Department of Radiology, Mayo Clinic, Rochester, Minnesota.
Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota.
J Am Coll Radiol. 2023 May;20(5):516-523. doi: 10.1016/j.jacr.2023.01.009. Epub 2023 Mar 17.
To examine follow-up care in patients with a history of acute allergic-like reaction to iodinated contrast material (ICM), including subsequent imaging management, allergy consultation, and repeat ICM exposure and reactions.
All patients who had a moderate or severe acute allergic-like reaction to ICM after contrast-enhanced CT (CECT) examination from June 1, 2009, to January 1, 2022, at our institution were included. Chart review was performed to determine (1) whether subsequent imaging was not performed or was altered in these patients, (2) whether the patient underwent a subsequent CECT examination, and (3) whether the patient had an allergist consultation.
A total of 251 patients were identified. One-third of patients (90 of 251, 36%) had at least one change to their subsequent imaging management due to their reaction, including performing an unenhanced CT (62 of 251, 25%) or MRI (22 of 251, 8.8%) instead of a CECT or not performing a CECT when otherwise clinically indicated (20 of 251, 8.0%). Patients with a prior severe reaction were more likely to have a change in management than patients with a prior moderate reaction (severe: 22 of 32 [69%] versus moderate: 68 of 219 [31%], P < .0001). Only 17 patients (6.8%) had an allergy consult for their ICM reaction. A total of 90 patients underwent 274 subsequent CECT examinations. Repeat allergic-like reactions were observed in one quarter of patients (24 of 90, 27%) and a tenth of CECT examinations (29 of 274, 11%).
One-third of patients with a history of a moderate or severe allergic-like reaction to ICM had their subsequent imaging care modified due to their reaction.
研究有碘造影剂（ICM）急性过敏样反应病史患者的随访情况，包括后续影像学管理、过敏咨询以及重复使用 ICM 并观察其反应。
纳入 2009 年 6 月 1 日至 2022 年 1 月 1 日期间在我院因增强 CT（CECT）检查后发生中度或重度急性过敏样反应的所有患者。通过病历回顾，确定（1）这些患者是否未进行后续影像学检查或改变了后续影像学检查，（2）患者是否进行了后续 CECT 检查，以及（3）患者是否进行了过敏咨询。
共确定 251 例患者。由于反应，三分之一的患者（251 例中的 90 例，36%）的后续影像学管理至少发生了一次改变，包括进行未增强 CT（251 例中的 62 例，25%）或 MRI（251 例中的 22 例，8.8%）检查，而不是 CECT，或者在临床有指征时未进行 CECT（251 例中的 20 例，8.0%）。与中度反应患者相比，有重度反应病史的患者更可能改变管理方式（重度反应：32 例中的 22 例[69%]，中度反应：219 例中的 68 例[31%]，P<.0001）。仅有 17 例（6.8%）患者因 ICM 反应接受过敏咨询。共 90 例患者进行了 274 次后续 CECT 检查。四分之一的患者（24 例中的 90 例，27%）和十分之一的 CECT 检查（29 例中的 274 例，11%）观察到再次发生过敏样反应。
有中度或重度 ICM 急性过敏样反应病史的患者中，有三分之一的患者因反应而改变了后续影像学检查的方式。
