Investigative Magnetic Resonance Imaging

  • 제15권2호
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  • Pages.139-145
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  • 2011
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  • 2384-1095(pISSN)
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  • 2384-1109(eISSN)
대한자기공명의과학회 (Korean Society of Magnetic Resonance in Medicine)
권호 표지

자기공명영상검사용 가돌리늄 경정맥 조영제의 급성 부작용: 부작용 전산 체계를 이용한 후향적 분석

Acute Adverse Reactions to Gadolinium-based Intravenous Contrast Agents for MRI : Retrospective Analysis Using Computed Reporting System

  • 최문형 (가톨릭대학교 서울성모병원 영상의학과) ;
  • 최준일 (가톨릭대학교 서울성모병원 영상의학과) ;
  • 정승은 (가톨릭대학교 서울성모병원 영상의학과) ;
  • 안국진 (가톨릭대학교 서울성모병원 영상의학과) ;
  • 이해규 (가톨릭대학교 서울성모병원 영상의학과)
  • Choi, Moon-Hyung (Department of Radiology, Seoul St. Mary's Hospital, The Catholic University of Korea) ;
  • Choi, Joon-Il (Department of Radiology, Seoul St. Mary's Hospital, The Catholic University of Korea) ;
  • Jung, Seung-Eun (Department of Radiology, Seoul St. Mary's Hospital, The Catholic University of Korea) ;
  • Ahn, Kook-Jin (Department of Radiology, Seoul St. Mary's Hospital, The Catholic University of Korea) ;
  • Lee, Hae-Giu (Department of Radiology, Seoul St. Mary's Hospital, The Catholic University of Korea)
  • 투고 : 2011.07.05
  • 심사 : 2011.08.05
  • 발행 : 2011.08.31
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초록

목적 : 단일기관에서 발생한 가돌리니움 기반의 자기공명영상 경정맥 조영제의 급성 부작용의 빈도 및 종류, 조영제 별 차이를 알아보았다. 대상 및 방법 : 병원정보시스템의 부작용 보고체계를 분석하여, 2008년 10월부터 2010년 12월 사이에 증례를 검색하였다. 부작용은 경증, 중등도, 중증으로 분류되었고 서로 다른 조영제간에 빈도의 차이가 있는지를 분석하였다. 결과 : 총 33,600건의 조영제가 투여되었고, Gd-BT-DO3A 20,824건 (62%), Gd-DTPA 10,417건 (31%), Gd-EOB-DTPA 2,359건 (7%)이었다. 부작용은 총 39예가 발생하여 빈도는 0.1161%였고, Gd-BT-DO3A 0.1248% (26/39,67%), Gd-DTPA 0.0768% (8/39, 21%), Gd-EOB-DTPA 0.2120% (5/39,13%) 였으며, 조영제 간에 유의한 차이는 없었다. 대부분 (89.7%) 이 경증 부작용이었으며 중등도 및 중증 부작용은 각각 2명에서 발생하였다. 결론 : 한국인에서의 자기공명영상 검사용 경정맥 조영제에 의한 부작용의 빈도는 드물었으며, 특히 중등도 혹은 중증 부작용은 매우 드물었다. 세가지 조영제 사이에 부작용 발생 빈도는 차이는 없었다.

Purpose : To assess the frequency and severity of acute adverse reactions to intravenous administration of gadolinium-based contrast agents using computerized reporting system at a single large academic institution. Materials and Methods : We assessed data from electronic hospital information system from October 2008 to December 2010. Reactions were classified as mild, moderate, or severe. We compared the frequency of adverse reactions among three contrast agents (Gd-BT-DO3A, Gd-DTPA and Gd-EOB-DTPA). Results : The total number of administrated contrast agents was 33,600, and the number of administration of Gd-BT-DO3A, Gd-DTPA and Gd-EOB-DTPA were 20,824 (62%), 10,417 (31%) and 2,359 (7%), respectively. Total 39 adverse reactions were reported accounting for 0.1161% of all administrations. The incidences of adverse reactions were 0.1248% (26/39, 67%) for Gd-BT-DO3A, 0.0768% (8/39, 21%) for Gd-DTPA, and 0.2120% (5/39, 13%) for Gd-EOB-DTPA. The difference of frequencies of adverse reaction among three contrast agents was not significant. Most cases of the adverse effect were mild (35/39, 89.7%). Moderate and severe adverse reactions were encountered in two patients, respectively. Conclusion : Among Koreans, adverse effects were rare, and especially, moderate to severe adverse reactions were much rarer. There was no difference among the frequencies of adverse reactions caused by three different contrast agents.

키워드

참고문헌

  1. Niendorf HP, Dinger JC, Haustein J, Cornelius I, Alhassan A, Clauss W. Tolerance data of Gd-DTPA: a review. Eur J Radiol 1991;13:15-20 https://doi.org/10.1016/0720-048X(91)90049-2
  2. Nelson KL, Gifford LM, Lauber-Huber C, Gross CA, Lasser TA. Clinical safety of gadopentetate dimeglumine. Radiology 1995;196:439-443
  3. Murphy KJ, Brunberg JA, Cohan RH. Adverse reactions to gadolinium contrast media: a review of 36 cases. AJR Am J Roentgenol 1996;167:847-849
  4. Li A, Wong CS, Wong MK, Lee CM, Au Yeung MC. Acute adverse reactions to magnetic resonance contrast media--gadolinium chelates. Br J Radiol 2006;79:368-371 https://doi.org/10.1259/bjr/88469693
  5. Dillman JR, Ellis JH, Cohan RH, Strouse PJ, Jan SC. Frequency and severity of acute allergic-like reactions to gadolinium-containing i.v. contrast media in children and adults. AJR Am J Roentgenol 2007;189:1533-1538 https://doi.org/10.2214/AJR.07.2554
  6. Bleicher AG, Kanal E. Assessment of adverse reaction rates to a newly approved MRI contrast agent: review of 23,553 administrations of gadobenate dimeglumine. AJR Am J Roentgenol 2008;191:W307-311 https://doi.org/10.2214/AJR.07.3951
  7. Marckmann P, Skov L, Rossen K, et al. Nephrogenic systemic fibrosis: suspected causative role of gadodiamide used for contrast- enhanced magnetic resonance imaging. J Am Soc Nephrol 2006;17:2359-2362 https://doi.org/10.1681/ASN.2006060601
  8. Tne American College of Radiology. Manual on contrast media version 7 2010. www.acr.org/SecondaryMainMenuCategories/quality_safety/contrast_manual/FullManual.aspx
  9. Sadowski EA, Bennett LK, Chan MR, et al. Nephrogenic systemic fibrosis: risk factors and incidence estimation. Radiology 2007;243:148-157 https://doi.org/10.1148/radiol.2431062144
  10. Shellock FG, Parker JR, Pirovano G, et al. Safety characteristics of gadobenate dimeglumine: clinical experience from intraand interindividual comparison studies with gadopentetate dimeglumine. J Magn Reson Imaging 2006;24:1378-1385 https://doi.org/10.1002/jmri.20764
  11. Murphy KP, Szopinski KT, Cohan RH, Mermillord B, Ellis JH. Occurrence of adverse reactions to gadolinium-based contrast material and management of patients at increased risk: a survey of the American Society of Neuroradiology Fellowship Directors. Acad Radiol 1999;6:656-664 https://doi.org/10.1016/S1076-6332(99)80114-7
  12. Knopp MV, Balzer T, Esser M, Kashanian FK, Paul P, Niendorf HP. Assessment of utilization and pharmacovigilance based on spontaneous adverse event reporting of gadopentetate dimeglumine as a magnetic resonance contrast agent after 45 million administrations and 15 years of clinical use. Invest Radiol 2006;41:491-499 https://doi.org/10.1097/01.rli.0000209657.16115.42
  13. Abujudeh HH, Kosaraju VK, Kaewlai R. Acute adverse reactions to gadopentetate dimeglumine and gadobenate dimeglumine: experience with 32,659 injections. AJR Am J Roentgenol 2010;194:430-434 https://doi.org/10.2214/AJR.09.3099
  14. Morgan DE, Spann JS, Lockhart ME, Winningham B, Bolus DN. Assessment of adverse reaction rates during gadoteridolenhanced MR imaging in 28,078 patients. Radiology 2011;259:109-116 https://doi.org/10.1148/radiol.10100906
  15. Forsting M, Palkowitsch P. Prevalence of acute adverse reactions to gadobutrol--a highly concentrated macrocyclic gadolinium chelate: review of 14,299 patients from observational trials. Eur J Radiol 2010;74:e186-192 https://doi.org/10.1016/j.ejrad.2009.06.005
  16. Bluemke DA, Sahani D, Amendola M, et al. Efficacy and safety of MR imaging with liver-specific contrast agent: U.S. multicenter phase III study. Radiology 2005;237:89-98 https://doi.org/10.1148/radiol.2371031842
  17. Lalli AF. Contrast media reactions: data analysis and hypothesis. Radiology 1980;134:1-12
  18. Gonen M, Panageas KS, Larson SM. Statistical issues in analysis of diagnostic imaging experiments with multiple observations per patient. Radiology 2001;221:763-767 https://doi.org/10.1148/radiol.2212010280