Quality initiatives: MR imaging in patients at risk for developing nephrogenic systemic fibrosis: Protocols, practices, and imaging techniques to maximize patient safety

Krishna Juluru, Jens Vogel-Claussen, Katarzyna Macura, Ihab R Kamel, Alexander Steever, David A. Bluemke

Research output: Contribution to journalArticle

Abstract

Nephrogenic systemic fibrosis (NSF) is a rare but potentially debilitating or even fatal fibrosing condition that most often affects the skin but is now also recognized to involve multiple organs. The first report on NSF was published in 1997, and there is mounting evidence that this condition is associated with renal failure and the administration of large amounts of gadolinium. Although gadolinium-enhanced magnetic resonance (MR) imaging was once considered one of the safer imaging procedures, concerns over NSF have led the radiology community to rethink its imaging practices. Several noncontrast angiographic techniques based on fast spin-echo, gradient-echo, phase-contrast, and inversion-recovery principles are currently available. These techniques allow MR angiography to be performed safely, even in patients at risk for developing NSF. When use of gadolinium-based contrast material is necessary for diagnosis, it is possible to reduce total gadolinium administration through the use of agents with higher relaxivity, timeresolved imaging, high-field-strength magnets, and body compression devices. Management of NSF also requires an understanding of the risk factors of this disease and developing an institutional policy for identifying and testing at-risk patients.

Original languageEnglish (US)
Pages (from-to)9-22
Number of pages14
JournalRadiographics : a review publication of the Radiological Society of North America, Inc
Volume29
Issue number1
DOIs
StatePublished - Jan 2009

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Nephrogenic Fibrosing Dermopathy
Patient Safety
Gadolinium
Magnetic Resonance Imaging
Organizational Policy
Magnets
Magnetic Resonance Angiography
Radiology
Contrast Media
Renal Insufficiency
Equipment and Supplies
Skin

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Medicine(all)

Cite this

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title = "Quality initiatives: MR imaging in patients at risk for developing nephrogenic systemic fibrosis: Protocols, practices, and imaging techniques to maximize patient safety",
abstract = "Nephrogenic systemic fibrosis (NSF) is a rare but potentially debilitating or even fatal fibrosing condition that most often affects the skin but is now also recognized to involve multiple organs. The first report on NSF was published in 1997, and there is mounting evidence that this condition is associated with renal failure and the administration of large amounts of gadolinium. Although gadolinium-enhanced magnetic resonance (MR) imaging was once considered one of the safer imaging procedures, concerns over NSF have led the radiology community to rethink its imaging practices. Several noncontrast angiographic techniques based on fast spin-echo, gradient-echo, phase-contrast, and inversion-recovery principles are currently available. These techniques allow MR angiography to be performed safely, even in patients at risk for developing NSF. When use of gadolinium-based contrast material is necessary for diagnosis, it is possible to reduce total gadolinium administration through the use of agents with higher relaxivity, timeresolved imaging, high-field-strength magnets, and body compression devices. Management of NSF also requires an understanding of the risk factors of this disease and developing an institutional policy for identifying and testing at-risk patients.",
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