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Journal of Radiological Review 2020 November-December;7(6):435-47

DOI: 10.23736/S2723-9284.20.00066-1

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English, Italian

Use of intravascular contrast agents: what radiologists need to know

Antonio ORLACCHIO 1, 2 , Silvia ROMA 3, Emanuele GRASSEDONIO 4, 5, Matteo PASSAMONTI 6, Michele GALLUZZO 7, Laura ROMANINI 8

1 Unit of Radiology, Department of Surgical Sciences, Tor Vergata University Hospital, Tor Vergata University, Rome, Italy; 2 Unit of Emergency Radiology, Policlinico Tor Vergata University Hospital, Rome, Italy; 3 Department of Radiology, F. Spaziani General Hospital, Frosinone, Italy; 4 Department of Biomedicine, Neurosciences and Advanced Diagnostic, Paolo Giaccone University Hospital, University of Palermo, Palermo, Italy; 5 Department of Diagnostic Imaging and Interventional Neurosciences, Paolo Giaccone University Hospital, University of Palermo, Palermo, Italy; 6 Breast Unit, ASST Hospital of Lodi, Lodi, Italy; 7 Department of Emergency Radiology, AO San Camillo Forlanini, Rome, Italy; 8 Department of Radiology, Istituti Ospitalieri, Cremona, Italy


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Contrast media are widely used in diagnostic imaging thanks to their ability to improve the Imaging quality test, they are considered full-fledged drugs and, as such, are not completely risk-free. The radiologist is responsible of contrast agent administration, so he has to know about contrast agents nature and regarding the recommendation and contraindication against the use and he also should consider the risk-to-benefit profile of the proposed contrast material - enhanced examination and confirm a valid clinical indication based on clinical indication and laboratory tests. This document describes the chemical-physical characteristics of contrast media for intravascular use and deals of the main problems related to contrast media administration. Acute post-contrast kidney injury (PC-AKI) is treated, summarizing its pathophysiological mechanisms, identifying subjects at risk and providing indications on suitable measures to prevent it. Indications are also provided regarding the use of contrast medium in pregnant and breastfeeding women and regarding the management of contrast agent extravasation. The problem concerning Gadolinium retention in tissues is addressed, from Nephrogenic Systemic Fibrosis to the Gadolinium deposit in brain tissue, also assessing this problem in categories such as women with increased risk of breast cancer who perform MRI screening. The purpose of this document is to provide the radiologist with practical indications to better manage the contrast media administration even in these particular cases.


KEY WORDS: Contrast media; Kidney diseases; Pregnant women

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