Bookwalter Candice A, McDonald Robert J, Packard Annie T, Little Jason T, McDonald Jennifer S, Watson Robert E
Department of Radiology, College of Medicine, Mayo Clinic, 200 1st St SW, Rochester, MN 55905.
Division of Abdominal Radiology, College of Medicine, Mayo Clinic, Rochester, MN.
AJR Am J Roentgenol. 2025 Apr;224(4):e2431415. doi: 10.2214/AJR.24.31415. Epub 2024 Jul 24.
IV contrast media improve the diagnostic power of radiology examinations. These media include gadolinium-based contrast media and iron oxide nanoparticles for MRI, iodinated contrast material for CT, microbubbles for ultrasound, and radiopharmaceuticals for nuclear medicine. As do all medications, contrast media carry risks, which may be heightened in the conditions of pregnancy and lactation. Radiologists must understand the potential risks from contrast media exposure to the pregnant patient, fetus, and nursing infant, as well as understand these administrations' impact on the clinical utility of examinations. This article reviews the available literature on these media, along with key regulatory bodies' and professional societies' current recommendations for their use, in the settings of pregnancy and lactation. This knowledge should help radiologists make well-reasoned risk-benefit analyses regarding contrast media administration and allow informed consent discussions with pregnant and nursing patients for whom contrast media administration is being considered. This information and analysis can also assist facilities in designing policies and standard operating procedures of possible clinical benefit to the pregnant patient, fetus, or nursing infant, balancing contrast media exposure considerations against augmented diagnostic capabilities.
静脉造影剂可提高放射学检查的诊断能力。这些造影剂包括用于磁共振成像(MRI)的钆基造影剂和氧化铁纳米颗粒、用于计算机断层扫描(CT)的碘化造影剂、用于超声检查的微泡以及用于核医学的放射性药物。与所有药物一样,造影剂也有风险,在怀孕和哺乳期这些风险可能会增加。放射科医生必须了解造影剂暴露对孕妇、胎儿和哺乳期婴儿的潜在风险,以及了解这些给药方式对检查临床效用的影响。本文回顾了关于这些造影剂的现有文献,以及关键监管机构和专业协会目前在怀孕和哺乳期使用这些造影剂的建议。这些知识应有助于放射科医生对造影剂给药进行合理的风险效益分析,并允许与正在考虑使用造影剂的孕妇和哺乳期患者进行知情同意的讨论。这些信息和分析还可以帮助医疗机构制定可能对孕妇、胎儿或哺乳期婴儿有临床益处的政策和标准操作程序,在考虑造影剂暴露的同时平衡增强的诊断能力。