Abstract
Contrast agents are essential for a number of radiological studies in children; most of them are handled and excreted by the kidney. This chapter tries to summarize the relevant contrast agents handled by the kidney that are used in childhood imaging, to give some considerations toward age and weight-adapted dose, and to discuss safety issues including precautions helpful to avoid complications or their sequelae. Contrast agents and applications outside the genitourinary tract as well as those not primarily handled by the kidney are not addressed – a comprehensive summary of all potential applications and risks can be found in the recently updated book entitled Contrast Media: Safety Issues and ESUR Guidelines (Thomsen et al. 2014).
References
American College of Radiology – ACR 2012/manual on contrast media v8 – contrast media in children. http://www.acr.org/Quality-Safety/Resources/Contrast-Manual
Ascenti G, Zimbaro G, Mazziotti S et al (2004) Harmonic US imaging of vesicoureteric reflux in children: usefulness of a second generation US contrast agent. Pediatr Radiol 34:481–487
Berrocal T, Gaya F, Arjonilla A et al (2001) Vesicoureteral reflux: diagnosis and grading with echo-enhanced cystosonography versus voiding cystourethrography. Radiology 221:359–365
Berrocal T, Gaya F, Arjonilla A (2005) Vesicoureteral reflux: can the urethra be adequately assessed by using contrast-enhanced voiding US of the bladder? Radiology 234:235–241, 650
Bosio M, Manzoni GA (2002) Detection of posterior urethral valves with voiding cysto-urethrosonography with echo contrast. J Urol 168:1711–1715
Brasch RC (2008) Contrast media toxicity in children. Pediatr Radiol 38(S2):S281–S284
Calliada F, Campani R, Bottinelli O, Bozzini A, Sommaruga MG (1998) Ultrasound contrast agents: basic principles. Eur J Radiol 27(S2):S157–S160
Darge K (2008) Voiding urosonography with ultrasound contrast agents for the diagnosis of vesicoureteric reflux in children. I. Procedure. Pediatr Radiol 38:40–53
Darge K (2010) Voiding urosonography with US contrast agent for the diagnosis of vesicoureteric reflux in children: an update. Pediatr Radiol 40:956–962
Darge K, Zieger B, Rohrschneider W et al (2001) Reduction in voiding cystourethrographies after the introduction of contrast enhanced sonographic reflux diagnosis. Pediatr Radiol 31:790–795
Darge K, Papadopoulou F, Ntoulia A, Bulas DI, Coley BD, Fordham LA, Paltiel HJ, McCarville B, Volberg FM, Cosgrove DO, Goldberg BB, Wilson SR, Feinstein SB (2013) Safety of contrast-enhanced ultrasound in children for non-cardiac applications: a review by the Society for Pediatric Radiology (SPR) and the International Contrast Ultrasound Society (ICUS). Pediatr Radiol 43:1063–1073
Davenport MS, Khalatbari S, Dillman JR, Cohan RH, Caoili EM, Ellis JH (2013) Contrast material-induced nephrotoxicity and intravenous low-osmolality iodinated contrast material. Radiology 267:94–105. doi:10.2214/AJR.14.13761
Dawson P, Becker A, Holton JM (1983) The effect of contrast media on the growth of bacteria. Br J Radiol 56:809–815
Dharnidharka VR, Wesson SK, Fennell RS (2007) Gadolinium and nephrogenic fibrosing dermopathy in pediatric patients. Pediatr Nephrol 22:1395
Duran C, Valera A, Alguersuari A et al (2009) Voiding urosonography: the study of the urethra is no longer a limitation of the technique. Pediatr Radiol 39:124–131
EMA’s final opinion confirms restrictions on use of linear gadolinium agents in body scans (2017). EMA/457616/2017, last visited April 2018. http://www.ema.europa.eu/docs/en_GB/document_library/Referrals_document/gadolinium_contrast_agents_31/Opinion_provided_by_Committee_for_Medicinal_Products_for_Human_Use/WC500231824.pdf
Esposito F, Di Serafino M, Sgambati P, Mercogliano F, Tarantino L, Vallone G, Oresta P (2012) Ultrasound contrast media in paediatric patients: is it an off-label use? Regulatory requirements and radiologist’s liability. Radiol Med 117:148–159
Foss C, Smith JK, Ortiz L, Hanevold C, Davis L (2009) Gadolinium-associated nephrogenic systemic fibrosis in a 9-year-old boy. Pediatr Dermatol 26:579–582
Frush DP (2008) Pediatric abdominal CT angiography. Pediatr Radiol 38(S2):S259–S266
Garfinkle MA, Stewart S, Basi R (2015) Incidence of ct contrast agent–induced nephropathy: toward a more accurate estimation. AJR Am J Roentgenol 204:1146–1151. doi:10.2214/AJR.14.13761
Hahn G, Sorge I, Gruhn B et al (2009) Pharmacokinetics and safety of gadobutrol-enhanced magnetic resonance imaging in pediatric patients. Invest Radiol 44:776–783
Heran MK, Marshalleck F, Temple M et al. Society of Interventional Radiology Standards of Practice Committee; Society of Pediatric Radiology Interventional Radiology Committee (2010) Joint quality improvement guidelines for pediatric arterial access and arteriography: from the Societies of Interventional Radiology and Pediatric Radiology. Pediatr Radiol 40:237–250
Hiorns MP (2011) Gastrointestinal tract imaging in children: current techniques. Pediatr Radiol 41:42–54
Jain SM, Wesson S, Hassanein A et al (2004) Nephrogenic fibrosing dermopathy in pediatric patients. Pediatr Nephrol 19:467–470
Kalmar P, Riccabona M (2013) Intramedulläre Gadoliniumresiduen in Nieren pädiatrischer Onkologie-Patienten – ein Wort zur Vorsicht. 50. GPR Jahrestagung, Jena, September 2013. Fortschr Röntgenstr (RöFo) 185:893 (abstract)
Karcaaltincaba M, Oguz B, Haliloglu M (2009) Current status of contrast-induced nephropathy and nephrogenic systemic fibrosis in children. Pediatr Radiol 39(S3):S382–S384
Kurian J, Epelman M, Darge K et al (2013) The role of CT angiography in the evaluation of pediatric renovascular hypertension. Pediatr Radiol 43:490–501
Mannelli L, Maki JH, Osman SF et al (2012) Non-contrast functional MRI of the kidneys. Curr Urol Rep 13:99–107
McCarville MB (2011) Contrast-enhanced sonography in pediatrics. Pediatr Radiol 41(S1):S238–S242
McDonald RJ, McDonald JS., Kallmes DF, Jentoft ME, Murray DL, Thielen KR, Williamson EE, Eckel LJ (2015) Intracranial gadolinium deposition after contrast-enhanced MR imaging. Radiology 275:772–7782. doi:http://dx.doi.org/10.1148/radiol.15150025
Mendichovszky IA, Marks SD, Simcock CM, Olsen OE (2008) Gadolinium and nephrogenic systemic fibrosis: time to tighten practice. Pediatr Radiol 38:489–496
Mentzel HJ, Vogt S, Patzer L, Schubert R, John U, Misselwitz J, Kaiser WA (1999) Contrast-enhanced sonography of vesicoureteral reflux in children: preliminary results. Am J Roentgenol 173:737–740
Mikkonen R, Kontkanen T, Kivisaari L (1995) Late and acute adverse reactions to iohexol in a pediatric population. Acta Radiol 35:350–352
Morcos SK (2007) Nephrogenic systemic fibrosis following the administration of extracellular gadolinium based contrast agents: is the stability of the contrast agent molecule an important factor in the pathogenesis of this condition? Br J Radiol 80:73–76, Erratum in: Br J Radiol 2007;80:586
Newhouse JH, Kho D, Rao QA, Starren J (2008) Frequency of serum creatinine changes in the absence of iodinated contrast material: implications for studies of contrast nephrotoxicity. AJR Am J Roentgenol 191:376–382. doi:10.2214/AJR.14.13761
Papadopoulou F, Ntoulia A, Siomou E, Darge K (2014) Contrast-enhanced voiding urosonography with intravesical administration of a second-generation ultrasound contrast agent for diagnosis of vesicoureteral reflux: prospective evaluation of contrast safety in 1,010 children. Pediatr Radiol 44:719–728
Pärtan G (2014) Radiography and fluoroscopy. In: Riccabona M (ed) Pediatric imaging essentials. Thieme, Stuttgart/New-York, pp 10–19. ISBN 987-3-13-166191-3
Penfield JG, Reilly RF (2008) Nephrogenic systemic fibrosis risk: is there a difference between gadolinium-based contrast agents? Semin Dial 21:129–134
Piscaglia F, Bolondi L (2006) The safety of Sonovue in abdominal applications: retrospective analysis of 23188 investigations. Ultrasound Med Biol 32:1369–1375
Piskunowicz M, Kosiak W, Irga N (2011) Primum non nocere? Why can’t we use second generation ultrasound contrast agents for the examination of children? Ultraschall Med 32:83–86
Piskunowicz M, Kosiak W, Batko T (2012) Intravenous application of second-generation ultrasound contrast agents in children: a review of the literature. Ultraschall Med 33:135–140
Riccabona M (2002) Cystography in infants and children: a critical appraisal of the many forms with special regard to voiding cystourethrography. Eur Radiol 12:2910–2918
Riccabona M (2012) Application of a second-generation US contrast agent in infants and children – a European questionnaire-based survey. Pediatr Radiol 42:1471–1480
Riccabona M (2014) Contrast media use in pediatrics: safety issues. In: Thomsen HS, Webb JAW (eds) Contrast media. Safety issues and ESUR guidelines, 3rd edn. Springer, Heidelberg/New-York/Dordrecht/London, pp 245–253. ISBN 978-3-642-36723-6
Riccabona M, Avni FE, Blickman JG et al (2008) Imaging recommendations in paediatric uroradiology: minutes of the ESPR workgroup session on urinary tract infection, fetal hydronephrosis, urinary tract ultrasonography and voiding cystourethrography. Barcelona, Spain, June 2007. Pediatr Radiol 38:138–145
Riccabona M, Avni FE, Blickman JG, Dacher JN, Darge K, Lobo ML, Willi U, Members of the ESUR Paediatric Paediatric Recommendation Work Group and ESPR Paediatric Uroradiology Work Group (2009) Imaging recommendations in paediatric uroradiology, part II: urolithiasis and haematuria in children, paediatric obstructive uropathy, and postnatal work-up of foetally diagnosed high grade hydronephrosis. Minutes of a mini-symposium at the ESPR annual meeting, Edinburg, June. Pediatr Radiol 39:891–898
Riccabona M, Avni F, Damasio B et al (2012) ESPR Uroradiology Task Force and ESUR Paediatric Working Group: imaging recommendations in paediatric uroradiology, part V: childhood cystic kidney disease, childhood renal transplantation and contrast-enhanced ultrasound in children. Pediatr Radiol 42:1275–1283
Schreiber-Dietrich D, Dietrich CF (2012) Contrast enhanced ultrasound (CEUS) and off-label use (in children). Ultraschall Med 33:295–296
Sorantin E, Weissensteiner S, Hasenburger G, Riccabona M. CT in children - dose protection and generalconsiderations when planning a CT in a child. Eur Radiol 2013; 82 (7): 1043-1049.
Sorantin E (2013) Special aspects of computed tomography in children. In: Riccabona M (ed) Pediatric imaging essentials. Thieme, Stuttgart/New-York, pp 22–28. ISBN 987-3-13-166191-3
Sorantin E, Zsivcsec B, Zebedin D, Fotter R (2002) Optimierung von i.v. Kontrastmittel-applikatonen für pädiatrische Spiral-CT Untersuchungen (Optimisation of i.v. contrast application for pediatric spiral-CT). Radiologe 45:683–684
Sorantin E, Weissensteiner S, Hasenburger G, Riccabona M (2013) CT in children – dose protection and general considerations when planning a CT in a child. Eur J Radiol 82:1043–1049
Speck U (1999) Kontrastmittel: Übersicht, Anwendung und pharmazeutische Aspekte [Contrast Media. overview, use and pharmaceutical aspects]. Springer, Berlin, pp 16–17. ISBN 978-3-540-65712-5
Stenzel M (2013) Intravenous contrast-enhanced sonography in children and adolescents – a single center experience. J Ultrason 13:133–144
Stenzel M, Mentzel HJ (2014) Ultrasound elastography and contrast-enhanced ultrasound in infants, children and adolescents. Eur J Radiol 83:1560–1569
ter Haar G (2009) Safety and bio-effects of ultrasound contrast agents. Med Biol Eng Comput 47:893–900
Thaker VV, Leung AM, Braverman LE, Brown RS, Levine B (2014) Iodine-induced hypothyroidism in full-term infants with congenital heart disease: more common than currently appreciated? J Clin Endocrinol Metab 99:3521–3526. doi:10.1210/jc.2014-1956
Thomsen HS, Webb JAW (eds) (2014) Contrast media. Safety issues and ESUR guidelines, 3rd edn. Springer, Heidelberg/New-York/Dordrecht/London. ISBN 978-3-642-36723-6
Torzilli G (2005) Adverse effects associated with SonoVue use. Expert Opin Drug Saf 4:399–401
Valentini AL, De Gaetano AM, Destito C et al (2002) The accuracy of voiding urosonography in detecting vesico-ureteral reflux: a summary of existing data. Eur J Pediatr 161:380–384
Valentino M, Serra C, Pavlica P et al (2008) Blunt abdominal trauma: diagnostic performance of contrast-enhanced US in children – initial experience. Radiology 246:903–909
Webb JAW (2014) Pregnancy and lactation: intravascular use of contrast media. In: Thomsen HS, Webb JAW (eds) Contrast media: safety issues and ESUR guidelines, 3rd edn. Springer, Heidelberg/New-York/Dordrecht/London, pp 113–121. ISBN 978-3-642-36723-6
Zerin JM (1992) Contrast studies of the gastrointestinal tract in the neonate. Semin Pediatr Surg 1:284–295
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2018 Springer International Publishing AG, part of Springer Nature
About this chapter
Cite this chapter
Riccabona, M., Mentzel, HJ. (2018). Contrast Agents in Childhood: Application and Safety Considerations. In: Riccabona, M. (eds) Pediatric Urogenital Radiology. Medical Radiology(). Springer, Cham. https://doi.org/10.1007/978-3-319-39202-8_6
Download citation
DOI: https://doi.org/10.1007/978-3-319-39202-8_6
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-39200-4
Online ISBN: 978-3-319-39202-8
eBook Packages: MedicineMedicine (R0)