Editorial for "Relationship Between Patient-friendly Audiovisual Systems and MRI Contrast Agent to Adverse Reactions".
Editorial for "Relationship Between Patient-friendly Audiovisual Systems and MRI Contrast Agent to Adverse Reactions".
复制标题
“患者友好型视听系统与 MRI 造影剂与不良反应之间的关系”的社论。
DOI：
10.1002/jmri.28991
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Mao,Lu
中科院分区：
文献类型：
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作者：
Mao,Lu
钆 (Gd) 是一种稀土金属，常用于增强磁共振成像 (MRI)。 Gd 是一种具有七个不成对电子的顺磁元件，它会产生与 MR 扫描仪施加的方向和射频相同的磁场。 1 然后，感应电磁力会增强核自旋并加速激发质子的能量释放，从而在不同质子密度的组织部分之间产生亮度对比度更清晰的图像。如今，大约三分之一的 MRI 扫描采用钆基造影剂 (GBCA) 来提高图像质量。 2大多数 GBCA 通过静脉注射给药，在重金属上涂上有机配体，以防止其对身体造成伤害。解毒后的化合物被认为是安全的，大多数分子会在注射后 24 小时内排出体外。 3 尽管如此，据报道，0.2%–4% 的病例出现轻度不良事件 (AE)，例如头痛、恶心/呕吐、荨麻疹（可能由游离的 Gd 离子或化合物局部浓度升高引起）。 2, 3 据观察，此类生理/过敏反应与患者因幽闭恐惧症或令人不安的机器噪音而产生的焦虑密切相关。 4 同时，据报道，在 MRI 期间，视听 (AV) 系统会播放舒缓的音乐并改变灯光以分散注意力，患者通常会放松。 5 这样的系统能否通过减轻患者压力来缓解 GBCA 的副作用？
Gadolinium (Gd) is a rare earth metal commonly used to enhance magnetic resonance imaging (MRI). A paramagnetic element with seven unpaired electrons, Gd generates a magnetic field in the same direction and radiofrequency as imposed by the MR scanner. 1 The induced electromagnetism then strengthens nuclear spin and expedites energy release from excited protons, creating an image with sharper contrast in brightness between tissue parts of varying proton densities. Today, about one in three MRI scans employs gadoliniumbased contrast agents (GBCA) to improve image quality. 2Administered through intravenous injection, most GBCAs coat the heavy metal with organic ligands to prevent it from harming the body. The detoxified compounds are then considered safe, with most molecules urinated out within 24 hours after injection. 3 Notwithstanding, mild adverse events (AE), for example, headache, nausea/vomiting, hives (urticaria), are reported in 0.2%–4% of cases (possibly caused by freed Gd ions or elevated local concentrations of the compound). 2, 3 Such physiological/allergic reactions are observed to go hand in hand with patient anxiety due to claustrophobia or unsettling machine noise. 4 Meanwhile, patients are reported to generally relax in the presence of an audiovisual (AV) system that plays soothing music and varies lighting during MRI as a distraction. 5 Could such a system be useful in mitigating GBCA’s side effects, possibly by reducing patient stress?