Sandougah Kholoud, AlJohar Raghad, Aladhadhi Dina, AlHazmi Yara T, Kariri Marwh N, Bin Abdulrahman Khalid A
Radiology, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU.
Medicine, Imam Mohammed Ibn Saud Islamic University, Riyadh, SAU.
Cureus. 2022 Jan 11;14(1):e21104. doi: 10.7759/cureus.21104. eCollection 2022 Jan.
Introduction and aim Gadolinium toxicity has been accompanied by side effects among patients scanned with MRI, especially patients with chronic renal insufficiency. The toxicity, pharmacokinetics, and pharmacodynamics of gadolinium-based contrast agents intact blood-brain barriers accumulate in the brain. This study aimed to estimate the awareness about the side effects of gadolinium-enhanced MRI scans among Saudi non-radiologists to improve and raise the level of awareness of all physicians about the side effects of gadolinium-enhanced MRI studies among patients. This improvement will be due to our clarification of the most important issues related to gadolinium contrast in MRI, by illustrating the uses and the major side effects of this contrast. Additionally, we want to find a method that will help with raising awareness of gadolinium toxicity and alert the stakeholders and the head of radiology departments about the need of creating and implementing new official regulations to minimize the abuse of enhanced MRI studies. Materials and methods This is a cross-sectional study conducted among non-radiological doctors in Saudi Arabia. A questionnaire based on a literature review was developed and distributed among non-radiological doctors through an online platform. The questionnaire included basic demographic data and a behavioral and awareness assessment about gadolinium. All statistical analyses were carried out using Statistical Package for the Social Sciences (SPSS) IBM Corp. Released 2019. IBM SPSS Statistics for Windows, Version 26.0. Armonk, NY: IBM Corp. Results 460 non-radiological doctors contributed, 65% males vs. 35% females. The most commonly known side effect of gadolinium was acute pancreatitis (92.8%), followed by encephalopathy (90%) and arrythmias (88.9%). Awareness of gadolinium toxicity among the non-radiological doctors was poor in 74.6%, 20.9% were moderate, and only 4.6% were classified into a good awareness level. The factor associated with an increased level of awareness was being an internal medicine doctor (p=0.006). Conclusion The awareness level of non-radiological doctors about gadolinium toxicity was suboptimal. The knowledge of internal medicine physicians was better, but the other specialties need more education. As most of the physicians were not exposed to patients' adverse reactions, this could be one of the reasons why they have a lack of knowledge about the subject. On the other hand, appropriate patient screening and sufficient prophylactic measures can prevent adverse events. Therefore, in knowledge, understanding, and practice, it is important to come up with the most effective response to any gadolinium contrast adverse events.
引言与目的
钆毒性一直伴随着接受磁共振成像(MRI)扫描的患者出现副作用,尤其是慢性肾功能不全患者。基于钆的造影剂的毒性、药代动力学和药效学在完整血脑屏障的情况下会在大脑中蓄积。本研究旨在评估沙特非放射科医生对钆增强MRI扫描副作用的认知情况,以提高并提升所有医生对钆增强MRI检查在患者中副作用的认知水平。这种提升将源于我们通过阐述该造影剂的用途和主要副作用,来澄清与MRI中钆造影剂相关的最重要问题。此外,我们希望找到一种方法,有助于提高对钆毒性的认识,并提醒利益相关者和放射科主任有必要制定和实施新的官方规定,以尽量减少增强MRI检查的滥用。
材料与方法
这是一项在沙特非放射科医生中开展的横断面研究。基于文献综述编制了一份问卷,并通过在线平台分发给非放射科医生。问卷包括基本人口统计学数据以及关于钆的行为和认知评估。所有统计分析均使用社会科学统计软件包(SPSS)IBM公司2019年发布的版本。适用于Windows的IBM SPSS Statistics,版本26.0。纽约州阿蒙克:IBM公司。
结果
460名非放射科医生参与,男性占65%,女性占35%。钆最常见的已知副作用是急性胰腺炎(92.8%),其次是脑病(90%)和心律失常(88.9%)。非放射科医生中对钆毒性认知较差的占74.6%,中等认知的占20.9%,只有4.6%被归类为认知良好水平。与认知水平提高相关的因素是内科医生(p = 0.006)。
结论
非放射科医生对钆毒性的认知水平欠佳。内科医生的知识较好,但其他专科需要更多教育。由于大多数医生未接触过患者的不良反应,这可能是他们对该主题缺乏了解的原因之一。另一方面,适当的患者筛查和充分的预防措施可以预防不良事件。因此,在知识、理解和实践方面,对任何钆造影剂不良事件想出最有效的应对措施很重要。