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Late gadolinium enhancement (LGE) and T1 mapping allow infarction and fibrosis to be identified for characterizing cardiomyopathy and assessing viability. [8] Magnetic resonance angiography may be performed with or without contrast medium and is used to assess congenital or acquired abnormalities of the coronary arteries and great vessels. [9]
Late gadolinium enhancement shows increased signal of the midwall at the inferolateral wall of the base of the left ventricle, usually in the non-hypertrophic ventricle. T1-weighted imaging can show low T1 signal due to sphingolipid storage in the heart even without ventricular hypertrophy in 40% of those affected by the disease.
As a free solubilized aqueous ion, gadolinium(III) is highly toxic, but the chelated compounds are generally regarded as safe for individuals without kidney disease. Free Gd 3+ has a median lethal dose of 0.34 mmol/kg (IV, mouse) [27] or 100–200 mg/kg, but the LD50 is increased by a factor of 31 times [28] when Gd 3+ is chelated. [29]
The drug, under the brand name Dotarem, was brought to market by Guerbet. [13] It was launched on French market in 1989 and was FDA-approved in United States in March 2013. [13] As of 2013, gadoteric acid was approved in around 70 countries. [14] [15] Dotarem is the seventh FDA-approved GBCA for use in central nervous system MRI. [citation needed]
Delayed Gadolinium-enhanced MR Imaging of Articular Cartilage: Three-dimensional T1 Mapping with Variable Flip Angles and B1 Correction; Toward Imaging Biomarkers for Glycosaminoglycans; Longitudinal Evaluation of Cartilage Composition of Matrix-Associated Autologous Chondrocyte Transplants with 3-T Delayed Gadolinium-Enhanced MRI of Cartilage
A 2015 study found gadolinium deposited in the brain tissue of people who had received gadodiamide. [8] Other studies using post-mortem mass spectrometry found most of the deposit remained at least 2 years after an injection and deposit also in individuals with no kidney issues.
It supports this diagnosis if it shows at least two of the following abnormalities: a) an increased signal in T2-weighted images; b) an increased global myocardial early enhancement ratio between myocardial and skeletal muscle in enhanced T1 images and c) one or more focal enhancements distributed in a non-vascular pattern in late enhanced T1 ...
Meanwhile, late gadolinium contrast (LGE) can detect fibrosis or scar. Lesions at the subpericardium and midwall enhancement of basal septum or inferolateral wall is strongly suggestive of sarcoidosis. [38] MRI can also follow up on the treatment efficacy of corticosteroids and prognosis of cardiac sarcoidosis. [106]