Contrast Media in Children: Ten Important Concepts on Administration, Applications, Complications, and Environmental Considerations, From the AJR Special Series on Contrast Media

Contrast media are an indispensable adjunct to pediatric imaging. The most common include iodine-based contrast media for CT and fluoroscopy, gadolinium-based contrast media and iron-oxide nanoparticles for MRI, and microbubbles for ultrasound. Although many of the considerations in the routine use of contrast media in infants and children (relating for example to renal function, allergic-like reactions, GBCM deposition, and extravasations) are similar to considerations in adult patients, some important differences exist. These variances are often age-dependent and require an appreciation of pediatric physiology for safe and effective clinical practice. This article highlights ten concepts relating to contrast media administration for diagnostic imaging in children that are important for radiologists and pediatricians to recognize and understand. We present contrast media classes and their use in children, discuss safety concerns and complications, and explore environmental impacts.