Gadolinium -based contrast agents

The influence of the electron spin relaxation on the relaxivity of gadolinium based contrast agents is essentially governed by the decay of the electron spin magnetization in the direction parallel to the external magnetic field, described... 

The use of gadolinium-based contrast agents as an alternative to iodinated contrast agents has been reported in a patient with a history of allergy to the latter (3). 

Adverse events associated with the non-ionic, gadolinium-based contrast agent gadodiamide have been reported in 1-2% of patients. Most of the commonly reported adverse events have been headache, dizziness, or nausea and vomiting. 

However, the use of large volumes of gadolinium-based contrast agents can cause deterioration in renal function, and the safety of these agents in relation to the kidney when a large volume is used is not known (27). 

This case underlines the fact that there is still misunderstanding about the nephrotoxic potential of gadolinium-based contrast agents. They should not replace iodinated contrast agents in patients with renal insufficiency. The recommended doses of up to 0.3 mmol/kg will not give satisfactory radiographic diagnostic information in most cases. 

Bassilios N, Vantelon C, Cluzel P, Baumelou A, Deray G. Use of gadolinium-based contrast agent for renal angiography case report and review of the literature. Ren Fail 2001 23(6) 857-61. 

To protect residual renal function, use doses under 0.3 mmol/kg of gadolinium-based contrast agents Referto ESUR guidelines to avoid contrast medium-induced renal damage (hydration, use small doses of low-osmolar contrast media)... 

In MRI avoid doses over 0.3 mmol/kg of gadolinium-based contrast agents... 

Strieker BH, Psaty BM. Detection, verification, and quantification of adverse drug reactions. Br Med J 2004 329(7456) 44-7. Thomsen HS, Marckmann P, Logager VB. Nephrogenic systemic fibrosis (NSF) a late adverse reaction to some of the gadolinium based contrast agents. Cancer Imaging 2007 7 130-7. 

Do all gadolinium-based contrast agents confer a similar risk of NSF Pathogenesis of NSF Treatment of NSF Prevention of NSF... 

Kaufman JA, Geller SC, Bazari H, Waltman AC Gadolinium-based contrast agents as an alternative at vena cavography in patients with renal insufficiency-early experience./ ad/o/ogy 212 280-284,1999. 

Morcos SK Nephrogenic systemic fibrosis following the administration of extracellular gadolinium based contrast agents Is the stability ofthe contrast agent molecule an important factor in the pathogenesis of this condition BrJ Radiol 80 73-76,2007. 

Brown JJ, Hynes MR,Wible JH,Jr Measurement of serum calcium concentration after administration of four gadolinium-based contrast agents to human volunteers. Ad/ AmdRoenfgeno/189 1539-1544, 2007. 

Extracellular gadolinium-based contrast agents are still highly important in liver imaging. However, there are also tissue-specific contrast agents available, which allow for an increased detection rate and more specific characterization of focal and diffuse liver diseases. 

Recently, the measnrement of FITC-sinistrin using the transcutaneous device (optical GFR) was directly compared with simultaneous GFR measurements obtained from gadolinium-based contrast agent filtration in the MRI (MRI-GFR ZoUner et al., 2013). While discrepancies between the two detection methods were observed, the study demonstrated that MRI-GFR, similarly to optical GFR, allowed for visualization of the filtration function in healthy and unilateral nephrectomy rats (Zollner et al., 2013). 

Immunologic Two cases of anaphylactic shock after first exposure to gadolinium-based contrast agents have been described [28 ]. 

Figure 3 The EIDOS and DoTS descriptions of systemic fibrosis due to gadolinium-based contrast agents.

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