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对比剂诱导性脑病的神经影像学表现与临床相关性。

Contrast-induced encephalopathy-neuroimaging findings and clinical relevance.

机构信息

Department of Medical Imaging, Radboud University Medical Center, Geert Grooteplein 10, Postbus 9101, 6500 HB, Nijmegen, The Netherlands.

Department of Neurology, Donders Center for Medical Neurosciences, Radboud University Medical Center, Nijmegen, The Netherlands.

出版信息

Neuroradiology. 2022 Jun;64(6):1265-1268. doi: 10.1007/s00234-022-02930-z. Epub 2022 Mar 15.

Abstract

Contrast-induced encephalopathy (CIE) is a rare encephalopathic condition after the administration of a contrast agent. The diagnosis of CIE is challenging because of the heterogeneity and non-specificity of the clinical presentation. The clinical course is usually favorable with full recovery within 48-72 h in most patients, although comorbidity is of relevance and contributes to the clinical outcome. It is expected that the incidence of CIE is currently increasing, due to an increase in endovascular and diagnostic imaging procedures using iodinated contrast. It is important to include CIE in the differential diagnosis when patients deteriorate during, or immediately after, contrast administration, even when only a small amount of non-ionic contrast agent is used. When CIE is considered to be the most likely explanation for the clinical symptoms, it is advised to refrain from unnecessary additional contrast studies such as angiography or perfusion CT.

摘要

对比剂诱发脑病(CIE)是一种罕见的在使用造影剂后出现的脑病。由于临床表现的异质性和非特异性,CIE 的诊断具有挑战性。在大多数患者中,临床病程通常是有利的,大多数患者在 48-72 小时内完全恢复,尽管合并症是相关的,并影响临床结局。由于使用碘造影剂的血管内和诊断性影像学检查的增加,预计 CIE 的发生率目前正在增加。当患者在使用造影剂期间或之后立即出现恶化时,即使仅使用少量非离子型造影剂,也应将 CIE 纳入鉴别诊断。当认为 CIE 是引起临床症状的最可能原因时,建议避免进行不必要的额外造影研究,如血管造影或灌注 CT。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c1b/9117370/f26cd59de3a2/234_2022_2930_Fig1_HTML.jpg

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