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Brain studies used a 20-channel head and neck coil, body studies used a combination of a 24-channel spine matrix coil and an 18-channel phased-array body flex coil, and lower extremity studies were performed with a 36-channel peripheral angiography coil. There were no adverse events in any of the 102 patients studied.Īll examinations were performed on a 3-T unit (Magnetom Skyra, Siemens Healthcare). Patients were carefully monitored during and after the injection of ferumoxytol because the reported incidence of anaphylaxis is higher with ferumoxytol than that with gadolinium-based contrast agents.
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All patients with the exception of those studied for AAA and pulmonary embolism had impaired renal function and received ferumoxytol to avoid risks of gadolinium-related toxicity. The mean age of the study group was 70.7 ± 10.5 (SD) years (range, 47–95 years) there were 100 male and two female participants. The clinical indications for the examinations were evaluation of abdominal aortic aneurysms (AAAs) (30 patients, 29.4%), thoracoabdominal aortic aneurysms (three patients, 2.9%), pulmonary embolism (eight patients, 7.8%), aortic dissection (two patients, 2.0%), intracranial aneurysms (two patients, 2.0%), arteriovenous fistulas (15 patients, 14.7%), coronary arteries (four patients, 3.9%), carotid arteries (11 patients, 10.8%), and lower extremity vasculature (27 patients, 26.5%).
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Informed consent for the use of ferumoxytol was acquired for all examinations, and medical records were reviewed to rule out iron overload and other potential contraindications for MRI or for USPIO administration. A total of 102 patients underwent MRA with ferumoxytol (Feraheme, AMAG Pharmaceuticals) between December 2010 and January 2015. This study was approved by the institutional review board at our facility and is compliant with HIPAA. The goal of this article is to summarize more than 3 years of clinical experience with ferumoxytol-enhanced MR angiography (MRA) at our institution for a range of applications including standard clinical indications (i.e., pulmonary embolism, aorta, coronary and peripheral vascular imaging) and advanced research topics (i.e., 4D flow imaging and imaging to detect vascular inflammation). This macrophage-selective feature of ferumoxytol allows the identification of pathologic inflammation, which can be applied to vessel wall imaging. In addition to its role as a positive contrast vascular imaging agent, ferumoxytol has a unique property as a USPIO: It is phagocytosed by macrophages after a delay. It has been broadly applied in both pediatric and adult patients for intracranial, chest, and abdominal vascular MRI. This extended plateau of increased vascular signal can be used for much longer imaging acquisitions than are possible with extracellular gadolinium-based agents, allowing improved performance of navigated MRI sequences, venous imaging, and the option for repeat imaging without the need for additional contrast material.įerumoxytol can be administered as a bolus injection, allowing both first-pass arterial and blood pool imaging. Another unique feature of ferumoxytol as a contrast agent is that, because of its size and carbohydrate coating, it has a prolonged intravascular residence time of more than 12 hours. Ferumoxytol is an attractive alternative to standard gadolinium-based MRI contrast agents that carry potential risks if given to patients with renal failure. Food and Drug Administration as an IV treatment of iron-deficiency anemia in patients with chronic kidney disease. In this review, we focus on the ES-MIONs because ES-MIONs avoid the disadvantages of MION-based T 2- and gadolinium chelate-based T 1-weighted contrast agents.Ĭontrast agents extremely small MIONs (ES-MIONs) magnetic iron oxide nanoparticles (MIONs) magnetic resonance imaging (MRI) synthesis methods.Ferumoxytol is an ultrasmall superparamagnetic iron oxide (USPIO) particle that was first investigated as an MRI contrast agent more than a decade ago. In addition, the MIONs larger than 10 nm can be used as negative contrast agents and the recently emerged extremely small MIONs (ES-MIONs) smaller than 5 nm are potential positive contrast agents. Herein, we only focus on the liquid-based synthesis methods including aqueous phase methods and organic phase methods.
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Currently, many methods have been reported for the synthesis of MIONs. This review article introduces the methods of synthesizing MIONs, and their application as MRI contrast agents. Magnetic iron oxide nanoparticles (MIONs) have attracted enormous attention due to their wide applications, including for magnetic separation, for magnetic hyperthermia, and as contrast agents for magnetic resonance imaging (MRI).