Gallo-Bernal Sebastian, Patino-Jaramillo Nasly, Calixto Camilo A, Higuera Sergio A, Forero Julian F, Lara Fernandes Juliano, Góngora Carlos, Gee Michael S, Ghoshhajra Brian, Medina Hector M
Department of Radiology, Massachusetts General Hospital, Boston, MA 02114, USA.
Department of Radiology, Harvard Medical School, Boston, MA 02115, USA.
Diagnostics (Basel). 2022 Jul 28;12(8):1816. doi: 10.3390/diagnostics12081816.
Gadolinium-enhanced cardiac magnetic resonance has revolutionized cardiac imaging in the last two decades and has emerged as an essential and powerful tool for the characterization and treatment guidance of a wide range of cardiovascular diseases. However, due to the high prevalence of chronic renal dysfunction in patients with cardiovascular conditions, the risk of nephrogenic systemic fibrosis (NSF) after gadolinium exposure has been a permanent concern. Even though the newer macrocyclic agents have proven to be much safer in patients with chronic kidney disease and end-stage renal failure, clinicians must fully understand the clinical characteristics and risk factors of this devastating pathology and maintain a high degree of suspicion to prevent and recognize it. This review aimed to summarize the existing evidence regarding the physiopathology, clinical manifestations, diagnosis, and prevention of NSF related to the use of gadolinium-based contrast agents.
钆增强心脏磁共振成像在过去二十年中彻底改变了心脏成像技术，并已成为用于多种心血管疾病的特征描述和治疗指导的重要且强大的工具。然而，由于心血管疾病患者中慢性肾功能不全的高患病率，钆暴露后发生肾源性系统性纤维化（NSF）的风险一直是一个长期关注的问题。尽管新型大环类药物已被证明在慢性肾脏病和终末期肾衰竭患者中要安全得多，但临床医生必须充分了解这种毁灭性病理状况的临床特征和危险因素，并保持高度警惕以预防和识别它。这篇综述旨在总结关于与使用钆基造影剂相关的NSF的生理病理学、临床表现、诊断和预防的现有证据。
