Use of Intravenous Gadolinium-based Contrast Media in Patients with Kidney Disease: Consensus Statements from the American College of Radiology and the National Kidney Foundation

Weinreb, Jeffrey C.; Rodby, Roger A.; Yee, Jerry; Wang, Carolyn L.; Fine, Derek M.; McDonald, Robert J.; Perazella, Mark A.; Dillman, Jonathan R.; Davenport, Matthew S.

doi:10.1148/radiol.2020202903

Cited by 134 publications

(113 citation statements)

References 43 publications

(50 reference statements)

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“…In our study, safety protocol was obtained, providing information on patients with low eGFR in consultation with nephrologist, and those patients were not endured by this procedure, as advised by many authors [10], [14]. We performed it in most of our patients and found it positive in 30% of them, which was as high as in many other studies [26].…”

Section: Considerationsmentioning

confidence: 86%

Introduction of Cardiac Magnetic Resonance Imaging in Kosovo: First Fifty Consecutive Patients Registry Report

Trajcheski

Brovina

Zafirova

et al. 2021

Open Access Maced J Med Sci

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BACKGROUND: Cardiac magnetic resonance (CMR) as advanced diagnostic tool for the heart has been introduced in our institution since September 2019. AIM: We report on the first fifty consecutive patients using this imaging modality. METHODS AND MATERIALS: Strict protocol for CMR procedure, imaging quality assessment, contraindications, and informed consent were established. Patients selected for CMR were enrolled in a prospective registry. Visualizing the heart chambers, heart muscle and heart valves, resulted in acquiring complex imaging of the heart structure and function. When applicable, patients received gadolinium contrast agent for Late Gadolinium Enhancement (LGE). Adenosine was used for stress induced myocardial perfusion study. In this study, we report on the initial CMR procedures in the first 15 months. RESULTS: The age of the patients ranges from 17 to 82 and the number of male and female patients was well balanced. No absolute contraindications were met in any patient. Relative contraindications were noted but did not prevent from performing the scan. Different cardiac pathologies were encountered in the examined patients. Most common was the ischemic heart disease – 19 (38%). We had 15 (30%) out of 46 (92%) CMR procedures with LGE showing fibrotic scaring. Quality image assessment was scaled from poor to excellent. Most of the assessments were graded very good and good (46% and 48%), no poor, and very poor noted. CONCLUSION: CMR has been successfully introduced in Kosovo as excellent imaging tool for diagnosing and characterizing a nearly exhaustive spectrum of heart diseases.

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Section: Considerationsmentioning

confidence: 86%

Introduction of Cardiac Magnetic Resonance Imaging in Kosovo: First Fifty Consecutive Patients Registry Report

Trajcheski

Brovina

Zafirova

et al. 2021

Open Access Maced J Med Sci

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“…Furthermore, there is an ongoing debate about administration of Gadolinium containing contrast agents in patients with kidney disease which is suspected to cause nephrogenic systemic fibrosis (NSF)—which Weinreb et al summarized to be very low 22 . Therefore, they recommend to balance rarely occurring NSF and potentially delayed diagnosis against each other 22 .…”

Section: Discussionmentioning

confidence: 99%

Multiparametric ultrasound findings in acute kidney failure due to rare renal cortical necrosis

Spiesecke

Muench

Fischer

et al. 2021

Sci Rep

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Renal cortical necrosis (RCN) is a rare cause of acute kidney failure and is usually diagnosed on the basis of characteristic enhancement patterns on cross-sectional imaging. Contrast-enhanced ultrasound (CEUS) offers benefits in patients with kidney failure in the clinical setting including the use of a nonnephrotoxic intravascular contrast agent and the fact that it can be performed at the bedside in critical cases. Therefore, the aim of this study is to investigate whether CEUS can reliably identify typical imaging features of RCN. We retrospectively analyzed 12 patients with RCN examined in our department and confirmation of the diagnosis by either histopathology, other contrast-enhanced cross-sectional imaging tests, and/or CEUS follow-up. Assessed parameters in conventional US were reduced echogenicity, loss of corticomedullary differentiation, length and width of kidney, hypoechoic rim, resistance index and in CEUS delayed wash-in of contrast agent (> 20 s), reverse rim sign, maximum nonenhancing rim and additional renal infarction. Furthermore, imaging features in RCN were compared with the findings in renal vein thrombosis (RVT), among them echogenicity, corticomedullar differentiation, hypoechoic rim, RI value, delayed cortical enhancement, total loss of cortical perfusion and enhancement of renal medulla. All 12 patients showed the reverse rim sign, while a hypoechogenic subcapsular rim was only visible in four patients on B-mode ultrasound. A resistance index (RI) was available in 10 cases and was always less than 1. RI was a strong differentiator in separating RVT from RCN (RI > 1 or not measurable due to hypoperfusion as differentiator, p = 0.001). CEUS showed total loss of medullary enhancement in all cases of RVT. With its higher temporal resolution, CEUS allows dynamic assessment of renal macro- and microcirculation and identification of the typical imaging findings of RCN with use of a nonnephrotoxic contrast agent.

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“…1.73 m À2 should be balanced against and may outweigh the risk of NSF. Dialysis initiation or alteration is likely unnecessary based on group II or group III GBCM administration [12]. Besides, gadolinium may stay in the body for months to years and accumulate in bone, brain, and kidney tissue without necessarily pre-existing kidney disease.…”

Section: Chronic Nephropathymentioning

confidence: 99%

Diagnosis of coronary artery disease: potential complications of imaging techniques

et al. 2021

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Use of Intravenous Gadolinium-based Contrast Media in Patients with Kidney Disease: Consensus Statements from the American College of Radiology and the National Kidney Foundation

Cited by 134 publications

References 43 publications

Introduction of Cardiac Magnetic Resonance Imaging in Kosovo: First Fifty Consecutive Patients Registry Report

Introduction of Cardiac Magnetic Resonance Imaging in Kosovo: First Fifty Consecutive Patients Registry Report

Multiparametric ultrasound findings in acute kidney failure due to rare renal cortical necrosis

Diagnosis of coronary artery disease: potential complications of imaging techniques

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