Document Detail


The relative safety of MRI contrast agent in acute necrotizing pancreatitis.
MedLine Citation:
PMID:  9445117     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To validate the safety of gadolinium-diethylenetriamine pentaacetic acid (GD-DTPA) by measuring its effect on pancreatic capillary perfusion and acinar injury in acute pancreatitis. BACKGROUND: Contrast-enhanced computed tomography (CECT) is proposed as a gold standard for early evaluation of acute necrotizing pancreatitis. However, iodinated contrast media used for CECT have been shown in these circumstances to reduce pancreatic capillary flow and increase necrosis and mortality. Recent reports suggest that post-GD MRI provides images comparable to CECT in the assessment of severe acute pancreatitis. METHODS: Necrotizing pancreatitis was induced in 14 Wistar rats by intraductal glycodeoxycholic acid (10 mM/L) and intravenous caerulein (5 microg/kg/h) over 6 hours. Intravital microscopic quantitation of pancreatic capillary blood flow was performed using fluorescein isothiocyanate-labeled erythrocytes after induction of pancreatitis and 30 and 60 minutes after an intravenous bolus of either Ringer's solution or GD-DTPA (0.2 mL/kg). RESULTS: The two study groups were comparable with regard to mean arterial pressure, heart rate, arterial blood gases, hematocrit, amylase, lipase, and trypsinogen activation peptide production throughout the experiment. GD-DTPA did not reduce capillary flow (1.93 +/- 0.05 nL/capillary/min) compared to animals infused with Ringer's solution (1.90 +/- 0.06 nL/capillary/min). CONCLUSIONS: Intravenous injection of GD-DTPA does not further impair pancreatic microcirculation or increase acinar injury in acute necrotizing pancreatitis. Because of this advantage over CT contrast medium, further development of MRI as a staging tool in acute pancreatitis seems desirable.
Authors:
J Werner; J Schmidt; A L Warshaw; M M Gebhard; C Herfarth; E Klar
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of surgery     Volume:  227     ISSN:  0003-4932     ISO Abbreviation:  Ann. Surg.     Publication Date:  1998 Jan 
Date Detail:
Created Date:  1998-02-05     Completed Date:  1998-02-05     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  0372354     Medline TA:  Ann Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  105-11     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, University of Heidelberg, Germany.
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MeSH Terms
Descriptor/Qualifier:
Animals
Disease Models, Animal
Drug Evaluation, Preclinical
Drug Monitoring
Erythrocytes
Gadolinium DTPA / diagnostic use*,  pharmacokinetics
Hemodynamics / drug effects
Isothiocyanates
Magnetic Resonance Imaging*
Male
Microcirculation / drug effects
Pancreatitis, Acute Necrotizing / diagnosis*,  physiopathology
Rats
Rats, Wistar
Severity of Illness Index
Tomography, X-Ray Computed / adverse effects
Chemical
Reg. No./Substance:
0/Isothiocyanates; 3129-90-6/isothiocyanic acid; 80529-93-7/Gadolinium DTPA
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