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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.
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.
European guidelines classify a pre-existing decreased kidney function to be a risk factor of contrast-induced nephropathy in the following cases: [5]. Estimated glomerular filtration rate (eGFR) < 45 ml/min/1.73 m 2 of body surface area before intra-arterial administration with first-pass renal exposure (not passing lungs or peripheral circulation before kidneys), or in the intensive care unit
Gadodiamide is one of the main GBCA associated with nephrogenic systemic fibrosis (NSF), a toxic reaction occurring in some people with kidney problems. [6] 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]
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).
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. It may occur months after a contrast agent has been injected.
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.
A contrast agent (or contrast medium) is a substance used to increase the contrast of structures or fluids within the body in medical imaging. [1] Contrast agents absorb or alter external electromagnetism or ultrasound , which is different from radiopharmaceuticals , which emit radiation themselves.