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- W12457856 abstract "Purpose: Hepatorenal syndrome (HRS) is a relative contraindication to receiving gadolinium-based contrast media secondary to risk of nephrogenic systemic fibrosis. Since patients with cirrhosis frequently require magnetic resonance imaging (MRI) for hepatocellular cancer screening and liver transplant evaluation, most centers are mandating documented serum creatinine levels within 10-14 days of performing MRIs on patients with cirrhosis. Ascites can be detected on MRI without contrast enhancement. Objective: To determine whether the presence of ascites on MRI can be used to recommend against a diagnosis of HRS without knowledge of a serum creatinine level. Methods: We performed a retrospective review of 234 unique inpatients with an ICD9 code of HRS from 1/2004 - 1/2010 at a single, academic, liver transplant center. Among this group, we identified 43 patients who underwent MRI during an HRS admission. Medical charts were reviewed to collect demographic information and determine the accuracy of the HRS diagnosis. MRI studies were reviewed to determine the presence of ascites. Results: The diagnosis of HRS was verified in 27/43 patients by chart review (mean age 53.8±11.3, 81.5% male, mean MELD 32.7±6.6). The primary etiologies of cirrhosis were alcohol in 48.1% and viral hepatitis in 44.4%. Four patients (14.8%) had concomitant hepatocellular carcinoma. Three patients (11.1%) were receiving hemodialysis at the time of MRI for their HRS. MRI revealed intra-abdominal ascites in all 27 patients (100%). Four patients (14.8%) had mild ascites, while all others (85.2%) had moderate or severe ascites. Conclusion: In patients with cirrhosis and no known renal insufficiency, the absence of intra-abdominal ascites on an unenhanced abdominal MRI performed before administration of gadolinium-based contrast media may reliably exclude the diagnosis of HRS, obviating the need for serum creatinine measurement less than 2 weeks before MRI. These findings should be confirmed in a prospective study before routine adoption of this practice." @default.
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- W12457856 date "2010-10-01" @default.
- W12457856 modified "2023-09-26" @default.
- W12457856 title "Non-contrast MRI May Predict Safety of Gadolinium-enhanced MRI in Patients with Cirrhosis" @default.
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- W12457856 doi "https://doi.org/10.14309/00000434-201010001-00301" @default.
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