Rath Jakob, Mauritz Matthias, Zulehner Gudrun, Hilger Eva, Cetin Hakan, Kasprian Gregor, Auff Eduard, Zimprich Fritz
Department of Neurology, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
J Neurol. 2017 Jun;264(6):1209-1217. doi: 10.1007/s00415-017-8518-8. Epub 2017 May 26.
Currently, it has not been satisfactorily established, whether modern low-osmolality iodinated contrast agents (ICAs) used in computed tomography (CT) studies are a risk factor for exacerbation of myasthenic symptoms. The rate of acute adverse events as well as delayed clinical worsening up to 30 days were analyzed in 73 patients with confirmed myasthenia gravis (MG) who underwent contrast-enhanced CT studies and compared to 52 patients who underwent unenhanced CT studies. One acute adverse event was documented. 12.3% of MG patients experienced a delayed exacerbation of symptoms after ICA administration. The rate of delayed severe exacerbation was higher in the contrast-enhanced group. Alternative causes for the exacerbation of MG-related symptoms were more likely than ICA administration in all cases. ICA administration for CT studies in MG patients should not be withheld if indicated, but patients particularly those with concomitant acute diseases should be carefully monitored for exacerbation of symptoms.
目前，计算机断层扫描（CT）研究中使用的现代低渗碘化造影剂（ICAs）是否是重症肌无力症状加重的危险因素，尚未得到令人满意的确立。对73例确诊为重症肌无力（MG）并接受增强CT检查的患者的急性不良事件发生率以及长达30天的延迟临床恶化情况进行了分析，并与52例接受非增强CT检查的患者进行了比较。记录了1例急性不良事件。12.3%的MG患者在给予ICA后出现症状延迟加重。在增强组中，延迟严重加重的发生率更高。在所有病例中，MG相关症状加重的其他原因比给予ICA更有可能。如果有指征，不应拒绝为MG患者进行CT检查时使用ICA，但应仔细监测患者，尤其是伴有急性疾病的患者，以防症状加重。
