Survey of gadolinium-based contrast agent utilization among the members of the Society for Pediatric Radiology: a Quality and Safety Committee report
Survey of gadolinium-based contrast agent utilization among the members of the Society for Pediatric Radiology: a Quality and Safety Committee report
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DOI：
10.1007/s00247-017-3807-z
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发表时间：
2017-05-01
影响因子：
2.3
通讯作者：
Iyer, Ramesh S.
中科院分区：
文献类型：
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作者：
Blumfield, Einat;Moore, Michael M.;Iyer, Ramesh S.
在过去的三十年中，钆基造影剂（GBCA）已用于磁共振（MR）成像。最近的报告表明静脉注射后钆在患者的大脑中保留。由于钆是一种剧毒重金属，长期保留或沉积可能会产生不良影响，特别是对儿童。因此，儿科放射学质量和安全委员会（SPR）进行了一项调查，以评估儿科放射科医生使用GBCA的现状。评估SPR成员使用GBCA的情况。向SPR成员分发了一份15个问题的在线调查。调查问题涉及使用的GBCA类型、协议工作流程、肾功能或妊娠试验要求以及对比增强MRI检查的各种临床指征。共收集了163份调查回复（占调查邀请的11.1%），其中大部分来自美国的学术机构。94%的患者报告MR检查总是或通常由儿科放射科医生进行。调查受访者最常用的GBCA是Eovist（60.7%）、Ablavar（45.4%）、Gadovist（38.7%）、Magnevist（34.4%）和Dotarem（32.5%）。对于几种临床适应症，关于GBCA给药的调查答复与美国放射学会（ACR）适当性标准一致，包括癫痫发作、头痛和骨髓炎。对于其他适应症，包括生长激素缺乏症和疑似血管环，调查结果显示，潜在的过度使用GBCA相比，ACR recommendation.Survey结果表明，GBCA管理明智的儿童，但有机会提高其利用率，以减少潜在的未来不良反应的目标。
Gadolinium-based contrast agents (GBCAs) have been used for magnetic resonance (MR) imaging over the last three decades. Recent reports demonstrated gadolinium retention in patients' brains following intravenous administration. Since gadolinium is a highly toxic heavy metal, there is a potential for adverse effects from prolonged retention or deposition, particularly in children. For this reason, the Society (SPR) for Pediatric Radiology Quality and Safety committee conducted a survey to evaluate the current status of GBCAs usage among pediatric radiologists.To assess the usage of GBCAs among SPR members.An online 15-question survey was distributed to SPR members. Survey questions pertained to the type of GBCAs used, protocoling workflow, requirement of renal function or pregnancy tests, and various clinical indications for contrast-enhanced MRI examinations.A total of 163 survey responses were compiled (11.1% of survey invitations), the majority of these from academic institutions in the United States. Ninety-four percent reported that MR studies are always or usually protocoled by pediatric radiologists. The most common GBCA utilized by survey respondents were Eovist (60.7%), Ablavar (45.4%), Gadovist (38.7%), Magnevist (34.4%) and Dotarem (32.5%). For several clinical indications, survey responses regarding GBCA administration were concordant with American College of Radiology (ACR) Appropriateness Criteria, including seizures, headache and osteomyelitis. For other indications, including growth hormone deficiency and suspected vascular ring, survey responses revealed potential overutilization of GBCAs when compared to ACR recommendations.Survey results demonstrate that GBCAs are administered judiciously in children, yet there is an opportunity to improve their utilization with the goal of reducing potential future adverse effects.