Well Lennart, Weinrich Julius Matthias, Adam Gerhard, Bannas Peter
Rofo. 2018 Jan;190(1):20-30. doi: 10.1055/s-0043-120116. Epub 2017 Nov 20.
Gadoxetate disodium is an intracellular contrast agent for magnetic resonance imaging (MRI) of the liver. Recent publications revealed that injection of gadoxetate disodium can lead to imaging artifacts due to transient severe motion (TSM) in the arterial phase of contrast-enhanced liver MRI. In this review we present and discuss published frequencies of TSM, contrast injection and image acquisition protocols, potential risk factors, and proposed strategies to avoid or minimize the effects of TSM.
Two reviewers independently searched the PubMed search engine for "transient severe motion artifact" and related terms. Reference lists of retrieved articles were also searched. The two reviewers selected in consensus nine studies that reported both frequencies of TSM and potential risk factors. Study data were extracted by both reviewers, and disagreement was resolved by consensus.
TSM is caused by impaired breath-hold ability after gadoxetate disodium injection and occurs in 5 - 22 % of patients. The dose of applied contrast agent, repeated exposure to gadoxetate disodium, high BMI and pulmonary disease have been described as potential risk factors for TSM. However, there are only few concordant results on this topic and the pathophysiology of TSM has not been identified. Proposed strategies for the prevention of TSM are slow injection rates and low doses of diluted gadoxetate disodium. Accelerated and free-breathing MRI sequence protocols and breath-hold training may minimize the effects of TSM. Further prospective studies are needed to confirm these strategies and to identify the underlying mechanism of TSM.
· TSM occurs in 5 - 22 % of patients after gadoxetate disodium injection.. · Potential risk factors of TSM are dose, repeated exposure, BMI, pulmonary disease.. · The underlying mechanism for TSM has not been identified.. · Slow injection rates and diluted gadoxetate disodium may prevent TSM.. · Accelerated image acquisition or free-breathing sequences may mitigate the effects of TSM..
· Well L, Weinrich JM, Adam G et al. Transient Severe Respiratory Motion Artifacts After Application of Gadoxetate Disodium: What We Currently Know. Fortschr Röntgenstr 2018; 190: 20 - 30.
钆塞酸二钠是一种用于肝脏磁共振成像（MRI）的细胞内造影剂。最近的出版物表明，在肝脏对比增强MRI的动脉期，注射钆塞酸二钠可因短暂剧烈运动（TSM）导致成像伪影。在本综述中，我们展示并讨论已发表的TSM发生率、对比剂注射和图像采集方案、潜在危险因素以及为避免或最小化TSM影响而提出的策略。
两名 reviewers 独立在 PubMed 搜索引擎中搜索“短暂剧烈运动伪影”及相关术语。还搜索了检索文章的参考文献列表。两名 reviewers 一致选择了九项报告了TSM发生率和潜在危险因素的研究。两名 reviewers 均提取了研究数据，分歧通过协商解决。
TSM 是由注射钆塞酸二钠后屏气能力受损引起的，发生在5%-22%的患者中。所用造影剂剂量、重复接触钆塞酸二钠、高体重指数和肺部疾病被描述为TSM的潜在危险因素。然而，关于这个主题只有少数一致的结果，并且TSM的病理生理学尚未确定。预防TSM的建议策略是缓慢注射速率和低剂量稀释的钆塞酸二钠。加速和自由呼吸MRI序列方案以及屏气训练可能会最小化TSM的影响。需要进一步的前瞻性研究来证实这些策略并确定TSM的潜在机制。
· 注射钆塞酸二钠后，5%-22%的患者会出现TSM。· TSM的潜在危险因素是剂量、重复接触、体重指数、肺部疾病。· TSM的潜在机制尚未确定。· 缓慢注射速率和稀释的钆塞酸二钠可能预防TSM。· 加速图像采集或自由呼吸序列可能减轻TSM的影响。
· Well L, Weinrich JM, Adam G等。应用钆塞酸二钠后短暂剧烈呼吸运动伪影：我们目前所知道的。Fortschr Röntgenstr 2018; 190: 20-30。
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