关键词: GBCA gadoterate meglumine nephrogenic systemic fibrosis renal impairment safety

Mesh : Aged Aged, 80 and over Contrast Media / adverse effects Humans Incidence Magnetic Resonance Imaging Male Meglumine / adverse effects Middle Aged Nephrogenic Fibrosing Dermopathy / chemically induced epidemiology Organometallic Compounds / adverse effects Prospective Studies

来  源:   DOI:10.1002/jmri.26851   PDF(Sci-hub)

Abstract:
Nephrogenic systemic fibrosis (NSF) is a rare life-threatening condition strongly associated with the administration of gadolinium-based contrast agents in patients with severe or endstage renal impairment.
To prospectively determine the incidence of NSF in patients with renal impairment after administration of gadoterate meglumine.
Prospective.
In all, 540 patients with moderate, severe, or endstage renal impairment, scheduled to undergo a routine contrast-enhanced MRI with gadoterate meglumine. Mean age was 69.7 ± 12.7 years (range: 21-95) with 58.4% of males.
1.5T or 3.0T, sequence according to each site practice.
Medical history, indication(s) for current MRI and adverse events were recorded for each patient. Patients were followed up over 2 years after administration with three visits separated by at least 3 months to detect any signs/symptoms suggestive of NSF.
Descriptive.
Renal impairment was graded as moderate for 69.4% of patients, severe for 16.0% and endstage for 12.1%; 2.6% had undergone a kidney transplant. Estimated glomerular filtration rate ranged from 4 to 59 mL/min/1.73 m2 except one value of 74 mL/min/1.73 m2 in a patient with kidney transplant. Central nervous system exploration was the main MRI indication (34.7%) and mean dose injected was 0.22 ± 0.09 mL/kg. Overall, 446 patients (82.6%) attended at least one follow-up visit and completed the NSF questionnaire and 329 (60.9%) attended the 2-year visit. No suspicion of NSF was reported in all 446 patients, including 119 patients with severe or endstage renal impairment. No deaths and no adverse events were reported during the MRI examination and the usual period of follow-up after gadoterate meglumine administration.
No cases of NSF were observed in the 446 patients with moderate to endstage renal impairment followed up over a maximum of 2 years after injection of gadoterate meglumine.
2 Technical Efficacy Stage: 4 J. Magn. Reson. Imaging 2020;51:607-614.
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