Journal of magnetic resonance imaging : JMRI
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Nephrogenic systemic fibrosis (NSF) is a rare systemic fibrosing disorder that primarily affects the skin and the subcutaneous structures. Also, there are reports of involvement of deeper structures and organs in the human body, but the confirmation of systemic involvement is complicated by overlap of other disease processes that occur in patients with severe renal impairment. The disorder leads to significant disability and is an important contributing factor of death. ⋯ Magn. Reson. Imaging 2009;30:1289-1297. (c) 2009 Wiley-Liss, Inc.
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Emerging evidence linking gadolinium-based contrast agents (GBCAs) to nephrogenic systemic fibrosis (NSF) has changed medical practice patterns toward forgoing GBCA-enhanced magnetic resonance imaging (MRI) or substituting other imaging methods, which are potentially less accurate and often radiation-based. This shift has been based on reports of high NSF incidence at sites where a confluence of risk factors occurred in patients with severe renal dysfunction. This review article explores the factors that affect NSF risk, compares risks of alternative imaging procedures, and demonstrates how risk can be managed by careful selection of GBCA dose, timing of injection with respect to dialysis, and other factors. ⋯ Magn. Reson. Imaging 2009;30:1298-1308. (c) 2009 Wiley-Liss, Inc.
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J Magn Reson Imaging · Dec 2009
Guideline to use gadolinium-based contrast agents at Kyoto University Hospital.
Guideline to use gadolinium-based contrast agents (GBCAs) to prevent nephrogenic systemic fibrosis (NSF) at Kyoto University Hospital is presented. This guideline is basically the same as the one issued by the joint committee of the Japan Radiological Society and Japanese Society of Nephrology. In the guideline of the joint committee of Japan Radiological Society and Japanese Society of Nephrology, it is described that GBCAs should be used only when they are indispensable for adequate diagnosis regardless of renal function. ⋯ Magn. Reson. Imaging 2009;30:1364-1365. (c)2009 Wiley-Liss, Inc.
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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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Nephrogenic systemic fibrosis (NSF) has been associated with the administration of gadolinium-based contrast agents in patients with severely impaired renal function (SIRF), endstage renal disease (ESRD), or acute renal failure (ARF). Since the vast majority of these patients do not get NSF, it is highly likely that patient factors play a role in its development. Although "free" or dechelated gadolinium is thought by some to be the only trigger of NSF, recent evidence suggests that chelated gadolinium may be important. ⋯ Magn. Reson. Imaging 2009;30:1277-1283. (c) 2009 Wiley-Liss, Inc.