Neuroimagem Flashcards
Como fazer desensibilização ao contraste iodado?
GUIDELINES FOR PREMEDICATION OF PATIENTS WITH PRIOR CONTRAST
ALLERGY 12 h prior to examination: Prednisone, 50 mg PO or methylprednisolone, 32 mg PO
2 h prior to examination:
Prednisone, 50 mg PO or methylprednisolone, 32 mg PO and Cimetidine, 300 mg PO or ranitidine, 150 mg
PO
Immediately prior to examination:
Benadryl, 50 mg IV (alternatively, can be given PO 2 h prior to exam)
Em quais pacientes devemos ter avaliação do RFG antes da RM com gadolíneo?
College of Radiology recommends that prior to elective gadolinium-based MR contrast agent (GBMCA) administration, a recent (e.g., past 6 weeks) glomerular filtration rate (GFR) assessment be obtained in patients with a history of: 1. Renal disease (including solitary kidney, renal transplant, renal tumor) 2. Age >60 years 3. History of hypertension 4. History of diabetes
5. History of severe hepatic disease/liver transplant/ pending liver transplant: for these patients it is recommended that the patient’s GFR assessment be nearly contemporaneous with the MR examination.
The incidence of NSF in patients with severe renal dysfunction (GFR <30) varies from 0.19 to 4%. A recent meta-analysis reported an odds ratio of 26.7 (95% CI = 10.3–69.4) for development of NSF after gadolinium administration in patients with impaired renal function (GFR <30 mL/min/1.72 m).
Quais as contraindicações a RM?
COMMON CONTRAINDICATIONS TO MR IMAGING
Cardiac pacemaker or permanent pacemaker leads
Internal defibrillatory device Cochlear prostheses
Bone growth stimulators Spinal cord stimulators Electronic infusion devices Intracranial aneurysm clips (some but not all)
Ocular implants (some) or ocular metallic foreign body McGee stapedectomy piston prosthesis
Duraphase penile implant Swan-Ganz catheter Magnetic stoma plugs Magnetic dental implants Magnetic sphincters Ferromagnetic IVC filters, coils, stents—safe 6 weeks after implantation Tattooed eyeliner (contains ferromagnetic material and may irritate eyes)
