Magnética/métodos , Ultrassonografia/métodos , Humanos , Rim/diagnóstico por imagem , Doenças Renais Císticas/complicações , Neoplasias Renais/complicaçõesRESUMO
MR imaging has been optimized for the evaluation of a multitude of disease processes affecting the kidneys. A wide variety of noncontrast methods are available for the evaluation of both kidney structure and function, which are especially useful in clinical scenarios that obviate the use of intravenous contrast. Contrast-enhanced methods remain important, especially for tumor evaluation, and are used increasingly for functional analysis of quantitative biometrics, such as glomerular filtration rate and kidney blood flow.
Assuntos
Meios de Contraste , Aumento da Imagem/métodos , Imageamento por Ressonância Magnética/métodos , Insuficiência Renal/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Taxa de Filtração Glomerular , Humanos , Rim/diagnóstico por imagem , Rim/fisiopatologia , Masculino , Pessoa de Meia-Idade , Insuficiência Renal/fisiopatologia , Adulto JovemRESUMO
Pregnant patients can receive allergy premedication prior to a contrast-enhanced computed tomography exam if the exam is indicated. The risks and benefits of allergy premedication for pregnant patients will be discussed, as well as imaging strategies for the pregnant patient with a contrast allergy. Alternative imaging including ultrasound, noncontrast magnetic resonance imaging, or noncontrast computed tomography can be diagnostic depending on the clinical scenario and is usually preferred, allowing physicians to avoid giving allergy premedication in pregnancy, a 13 h delay, and risking a breakthrough reaction.
Assuntos
Protocolos Clínicos , Meios de Contraste/efeitos adversos , Diagnóstico por Imagem/efeitos adversos , Hipersensibilidade a Drogas/prevenção & controle , Glucocorticoides/administração & dosagem , Antagonistas dos Receptores Histamínicos/administração & dosagem , Compostos de Iodo/efeitos adversos , Pré-Medicação , Feminino , Humanos , Gravidez , Fatores de RiscoRESUMO
OBJECTIVE: This article reviews optimal treatment of allergic reactions to iodinated contrast material in pregnant patients. Initial evaluation and treatment of a pregnant patient is similar to that for a nonpregnant patient. However, additional steps, including assessment for uterine cramping, using left uterine displacement to improve venous return, and maintaining blood pressure to ensure placental perfusion, may be required. CONCLUSION: Adequate preparation and a team approach will provide optimal care for a pregnant patient who has an allergic reaction to a contrast agent.
