van der Molen Aart J, Vega Francisco, A J M van de Ven Annick, Dekkers Ilona A, Laguna José J
Department of Radiology, C-2S, Leiden University Medical Center, Leiden, the Netherlands.
Department of Allergy, Hospital Universitario de la Princesa, Madrid, Spain.
Eur J Radiol. 2024 Dec;181:111803. doi: 10.1016/j.ejrad.2024.111803. Epub 2024 Oct 24.
The risk of hypersensitivity reactions (HSR) following nonvascular administration of contrast media (CM) for diagnostic studies is very low, likely due to minimal absorption into the systemic circulation. Most published individual cases of HSR after nonvascular CM administration are immediate reactions caused by ionic high-osmolar CM, few by nonionic low-osmolar CM, and none by gadolinium-based contrast agents. Measures to prevent recurrent HSR following nonvascular administration are similar to those recommended to prevent HSR after intravascular CM administration. Premedication as preventive measure has been abandoned, while switching to an alternative CM, preferably based on the results of an allergological analysis, is increasingly advocated. In selected scenarios, preventive measures may be minimized.
在诊断性研究中，非血管内注射造影剂（CM）后发生超敏反应（HSR）的风险非常低，这可能是由于其进入体循环的吸收量极少。大多数已发表的非血管内注射CM后发生HSR的个别病例是由离子型高渗CM引起的即刻反应，由非离子型低渗CM引起的较少，而钆基造影剂则未引起此类反应。预防非血管内注射后HSR复发的措施与推荐用于预防血管内注射CM后HSR的措施相似。作为预防措施的预处理已被摒弃，而越来越提倡根据过敏分析结果改用另一种CM，最好是这样。在特定情况下，预防措施可减至最少。
