Extravascular Toxicity of Two Magnetic Resonance Contrast Agents

Cohan, Richard H.; Ra, Leder; Aj, Herzberg; Lw, Hedlund; Ct, Wheeler; Ca, Beam; Sn, Nadel; Nr, Dunnick

doi:10.1097/00004424-199103000-00005

Cited by 57 publications

(23 citation statements)

References 0 publications

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“…However, MRL with perivascular gadolinium injection has been found to be relatively safe in previous studies and experimental animal models, with less tissue damage compared to conventional radiographic contrast media, but is not without at least a temporary adverse effect [6,8,[21][22][23][24][25].…”

Section: Discussionmentioning

confidence: 99%

MR-lymphangiography at 3.0T—a feasibility study

et al. 2009

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The purpose of this study was to establish and evaluate contrast-enhanced MR-lymphangiography (MRL) at 3.0 T for detection and visualization of abnormalities of the peripheral lymphatic system. Sixteen patients were examined with a highly resolved isotropic T1w-3D-GRE-(FLASH) sequence (TR 3.76 ms/TE 1.45 ms/FA 30 degrees /voxel-size 0.8 x 0.8 x 0.8 mm(3)) at 3T after intracutaneous injection of gadolinium-diethylene-triamine-pentaacetic-acid. Two radiologists evaluated overall image quality, contrast between lymph vessels and background tissue, venous contamination, visualized levels, and fat-saturation-homogeneity on 3D maximum-intensity projections. Overall image quality was good to excellent, and all examinations were diagnostic except one, where contrast medium was injected subcutaneously instead of intracutaneously. Overall image quality was good to excellent in 12/16 cases, depiction of lymph vessels was good to excellent in 15/16 cases. Venous contamination was always present, but diagnostically problematical in only one case. Instant lymphatic drainage was observed in unaffected extremities, reaching the pelvic level after approximately 10 min. Lymphatic drainage was considerably delayed in lymphedematous extremities. Ectatic lymph vessels, entrapment, and diffuse drainage of contrast medium correlated with impaired lymphatic drainage. In conclusion, MRL at 3.0 T provides very high spatial resolution and anatomical detail of normal and abnormal peripheral lymph vessels. MRL may thus become a valuable tool for microsurgical treatment planning and monitoring.

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Section: Discussionmentioning

confidence: 99%

MR-lymphangiography at 3.0T—a feasibility study

et al. 2009

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“…The safety of MR contrast agents has been shown to be comparable in several studies [2,25,26,27,28,29]. The frequency of single adverse events is approximately 1% or less of all patients [2].…”

Section: Tolerance and Adverse Eventsmentioning

confidence: 97%

“…Low-osmolarity chelates could be advantageous when higher doses are required. In addition, it has been shown in a rat model that the extravasation of ionic gadopentetate was associated with higher incidences of necrosis, haemorrhage and oedema than non-ionic gadoteridol [26]. The first commercially available agents had a 0.5-M osmolarity.…”

Section: Osmolalitymentioning

confidence: 99%

Currently used non-specific extracellular MR contrast media

2003

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Magnetic resonance contrast agents have demonstrated their clinical usefulness in a variety of organs for improved detection of various neoplastic, inflammatory and functional abnormalities. Gadolinium chelates are the most widely used. They are extracellular, non-specific contrast agents. Their use in many clinical indications is justified because, in conjunction with improved imaging techniques, these safe and image-enhancing contrast agents add morphologic and functional information compared with unenhanced MR images. This article describes the commercially available compounds, and summarizes their approval status on the international market regarding indications and doses. Their mechanisms of action, biodistributions, toxicities and tolerance profiles in normal and high-risk patient populations are described. Additionally, this article reviews the specific recommendations by the manufacturers for patients at risk. Finally, their main clinical applications are reviewed.

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“…The findings indicated that extravasation of Magnevist was associated with a higher incidence of necrosis, hemorrhage, and edema compared with ProHance. However, this report cautioned against extrapolating the results to extravasation of MR imaging contrast agents in human subjects (46).…”

Section: Osmolality and Osmotic Loadmentioning

confidence: 92%

“…The lower osmolality of ProHance compared with Magnevist was the subject of an investigation in the rat model into the effect of extravasation of this agent versus extravasation of Magnevist (46). The findings indicated that extravasation of Magnevist was associated with a higher incidence of necrosis, hemorrhage, and edema compared with ProHance.…”

Section: Osmolality and Osmotic Loadmentioning

confidence: 99%