Forbes-Amrhein Monica M, Chow Jeanne S, Horst Kelly K, Kim Helen Hr, Krishnamurthy Rajesh, Maloney Ezekiel, McDonald Robert J, Scheller Leah G, Stein Deborah, Callahan Michael J
Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN.
Department of Radiology, Boston Children's Hospital, Boston, MA.
AJR Am J Roentgenol. 2024 Nov 27. doi: 10.2214/AJR.24.32009.
Contrast media are an indispensable adjunct to pediatric imaging. The most common include iodine-based contrast media for CT and fluoroscopy, gadolinium-based contrast media and iron-oxide nanoparticles for MRI, and microbubbles for ultrasound. Although many of the considerations in the routine use of contrast media in infants and children (relating for example to renal function, allergic-like reactions, GBCM deposition, and extravasations) are similar to considerations in adult patients, some important differences exist. These variances are often age-dependent and require an appreciation of pediatric physiology for safe and effective clinical practice. This article highlights ten concepts relating to contrast media administration for diagnostic imaging in children that are important for radiologists and pediatricians to recognize and understand. We present contrast media classes and their use in children, discuss safety concerns and complications, and explore environmental impacts.
造影剂是儿科影像学不可或缺的辅助手段。最常见的包括用于CT和荧光透视的碘基造影剂、用于MRI的钆基造影剂和氧化铁纳米颗粒,以及用于超声的微泡。尽管婴儿和儿童常规使用造影剂时的许多考虑因素(例如与肾功能、类过敏反应、钆基造影剂沉积和外渗有关的因素)与成人患者的考虑因素相似,但仍存在一些重要差异。这些差异通常与年龄有关,为了安全有效地开展临床实践,需要了解儿科生理学。本文重点介绍了与儿童诊断成像造影剂给药相关的十个概念,放射科医生和儿科医生认识并理解这些概念很重要。我们介绍了造影剂类别及其在儿童中的应用,讨论了安全问题和并发症,并探讨了环境影响。