Gadolinium contrast media are more nephrotoxic than iodine media. The importance of osmolality in direct renal artery injections

Elmståhl, Barbara; Nyman, Ulf; Leander, Peter; Chai, Chun-Ming; Golman, Klaes; Björk, Jonas; Almén, Torsten

doi:10.1007/s00330-006-0445-5

Cited by 9 publications

(11 citation statements)

References 17 publications

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“…This eliminates the ability to make duplicate measures at a single time point and significantly reduces the ability to evaluate changes in physiology that might occur over a short time period. The number of measurements that can be made is also limited by the total amount of contrast material that can be given over a 24-h period (10,23,79). While regional blood volume is accurately determined directly from the area under the observed tissue concentration curve, the indicator dilution technique calculation of regional blood flow and MTT is less straightforward and may be subject to substantial error.…”

Section: Regional Perfusionmentioning

confidence: 99%

Advances in magnetic resonance imaging of lung physiology

Hopkins

Levin

Emami

et al. 2007

Journal of Applied Physiology

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This review presents an overview of some recent magnetic resonance imaging (MRI) techniques for measuring aspects of local physiology in the lung. MRI is noninvasive, relatively high resolution, and does not expose subjects to ionizing radiation. Conventional MRI of the lung suffers from low signal intensity caused by the low proton density and the large degree of microscopic field inhomogeneity that degrades the magnetic resonance signal and interferes with image acquisition. However, in recent years, there have been rapid advances in both hardware and software design, allowing these difficulties to be minimized. This review focuses on some newer techniques that measure regional perfusion, ventilation, gas diffusion, ventilation-to-perfusion ratio, partial pressure of oxygen, and lung water. These techniques include contrastenhanced and arterial spin-labeling techniques for measuring perfusion, hyperpolarized gas techniques for measuring regional ventilation, and apparent diffusion coefficient and multiecho and gradient echo techniques for measuring proton density and lung water. Some of the major advantages and disadvantages of each technique are discussed. In addition, some of the physiological issues associated with making measurements are discussed, along with strategies for understanding large and complex data sets.hyperpolarized helium-3 magnetic resonance imaging; regional ventilation; regional perfusion; apparent diffusion coefficient; ventilation-perfusion ratio; regional lung water MANY PULMONARY DISORDERS ARE characterized by either an inability to supply fresh air to the exchange membrane (ventilation), an inability to supply blood to the membrane (perfusion), or an abnormality of the membrane itself, which hinders efficient gas diffusion. As one of the primary and most accessible activities of the lung, measurement of ventilation and lung volumes has been the focus of most pulmonary function tests, and spirometry is performed regularly to assess pulmonary integrity. Despite their usefulness, however, these global measures do not ultimately allow adequate characterization of disease heterogeneity; thus sensitivity to early and mild disease is lost, and the clinically relevant information for disease diagnosis and classification, as well as surgical planning, is incomplete. Developments in new imaging technologies in the past few decades have opened up new possibilities in acquiring regional information about the lung function and structure, with promise to address many of the intrinsic limitations of global measurements.Shortly after the first axial X-ray computed tomograph became available in 1971, techniques were described that applied magnetic field gradients in three dimensions to create nuclear magnetic resonance (MR) images. The first images of two tubes of water were published in March 1973 (52). Since conventional MR imaging (MRI) exploits properties of protons in magnetic fields to produce images, the lung has historically presented problems, not only because it contains mostly air, and the...

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Section: Regional Perfusionmentioning

confidence: 99%

Advances in magnetic resonance imaging of lung physiology

Hopkins

Levin

Emami

et al. 2007

Journal of Applied Physiology

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“…Although other techniques such as positron emission tomography (PET) and histochemistry might also be used for this comparison, DCE-CT has the advantage of sharing many similarities with DCE-MRI. Contrast agents typically used for DCE-CT, such as iohexol, have similar pharmacokinetics to the low-molecular-weight gadolinium (Gd) chelates such as gadodiamide used in DCE-MRI, although the plasma elimination half-life of iohexol is slightly shorter (10). DCE-CT and DCE-MRI are both used for tumor detection and monitoring, have comparable temporal and spatial resolutions, and can be analyzed using similar tracer kinetic models.…”

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confidence: 99%

Tracer kinetic analysis of dynamic contrast‐enhanced MRI and CT bladder cancer data: A preliminary comparison to assess the magnitude of water exchange effects

Bains

McGrath

Naish

et al. 2010

Magnetic Resonance in Med

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The purpose of this study was to determine the impact of water exchange on tracer kinetic parameter estimates derived from T 1 -weighted dynamic contrast-enhanced (DCE)-MRI data using a direct quantitative comparison with DCE-CT. Data were acquired from 12 patients with bladder cancer who underwent DCE-CT followed by DCE-MRI within a week. A two-compartment tracer kinetic model was fitted to the CT data, and two versions of the same model with modifications to account for the fast exchange and no exchange limits of water exchange were fitted to the MR data. The two-compartment tracer kinetic model provided estimates of the fractional plasma volume (v p ), the extravascular extracellular space fraction (v e ), plasma perfusion (F p ), and the microvascular permeability surface area product. Our findings suggest that DCE-CT is an appropriate reference for DCE-MRI in bladder cancers as the only significant difference found between CT and MR parameter estimates were the no exchange limit estimates of v p (P 5 0.002). These results suggest that although water exchange between the intracellular and extravascularextracellular space has a negligible effect on DCE-MRI, vascular-extravascular-extracellular space water exchange may be more important. Magn Reson Med 64:595-603,

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“…Various animal studies and human case reports have been reviewed and demonstrate the potential of GBCA exposure to induce cellular and biochemical abnormalities. For example, studies in pigs demonstrated a specific nephrotoxic endpoint (reduced glomerular filtration) . Effects of GBCA exposure in mice include decreases in white blood cell counts, elevation of serum cytokines, and hepatic cell damage .…”

Section: Against the Proposition: Michael F Tweedle Phdmentioning

confidence: 99%