Böhm Ingrid, Morelli John, Nairz Knud, Silva Hasembank Keller Patricia, Heverhagen Johannes T
a Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital , University of Bern , Bern , Switzerland.
b Radiology Laboratory, Department Clinical Research , University of Bern , Bern , Switzerland.
Postgrad Med. 2017 Mar;129(2):259-266. doi: 10.1080/00325481.2017.1282296. Epub 2017 Jan 25.
Contrast-enhanced radiological examinations are an increasingly important diagnostic tool in modern medicine. All approved and available contrast media (iodinated and gadolinium-based) are safe compounds that are well-tolerated by most patients. However, a small percentage of patients exhibit contrast medium-induced adverse drug reactions that are dose-dependent and predictable (type A) or an even smaller cohort experience so-called type B (dose-independent, non-predictable). To increase patients' safety, recommendations/guidelines have been put forth in the literature and advice passed down informally by radiologists in practice to ensure contrast media safety. Through these, both reasonable suggestions as well as misinterpretations and myths (such as the misleading terms "allergy-like" reactions, and "iodine-allergy", the wrong assumption that the initial contact to a contrast medium could not induce an allergy, the estimation that an anti-allergy premedication could suppress all possible adverse reactions, and interleukin-2 as a risk/trigger for contrast medium adverse events) have arisen. Since the latter are not only unhelpful but also potentially reduce patients' safety, such myths and misconceptions are the focus of this review.
增强放射学检查在现代医学中是一种越来越重要的诊断工具。所有已批准且可用的造影剂（碘剂和钆剂）都是安全的化合物，大多数患者对其耐受性良好。然而，一小部分患者会出现造影剂诱发的药物不良反应，这些反应呈剂量依赖性且可预测（A型），或者有更小比例的患者会经历所谓的B型反应（剂量非依赖性、不可预测）。为了提高患者安全性，文献中已提出建议/指南，放射科医生在实践中也会非正式地传递相关建议以确保造影剂安全。通过这些方式，既出现了合理的建议，也出现了误解和错误观念（例如误导性术语“过敏样”反应和“碘过敏”、造影剂初次接触不会诱发过敏的错误假设、抗过敏预处理能抑制所有可能不良反应的估计，以及白细胞介素-2作为造影剂不良事件的风险/触发因素）。由于后者不仅无益，还可能降低患者安全性，因此这类错误观念和误解是本综述的重点。
