Local Tissue Toxicity in Response to Extravascular Extravasation of Magnetic Resonance Contrast Media

Runge, Val M.; Dickey, Kenneth M.; Williams, Neil M.; Peng, Xuejun

doi:10.1097/00004424-200207000-00006

Cited by 53 publications

(25 citation statements)

References 21 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 patient had no tissue damage from intrauterine injection of gadoteric acid because we used only 4 ml of a not very high osmolar contrast medium (<1,500 mOsm) [10].…”

Section: Discussionmentioning

confidence: 99%

Hysterosalpingography with gadolinium

Ferraiolo

Castelletti

et al. 2004

Eur Radiol

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“…Even though the very high dose of contrast agent used in this experiment exaggerates the adverse effects, the issue of extravasation should not be taken lightly, as the consequences can be quite severe. In addition to supportive treatment in the form of elevation, ice packs, and close observation, a plastic-surgery consult is warranted in cases of persistent pain, altered distal perfusion or sensation, or skin blistering (59,60).…”

Section: Contrast Extravasationmentioning

confidence: 99%

MR contrast agents: Physical and pharmacologic basics

Lin

Brown

2007

Magnetic Resonance Imaging

225

175

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Since approval of the first magnetic resonance (MR) contrast agent was granted in 1988, there has been remarkable growth in the utilization of intravenous gadolinium (Gd)-based agents. Currently it is estimated that nearly half of all MR studies performed are contrast-enhanced. Despite containing a toxic heavy metal, these agents have proven to be not only an effective diagnostic adjunct to non-enhanced MRI, but also remarkably well tolerated and safe. As a result, conventional wisdom has been that MR contrast media are "biologically inert," a notion that is clearly false. Ultimately, it is the radiologist's responsibility to understand the potential adverse effects of Gd-based agents and the special situations in which they are likely to occur; however, the basic pharmacology of contrast agents is generally not included in medical school curricula or formally taught in residency. The purpose of this review is to discuss the mechanism of action of MR contrast agents and relevant aspects of their clinical pharmacology, including effects on the cardiovascular and renal systems, potential laboratory errors, and special situations involving women and children. We also briefly discuss the issue of nephrogenic systemic fibrosis (NSF).

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Local Tissue Toxicity in Response to Extravascular Extravasation of Magnetic Resonance Contrast Media

Cited by 53 publications

References 21 publications

MR-lymphangiography at 3.0T—a feasibility study

MR-lymphangiography at 3.0T—a feasibility study

Hysterosalpingography with gadolinium

MR contrast agents: Physical and pharmacologic basics

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