Journal of magnetic resonance imaging : JMRI
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J Magn Reson Imaging · Dec 2009
Retrospective assessment of prevalence of nephrogenic systemic fibrosis (NSF) after implementation of a new guideline for the use of gadobenate dimeglumine as a sole contrast agent for magnetic resonance examination in renally impaired patients.
From May 2007 to January 2008, patients with Stage 3-5 chronic kidney disease (CKD) undergoing gadobenate dimeglumine (GBD)-enhanced magnetic resonance (MR) examinations were included in the retrospective investigation. The electronic medical records were reviewed to assess the prevalence of nephrogenic systemic fibrosis (NSF) in renally impaired patients underwent GBD-enhanced MR examinations. In all, 250 patients (98 men, mean age 72.6 years) were included: 97% of the patients had Stage 3 CKD (estimated GFR 30-59 mL/min/1.73 m(2)); 37% had been exclusively exposed to GBD. ⋯ Magn. Reson. Imaging 2009;30:1335-1340. (c) 2009 Wiley-Liss, Inc.
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J Magn Reson Imaging · Dec 2009
Gadolinium-based contrast agents and nephrogenic systemic fibrosis: why did it happen and what have we learned?
This article addresses two questions about gadolinium-based contrast agents (GBCAs) and nephrogenic systemic fibrosis (NSF): "Why did it happen" and "What have we learned"? It reviews the events leading to the discovery of an association between NSF and GBCAs. Various factors are elucidated that contributed to the delay between the time when GBCA came into widespread clinical use and a link was made with NSF, including use in renal-compromised patients, high-dose magnetic resonance angiography (MRA), lack of documentation and adequate databases, policy and regulatory changes, and an absence of scientific evidence. The authors conclude that the overriding cause was lack of awareness. ⋯ Magn. Reson. Imaging 2009;30:1236-1239. (c) 2009 Wiley-Liss, Inc.
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J Magn Reson Imaging · Dec 2009
ReviewNSF prevention in clinical practice: summary of recommendations and guidelines in the United States, Canada, and Europe.
In this article we summarize recommendations and guidelines for the prevention of NSF from the United States, Canada, and Europe. J. ⋯ Reson. Imaging 2009;30:1357-1363. (c) 2009 Wiley-Liss, Inc.
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J Magn Reson Imaging · Dec 2009
ReviewRemoval of gadolinium by dialysis: review of different strategies and techniques.
Nephrogenic systemic fibrosis (NSF) has been related to the administration of gadolinium-based contrast agents for magnetic resonance imaging studies in patients with kidney disease. After reviewing the pathophysiology of NSF, we discuss the possible factors contributing to the toxicity of gadolinium in susceptible patients, including the excessive amounts of intravenous iron and erythropoietin as well as the inflammatory states commonly seen in patients treated with hemodialysis. Since free gadolinium is the most accepted risk factor for NSF, we provide some suggestions to improve clearance of both free and chelated gadolinium using different dialysis strategies and techniques. ⋯ Magn. Reson. Imaging 2009;30:1347-1349. (c) 2009 Wiley-Liss, Inc.