![]() Nine agents have currently been approved and are available in Europe their characteristics are summarised in Table 1. ![]() However, if the GBCM concentration is high, T2 shortening is predominant, which causes a decrease in the signal. These contrast media act by shorting the T1 and T2 relaxation time of the tissues to which they are distributed, which fundamentally leads to an increased signal in T1-weighted sequences. Gadolinium-based contrast media (GBCM) are used in magnetic resonance imaging (MRI) studies due to their magnetic ability to change the position of the protons of water molecules in tissues, which is a change that improves the study’s diagnostic capacity. In this document, we aim to summarise the clinical expression of NSF, the data known about different gadolinium-based contrasts, the possibilities of identifying patients at risk in order to prevent its onset and the types of treatment for this disease. It has been defined as a fibrosing disease that predominantly affects patients who have received gadolinium-based contrasts, with an estimated glomerular filtration rate (GFR) of less than 30ml/min/1.73m 2 or those on haemodialysis 2,3. Since 1997, when it was reported by Cowper for the first time 1, a condition called nephrogenic systemic fibrosis (NSF) has drawn the attention of nephrologists and radiologists from all over the world. En un encuentro entre radiólogos y nefrólogos revisamos los aspectos más relevantes en la actualidad y las recomendaciones para su prevención. La estrecha farmacovigilancia y el rigor en la observación de las normativas actuales, con especial atención al valor del filtrado glomerular, han reducido los casos publicados relacionados con el uso de medios de contraste basados en el gadolinio. Se han intentado establecer parámetros de seguridad a fin de identificar a los pacientes con factores de riesgo por presentar insuficiencia renal. A pesar de tratarse de un grupo de fármacos que se consideraban seguros, la notificación de esta reacción adversa, potencialmente grave, supuso un punto de inflexión en las pautas de administración de estos medios de contraste. These latter patterns were associated with the highest prevalence of volvulus.La fibrosis sistémica nefrogénica es un trastorno fibrosante que afecta a pacientes con deterioro de la función renal y se asocia a la administración de medios de contraste basados en el gadolinio, empleados en la resonancia magnética. ![]() In the absence of a corkscrew or Z-shaped duodenum, patterns that usually indicate volvulus or obstructing Ladd bands, colon position had greater prognostic implication, especially when the cecum was situated in the right upper quadrant or left upper quadrant. Of 69 patients, only one (1.4%) had an anatomically normal duodenum, and four (5.8%) had a surgically confirmed normal cecum fixed in the right lower quadrant. Almost all children in the series had abnormalities of rotation or fixation of both the duodenum and colon, resulting in narrowing of the mesenteric base with potential for midgut volvulus. Seven patterns of duodenal malrotation were observed. In a series of 69 surgically proved cases, the authors studied the prevalence and clinical consequences of various radiographic patterns of malrotation and correlated surgical findings with the radiographic location of the duodenum and cecum. Sometimes the prognostic significance of the findings from upper gastrointestinal tract examinations is unclear. Intestinal malrotation is a major diagnostic challenge in children.
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