Systematic review of MRI and CT contrast media extravasation

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This systematic review combines data from multiple papers on contrast media extravasation to identify factors contributing to increased extravasation risk” Heshmatzadeh Behzadi et al (2018).

Abstract:

BACKGROUND: This systematic review combines data from multiple papers on contrast media extravasation to identify factors contributing to increased extravasation risk.

METHODS: Data were extracted from 17 papers reporting 2191 extravasations in 1,104,872 patients (0.2%) undergoing computed tomography (CT) or magnetic resonance imaging (MRI).

RESULTS: Extravasation rates were 0.045% for gadolinium-based contrast agents (GBCA) and nearly 6-fold higher, 0.26% for iodinated contrast agents. Factors associated with increased contrast media extravasations included: older age, female gender, using an existing intravenous (IV) instead of placing a new IV in radiology, in-patient status, use of automated power injection, high injection rates, catheter location, and failing to warm up the more viscous contrast media to body temperature.

CONCLUSION: Contrast media extravasation is infrequent but nearly 6 times less frequent with GBCA for MRI compared with iodinated contrast used in CT.

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Reference:

Heshmatzadeh Behzadi, A., Farooq, Z., Newhouse, J.H. and Prince, M.R. (2018) MRI and CT contrast media extravasation: A systematic review. Medicine (Baltimore). 97(9), p.e0055.

doi: 10.1097/MD.0000000000010055.

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