Journal of magnetic resonance imaging : JMRI
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J Magn Reson Imaging · Dec 2009
Retrospective assessment of prevalence of nephrogenic systemic fibrosis (NSF) after implementation of a new guideline for the use of gadobenate dimeglumine as a sole contrast agent for magnetic resonance examination in renally impaired patients.
From May 2007 to January 2008, patients with Stage 3-5 chronic kidney disease (CKD) undergoing gadobenate dimeglumine (GBD)-enhanced magnetic resonance (MR) examinations were included in the retrospective investigation. The electronic medical records were reviewed to assess the prevalence of nephrogenic systemic fibrosis (NSF) in renally impaired patients underwent GBD-enhanced MR examinations. In all, 250 patients (98 men, mean age 72.6 years) were included: 97% of the patients had Stage 3 CKD (estimated GFR 30-59 mL/min/1.73 m(2)); 37% had been exclusively exposed to GBD. ⋯ Magn. Reson. Imaging 2009;30:1335-1340. (c) 2009 Wiley-Liss, Inc.
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J Magn Reson Imaging · Dec 2009
ReviewRemoval of gadolinium by dialysis: review of different strategies and techniques.
Nephrogenic systemic fibrosis (NSF) has been related to the administration of gadolinium-based contrast agents for magnetic resonance imaging studies in patients with kidney disease. After reviewing the pathophysiology of NSF, we discuss the possible factors contributing to the toxicity of gadolinium in susceptible patients, including the excessive amounts of intravenous iron and erythropoietin as well as the inflammatory states commonly seen in patients treated with hemodialysis. Since free gadolinium is the most accepted risk factor for NSF, we provide some suggestions to improve clearance of both free and chelated gadolinium using different dialysis strategies and techniques. ⋯ Magn. Reson. Imaging 2009;30:1347-1349. (c) 2009 Wiley-Liss, Inc.
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J Magn Reson Imaging · Dec 2009
Guideline to use gadolinium-based contrast agents at Kyoto University Hospital.
Guideline to use gadolinium-based contrast agents (GBCAs) to prevent nephrogenic systemic fibrosis (NSF) at Kyoto University Hospital is presented. This guideline is basically the same as the one issued by the joint committee of the Japan Radiological Society and Japanese Society of Nephrology. In the guideline of the joint committee of Japan Radiological Society and Japanese Society of Nephrology, it is described that GBCAs should be used only when they are indispensable for adequate diagnosis regardless of renal function. ⋯ Magn. Reson. Imaging 2009;30:1364-1365. (c)2009 Wiley-Liss, Inc.
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J Magn Reson Imaging · Dec 2009
Incidence of nephrogenic systemic fibrosis at Chinese PLA General Hospital.
Magnetic resonance imaging (MRI), dermatology, and dermatopathology records were searched to determine the incidence of nephrogenic systemic fibrosis (NSF) at a large military hospital in China. Over the past 3.7 years, gadolinium-based contrast agent (GBCA)-enhanced MRI was performed with Gd-DTPA (n = 28,680) or MultiHance (n = 635) typically at slightly more than a standard dose, as most patients received a unit dose, 15 mL or 20 mL instead of a weight-based dose. This included 118 renal failure patients with estimated glomerular filtration rate (eGFR) less than 30 mL/min and 33 patients on chronic hemodialysis. ⋯ Magn. Reson. Imaging 2009;30:1309-1312. (c) 2009 Wiley-Liss, Inc.
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J Magn Reson Imaging · Dec 2009
Gadolinium-based contrast agents and nephrogenic systemic fibrosis: why did it happen and what have we learned?
This article addresses two questions about gadolinium-based contrast agents (GBCAs) and nephrogenic systemic fibrosis (NSF): "Why did it happen" and "What have we learned"? It reviews the events leading to the discovery of an association between NSF and GBCAs. Various factors are elucidated that contributed to the delay between the time when GBCA came into widespread clinical use and a link was made with NSF, including use in renal-compromised patients, high-dose magnetic resonance angiography (MRA), lack of documentation and adequate databases, policy and regulatory changes, and an absence of scientific evidence. The authors conclude that the overriding cause was lack of awareness. ⋯ Magn. Reson. Imaging 2009;30:1236-1239. (c) 2009 Wiley-Liss, Inc.