Safe Use of Contrast Media in Radiology (Clinical Guidelines)

Abstract

In recent years, the frequency of contrast-enhanced radiological studies has increased significantly, and the issues of their selection and rational use do not lose their relevance. These methodological recommendations represent a complete up-to-date guide for using contrast agents (CA) in radiology. Types of currently used CA in computed tomography, magnetic resonance imaging, and ultrasound examinations are described. Safety rules for injection of each CA type are systematized, the principles of dosing and possible side effects are explained. In addition, it is important to highlight the issues of interactions between CA and other drugs that patient might take, in particular, the possible deterioration of renal function when using CA in diabetes mellitus patients taking metformin. It should be noted that these recommendations have undergone significant changes in recent years. Also questionnaire templates for patients prior to the contrast-enhanced study are given in the supplements. The methodological guidelines are based on current publications of international experts on CA use in radiology as well as on the data of two major guidelines: American College of Radiologists (ACR) Guidelines (2023) and European Society of Urogenital Radiology (ESUR) Safety Recommendations (2018, version 10). Thus, the information presented is validated, which provides grounds for its application in real clinical practice. The guidelines will be actualized as new scientific evidence becomes available, but to date they appear to be the most relevant.

Keywords

• сontrast agent
• computed tomography
• magnetic resonance imaging
• ultrasound
• clinical guidelines
• drug
• post-contrast acute kidney injury