Moody William E, Khan-Kheil Ayisha Mehtab, Naneishvili Tamara, Hudsmith Lucy E, Captur Gabriella, Treibel Thomas A, Sado Daniel, Fairbairn Timothy, McCann Gerry P, Myerson Saul G, Berry Colin, Westwood Mark, Keenan Niall G
Institute of Cardiovascular Sciences, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, UK; Department of Cardiology, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Edgbaston, UK.
The Wolverhampton Heart and Lung Centre, New Cross Hospital, Wolverhampton, UK.
J Cardiovasc Magn Reson. 2025 Jan 26;27(1):101846. doi: 10.1016/j.jocmr.2025.101846.
To examine the provision of cardiovascular magnetic resonance (CMR) using gadolinium-based contrast agents (GBCA) in patients with chronic kidney disease (CKD).
An electronic survey was sent to the service leads of all CMR units in the UK in October 2022 requesting information on current departmental protocols and practices.
A response rate of 55% was achieved from the 82 UK CMR units surveyed. There were no known cases of nephrogenic systemic fibrosis (NSF) reported within the past 10 years. Just under half the centers (22 out of 45, 49%) routinely require an estimated glomerular filtration rate (eGFR) in patients before performing contrast-enhanced CMR. Conversely, 18% (8/45) of units do not check eGFR, 20% (9/45) only require an eGFR in patients aged >65 years, while 33% (15/45) assess eGFR in patients known to have CKD. All centers use group II GBCAs: the majority (36/45, 80%) favoring gadobutrol (Gadovist), while gadoterate meglumine (Dotarem) is used in most of the remaining units (8/45, 18%). One in five centers (9/45, 20%) do not currently offer contrast-enhanced CMR to patients with an eGFR <30 mL/min/1.73 m. Of the CMR units that do offer contrast to this group of patients, 28% (10/36) do not obtain consent for the risk of NSF.
One in five centers across the UK does not offer contrast-enhanced CMR to patients with stage 4 and 5 CKD. This finding serves as a call for updated guidance with the intention of standardizing care.
研究在慢性肾脏病（CKD）患者中使用钆基造影剂（GBCA）进行心血管磁共振成像（CMR）的情况。
2022年10月，向英国所有CMR科室的负责人发送了一份电子调查问卷，询问有关当前科室方案和实践的信息。
在接受调查的82个英国CMR科室中，回复率为55%。过去10年内未报告已知的肾源性系统性纤维化（NSF）病例。略低于半数的中心（45个中的22个，49%）在对患者进行对比增强CMR之前常规要求估算肾小球滤过率（eGFR）。相反，18%（8/45）的科室不检查eGFR，20%（9/45）仅要求年龄>65岁的患者提供eGFR，而33%（15/45）对已知患有CKD的患者评估eGFR。所有中心均使用II类GBCA：大多数（36/45，80%）倾向于使用钆布醇（Gadovist），而其余大多数科室（8/45，18%）使用钆特酸葡甲胺（Dotarem）。五分之一的中心（9/45，20%）目前不向eGFR<30 mL/min/1.73 m²的患者提供对比增强CMR。在确实为这组患者提供造影剂的CMR科室中，28%（10/（此处原文可能有误，推测应为36））未就NSF风险征得患者同意。
英国五分之一的中心不向4期和5期CKD患者提供对比增强CMR。这一发现呼吁更新指南，以规范治疗。
