The number of anaesthetists who are involved in magnetic resonance (MR) units is increasing. Magnetic resonance systems are becoming more powerful and interventional procedures are now possible. This paper updates information relating to safety terminology, occupational exposure, reactions to gadolinium-based contrast agents and the risk of nephrogenic systemic fibrosis. Magnetic resonance exam...

Noninvasive quantification of myocardial fibrosis in end-stage renal disease is challenging. Gadolinium contrast agents previously used for cardiac magnetic resonance imaging (MRI) are contraindicated because of an association with nephrogenic systemic fibrosis. In other populations, increased myocardial native T1 times on cardiac MRI have been shown to be a surrogate marker of myocardial fibro...

Introduction Carotid artery disease is a major cause of cerebral ischemia and infarction. It is routinely assessed using contrast-enhanced magnetic resonance angiography (MRA). Several methods for nonenhanced MRA exist, which may be particularly advantageous in patients with impaired renal function due to the risk of nephrogenic systemic fibrosis. Pulsed arterial spin-labeled (ASL) MRA has been...

The azygos venous system represents an accessory venous pathway supplying an important collateral circulation between the superior and inferior vena cava. The aim of this article is to revise the wide spectrum of changes ranging from normal to pathological conditions involving the azygos system. Teaching points • The azygos vein is a collateral venous pathway, becoming a vital shunt if major pa...

BACKGROUND Safety is a primary concern with contrast agents used for MRI. If precautions could be taken before the repeated administration of gadolinium-based contrast media, then the awareness and management of adverse reactions would be more efficient. OBJECTIVES To assess the safety and efficacy of gadoterate meglumine (Gd-DOTA) [Magnescope® in Japan, Dotarem® in other countries], a gadoli...

Background Imaging in patients with renal insufficiency (RI) is limited by contrast induced nephropathy and nephrogenic systemic fibrosis. Ferumoxytol is an FDA approved superparamagnetic iron compound used for the treatment of anemia in patients with renal insufficiency. Previous studies of its use as an MRA contrast agent did not assess safety, were not conducted in patients with RI, and were...

Systemic sclerosis (SSc) is a fibrosing connective tissue disease with significantly increased mortality. Therapeutic options to treat fibrosis are limited. The small molecule tyrosine kinase inhibitor imatinib and related drugs such as dasatinib and nilotinib target simultaneously two of the major profibrotic pathways, TGFbeta- and PDGF- signaling. Imatinib, dasatinib and nilotinib inhibit col...

In neutral media, reactions of gadolinium ethylenediaminetetraacetates with phosphorous acid result in the formation of the mixed-ligand polymeric complex K3n[Gd(EDTA)(HPO3)]n·7nH2O () and dimeric complex Na6[Gd2(EDTA)2(HPO3)2]·2.5NaCl·21H2O () (H4EDTA = ethylenediaminetetraacetic acid) in warm solution. Further substitution with citric acid gives the monomeric gadolinium citrate with EDTA (NH4...

OBJECTIVE Our objective was to determine the incidence of immediate adverse events for gadolinium-based contrast agents. MATERIALS AND METHODS All gadolinium-based contrast agent adverse events reported to radiology quality assurance committees were graded according to American College of Radiology criteria and divided by the total number of injections to determine incidence during the past 1...

In this issue of the Netherlands Journal of Medicine, Kampen et al. describe a patient with a hepatic angiosarcoma resulting from exposure to Thorotrast. Thorotrast was developed in 1928 and used as a radiocontrast agent in the period 1930 to 1960. Thorotrast is a colloidal solution containing the naturally occurring radionuclide Thorium. Thorotrast particles are deposited in the reticulo-endot...