Mukundan Srinivasan, Steigner Michael L, Hsiao Li-Li, Malek Sayeed K, Tullius Stefan G, Chin Matthew S, Siedlecki Andrew M
Brigham and Women's Hospital, Boston, MA.
Geisinger Wyoming Valley Medical Center, Wilkes-Barre, PA.
Am J Kidney Dis. 2016 Jun;67(6):984-8. doi: 10.1053/j.ajkd.2015.12.017. Epub 2016 Jan 16.
Ferumoxytol is a superparamagnetic iron oxide particle encapsulated by a semisynthetic carbohydrate with properties that can be used by the nephrologist for diagnosis and therapy. Ferumoxytol is approved by the US Food and Drug Administration for treating iron deficiency anemia in the setting of chronic kidney disease, but not for clinical diagnostic imaging. It has gained appeal as a magnetic resonance imaging contrast agent in patients with estimated glomerular filtration rates < 30mL/min/1.73m(2) in whom gadolinium-based contrast magnetic resonance imaging agents are relatively contraindicated because of the association with gadolinium deposition and nephrogenic systemic fibrosis. Ferumoxytol metabolism is not dependent on kidney function, but rather is removed from the circulation by the reticuloendothelial system of the liver, spleen, and bone marrow. Additionally, the prolonged intravascular half-life (>14 hours) of ferumoxytol allows for longer image acquisition and repeat imaging, if necessary. In patients with contraindications for gadolinium contrast agents, ferumoxytol is an alternative agent for vascular assessment, including patency and course.
铁羧麦芽糖是一种由半合成碳水化合物包裹的超顺磁性氧化铁颗粒，具有可供肾病学家用于诊断和治疗的特性。铁羧麦芽糖已获美国食品药品监督管理局批准，用于治疗慢性肾脏病背景下的缺铁性贫血，但未获批用于临床诊断成像。在估算肾小球滤过率<30mL/min/1.73m²的患者中，由于钆基对比剂磁共振成像剂与钆沉积及肾源性系统性纤维化相关，相对禁忌使用，而铁羧麦芽糖作为磁共振成像对比剂已受到关注。铁羧麦芽糖的代谢不依赖于肾功能，而是通过肝脏、脾脏和骨髓的网状内皮系统从循环中清除。此外，铁羧麦芽糖延长的血管内半衰期（>14小时）允许进行更长时间的图像采集，如有必要还可进行重复成像。对于钆对比剂有禁忌证的患者，铁羧麦芽糖是用于血管评估（包括通畅性和走行）的替代剂。
