FDA: Restricting MRI Contrast Agents "Not Warranted"

當住院醫師時，腎臟病人要做檢查要儘量避免有顯影劑的CT，最好是做MRI因為不傷腎。當FELLOW時，腎臟病人儘量不要做顯影劑CT，最好也不要做MRI(因為使用gadolinium，有少數報告說會造成nephrogenic systemic fibrosis）。

10多年後，FDA說，MRI 用的gadolinium顯影劑沒有那麼多副作用，不需要限制使用。

Science is forever changing！

May 24, 2017
FDA: Restricting MRI Contrast Agents "Not Warranted"
By Kristin J. Kelley NEJM JOURNAL WATCH

Edited by David G. Fairchild, MD, MPH, and Lorenzo Di Francesco, MD, FACP, FHM

There isn't evidence to warrant restricting the use of gadolinium-based contrast agents (GBCAs), the IV drugs used during magnetic resonance imaging, the FDA has concluded.

The agency began evaluating the risk for adverse health events associated with the heavy metal gadolinium retained in the brain after multiple uses of GBCAs. Reports showed that while gadolinium is retained in the body (including the brain, bones, and skin), no adverse health effects were found to be associated with the retention, apart from a rare condition known as nephrogenic systemic fibrosis.

The safety of GBCAs will continue to be investigated by conducting more research, including studies on how gadolinium is retained in the body. Clinicians should follow the FDA recommendations issued in 2015.

https://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm559709.htm