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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.
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
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.
Gadodiamide is a contrast medium used for cranial and spinal magnetic resonance imaging (MRI) and for general MRI of the body after intravenous administration. It provides contrast enhancement and facilitates visualisation of abnormal structures or lesions in various parts of the body including the central nervous system (CNS).
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.
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).
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.
Polymeric Gd 3+ chelates are large in size, which prevents leakage into the interstitial space, and provides long imaging windows. Several polymeric gadolinium-based BPAs are currently in development but have not yet been approved for clinical use: Gadomelitol (Guerbet, France), also known as Vistarem and P792 [19] Gadomer-17 (Schering AG, Berlin, Germany) also known as Gd-DTPA-17, SH L 643 A ...