J Formos Med Assoc
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Contrast media are essential agents that enhance the diagnostic capabilities of imaging studies, such as computed tomography and magnetic resonance imaging. However, concerns regarding the risk of adverse events have led to cautious use in patients with chronic kidney disease. A multidisciplinary review by nephrologists, cardiologists, and radiologists at National Taiwan University Hospital examined evidence linking iodinated contrast media and gadolinium-based contrast agents with acute kidney injury and nephrogenic systemic fibrosis. ⋯ Preventive strategies, including hydration with 0.9% saline and limiting contrast volume, may further reduce acute kidney injury risk in susceptible individuals. For nephrogenic systemic fibrosis, the risk is negligible with group II gadolinium-based contrast agents, even in patients with advanced chronic kidney disease or those on dialysis. The panel concludes that the use of iodinated contrast media or group II gadolinium-based contrast agents should not be postponed in chronic kidney disease patients when clinically significant imaging studies are required.
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Dual-energy computed tomography (DECT) pulmonary angiography can reliably detect cement pulmonary embolisms (CPEs) and parenchymal perfusion defects. This prospective observational study investigated CPEs in asymptomatic patients using DECT. ⋯ CPEs frequently occur following vertebral augmentation, are associated with substantial prevertebral venous leakage, and predominantly occur in the subsegmental pulmonary artery. They do not always cause perfusion defects.
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Limited data exists regarding the long-term serum ferritin dynamics following sustained virologic response (SVR12) and factors associated with trends in changes among patients undergoing treatment for hepatitis C virus (HCV). ⋯ Patients achieving SVR12, irrespective of types of treatment, exhibited more favorable long-term ferritin dynamics compared to those not achieving SVR12. Absence of MASLD may help improve long-term ferritin dynamics among patients achieving SVR12.