Learning objectives
To classify the main adverse reactions to intravenous contrast media and recognize patients at risk; to provide possible prevention tools,
clinical manifestations of adverse reactions and therapeutic strategies.
Background
The administration of intravenous contrast media is one of the medical act of specific radiological competence.
Although the safety of these drugs is known,
it is good to know the possible adverse and hypersensitivity reactions which,
although rare,
may represent a life risk for the patient.
Intravenous contrast media are distinguished in radiographic contrast media (used in conventional radiology or in CT) and MR contrast media.
In the first group,
we find both water-soluble contrasts (administered by oral or by vascular route) and non-water-soluble contrasts...
Findings and procedure details
How to identify the patient at risk? Are there any measures to decrease the possibility of adverse reactions in these patients? If so,
which ones?
Identification of patients at risk of immediate hypersensitivity reactions
The incidence of adverse reactions,
especially those of immediate hypersensitivity,
is rather low; with the non-ionic iodinated contrast media the estimated frequency is between 0.2-0.7%; for Gadolinium-based contrast agents the incidence of hypersensitivity reactions is even lower,
around 0.04-0.67%.
[5]
The identification of patients at risk of adverse reaction is a...
Conclusion
Adverse events related to administration of intravenous contrast agents are rather rare but fearful.
For this reason it is the radiologist's duty to stratify the risk of each patient before administration of the contrast medium,
to put in place any prevention measure where possible,
to identify the clinical manifestations early and to promptly implement the most appropriate therapeutic strategy in order to guarantee the execution of the diagnostic procedure in conditions of maximum safety.
Personal information
Dr.
Federica Libra,
Radiology Resident -
[email protected]
Radiology Unit I - Department of Surgical Medical Sciences and Advanced Technologies "G.F.
Ingrassia" - University of Studies of Catania.
Via Santa Sofia,
78 - Catania (CT)
References
1.
P Feltrin,
M.Zandonà,
V.
Borile,
C.
Rettore,
D.
Miotto (2004) Fondamenti sui mezzi di contrasto iodati e reazioni avverse.
Radiol Med 107 (Suppl 1 al N.
4): 8-31.
2.
Katayama H et all.
(1990) Adverse reactions to ionic and nonionic contrast media.
Radiology 175: 621-628.
3.
Neal C.
Dalrymple,
John R.
Leyendecker,
Michael Oliphant (2009) Edizione italiana di R.
Pozzi Mucelli; Elsevier Masson.
Diagnostica per immagini dell’addome- Problem solving; 3: 56-59.
4.aifa.gov.it/content/nota-informativa-importante-sulluso-di-mezzi-di-contrasto-contenenti-gadolinio-12022018
5.
cpo.it/workspace/files/prev_trattam_reazioni_acute_ip-570e1cfe3f439.pdf
6.
sirm.org/download/3584
7.
esur.org/guidelines/it/
8.
Martinelli,
F.
Petrini,
E.Gamberini (2004)...