Incidence and severity of acute adverse reactions to four different gadolinium-based MR contrast agents.
OBJECTIVE
Differences in acute adverse reactions to different gadolinium (Gd)-based contrast agents have not been thoroughly evaluated. We investigated the relationships among the incidence and severity of acute adverse reactions, backgrounds of patients, and 4 types of different Gd-based contrast agents (gadopentetate dimeglumine, gadoteridol, gadoterate meglumine, and gadoxetate disodium).


METHODS
We retrospectively reviewed the radiological records of 10,595 consecutive patients (4,343 female; 6,252 male; mean age, 63.8 ± 14.0 years) who underwent contrast-enhanced magnetic resonance imaging between August 2006 and March 2011. Adverse reactions were classified as mild, moderate, and severe according to the definition of the American College of Radiology. The incidence of adverse reactions were compared on the basis of clinical characteristics and type, dose, and delivery methods of contrast agents by univariate and multivariate logistic regression analyses.


RESULTS
The incidence of overall reactions was 0.45% (48/10,595); 45 reactions were mild and three were moderate. No severe reactions were observed. Although the incidence of adverse reactions did not differ significantly between male and female patients, younger individuals were at higher risk for acute adverse reactions. The contrast injection rate and contrast dose were not significantly related to the incidence of adverse reactions. The incidence of adverse reactions was significantly higher for gadoxetate disodium (0.82%) than gadopentetate dimeglumine (0.43%).


CONCLUSIONS
The incidence of acute adverse reactions elicited by Gd-based contrast agents injection was only 0.45%. Younger age was a risk factor for acute reactions. All 4 agents were found to be safe, although gadoxetate disodium showed a relatively higher incidence of adverse reactions.
Diagnostic Imaging Center, Saiseikai Kumamoto Hospital.
Takashi
T
Okigawa
Daisuke
D
Utsunomiya
Satomi
S
Tajiri
Shuichiro
S
Okumura
Akira
A
Sasao
Hirohumi
H
Wada
Seitaro
S
Oda
Hiroki
H
Arimura
Eri
E
Hayashida
Joji
J
Urata
Yasuyuki
Y
Yamashita
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media / Q000009:adverse effects* / Q000737:chemistry; D005260:Female; D005682:Gadolinium / Q000009:adverse effects; D019786:Gadolinium DTPA / Q000009:adverse effects; D006571:Heterocyclic Compounds / Q000009:adverse effects; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008536:Meglumine / Q000009:adverse effects; D008875:Middle Aged; D009942:Organometallic Compounds / Q000009:adverse effects; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index
D003287:Contrast Media; D006571:Heterocyclic Compounds; D009942:Organometallic Compounds; C073590:gadolinium ethoxybenzyl DTPA; C062402:gadoteridol; D008536:Meglumine; D005682:Gadolinium; D019786:Gadolinium DTPA; C072417:gadoterate meglumine