Safety of Administering Intravenous CT Contrast Agents Repeatedly or Using Both CT and MRI Contrast Agents on the Same Day: An Animal Study

Abstract

Objective: To investigate molecular and functional consequences of additional exposures to iodine- or gadolinium -based contrast agents within 24 hours from the initial intravenous administration of iodine -based contrast agents through an animal study. Materials and Methods: Fifty-six Sprague-Dawley male rats were equally divided into eight groups: negative control, positive control (PC) with single -dose administration of CT contrast agent, and additional administration of either CT or MR contrast agents 2, 4, or 24 hours from initial CT contrast agent injection. A 12 mu L/g of iodinated contrast agent or a 0.47 mu L/g of gadoliniumbased contrast agent were injected into the tail vein. Serum levels of blood urea nitrogen, creatinine, cystatin C (Cys C), and malondialdehyde (MDA) were measured. mRNA and protein levels of kidney injury molecule -1 (KIM -1) and neutrophil gelatinaseassociated lipocalin (NGAL) were evaluated. Results: Levels of serum creatinine (SCr) were significantly higher in repeated CT contrast agent injection groups than in PC (0.21 +/- 0.02 mg/dL for PC; 0.40 +/- 0.02, 0.34 +/- 0.03, and 0.41 +/- 0.10 mg/dL for 2-, 4-, and 24 -hour interval groups, respectively; P < 0.001). There was no significant difference in the average Cys C and MDA levels between PC and repeated CT contrast agent injection groups (Cys C, P = 0.256-0.362; MDA, P > 0.99). Additional doses of MR contrast agent did not make significant changes compared to PC in SCr (P > 0.99), Cys C (P = 0.262), and MDA (P = 0.139-0.771) levels. mRNA and protein levels of KIM -1 and NGAL were not significantly different among additional CT or MR contrast agent groups (P > 0.05). Conclusion: A sufficient time interval, probably more than 24 hours, between repeated contrast -enhanced CT examinations may be necessary to avoid deterioration in renal function. However, conducting contrast -enhanced MRI on the same day as contrast -enhanced CT may not induce clinically significant kidney injury.