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Nephrogenic systemic fibrosis is a rare syndrome that involves fibrosis of the skin, joints, eyes, and internal organs. NSF is caused by exposure to gadolinium in gadolinium-based MRI contrast agents (GBCAs) in patients with impaired kidney function.
Gadoteric acid, sold under the brand name Dotarem among others, is a macrocycle-structured gadolinium-based MRI contrast agent (GBCA).It consists of the organic acid DOTA as a chelating agent, and gadolinium (Gd 3+), and is used in form of the meglumine salt (gadoterate meglumine).
While NSF is a severe form of disease, gadolinium deposition disease (GDD) is a mild variant with pain (e.g. headache), fatigue, and / or gadolinium depositions. [ 26 ] 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.
The contrast-enhancing effect is a result of the neutral complex of gadolinium and dihydroxy-hydroxymethylpropyl- tetraazacyclododecane-triacetic acid (butrol), which works to decrease differences in longitudinal relaxation times (T1) and differences in spin-spin or transverse relaxation times (T2).
Contrast-induced nephropathy (CIN) is a purported form of kidney damage in which there has been recent exposure to medical imaging contrast material without another clear cause for the acute kidney injury. Despite extensive speculation, the actual occurrence of contrast-induced nephropathy has not been demonstrated in the literature. [1]
No cases have been seen in people with normal kidney function. [7] 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.
In patients with kidney failure, there is a risk of a rare but serious illness called nephrogenic systemic fibrosis (NSF) [61] that is caused by the use of gadolinium-based contrast agents. The disease resembles scleromyxedema and to some extent scleroderma .
Iodinated contrast contains iodine.It is the main type of radiocontrast used for intravenous administration.Iodine has a particular advantage as a contrast agent for radiography because its innermost electron ("k-shell") binding energy is 33.2 keV, similar to the average energy of x-rays used in diagnostic radiography.