关于基于加多的对比剂安全性的更新,来自AJR对比媒介特别系列
Jitka Starekova1, Ali Pirasteh1,2, Scott B Reeder1,2,3,4,5
1Department of Radiology, University of Wisconsin Madison, 600 Highland Ave, Madison, WI 53792.
AJR. American journal of roentgenology
|October 18, 2023
概括
在MRI中使用的基于加多的对比剂 (GBCA) 通常是安全的,具有罕见的风险,如过敏反应和原性全身纤维化 (NSF). 加多沉积发生,但到目前为止没有显示任何不良影响.
科学领域:
- 放射学 放射学是一门学科.
- 医疗成像医学成像
- 药理学 药理学是指药理学的学科.
背景情况:
- 35多年来,加多增强型MRI一直是医学成像学的基石.
- 基于加多的对比剂 (GBCA) 通常是安全的,但具有潜在的风险.
- 关键的安全问题包括急性反应,原体系统纤维化 (NSF),加多沉积和暴露症状.
研究的目的:
- 审查商用GBCA的最新安全证据.
- 讨论美国放射学学院 (ACR) NSF GBCA安全分类的更新.
- 概述关于GBCA的监管决策的证据增强策略.
主要方法:
- 关于GBCA安全性的当前科学文献的审查.
- 分析不同GBCA组 (ACR组I,II,III) 的安全分类和风险概况.
- 检查关于加多沉积的数据及其临床影响.
主要成果:
- 对GBCA的急性过敏类反应不常见,并且比使用含的对比剂更少.
- 原性系统性纤维化 (NSF) 很少见,主要与衰竭患者的较老I组GBCA有关;较新的药物显著降低了这种风险.
- 在像大脑这样的器官中,加多沉积发生在所有GBCA中,线性剂的沉积量高于宏循环剂,但没有记录过任何不良临床影响.
结论:
- 虽然GBCA非常安全,但对潜在副作用的认识至关重要.
- 通过使用较新的GBCA配方和更新的分类,NSF的风险已被大大降低.
- 目前的证据表明,即使在功能正常的患者中,加多沉积也没有不利的临床结果.
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