Good MRI images: to Gad or not to Gad?

Steen, Henning; Schwenger, Vedat

doi:10.1007/s00467-007-0509-z

Cited by 19 publications

(9 citation statements)

References 19 publications

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“…It is important to consider the radiation exposure from CT and safety issues of gadolinium in MR imaging. There are published guidelines for the avoidance of gadolinium in patients with renal insufficiency and in infants below 1 year of age [21].…”

Section: Discussionmentioning

confidence: 99%

Idiopathic mid-aortic syndrome in children

et al. 2008

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Mid-aortic syndrome (MAS) is an uncommon condition characterized by narrowing of the abdominal aorta and stenosis of its major branches. Our goal was to illustrate the presentation, diagnosis and management of six new cases of idiopathic MAS together with 96 cases of idiopathic MAS from the literature. The mean age of the 102 cases was 14.3 years (19 days to 49 years). Our patient who presented at 19 days of age is the youngest reported to date. Clinical presentations included hypertension (94%), claudication (17%), renal failure (4%) and intestinal ischemia (1%). Angiography was the diagnostic imaging study of choice. Renal arteries were involved in 91% of patients, while the superior mesenteric artery and celiac artery were involved in 35%. Thirteen percent of cases were managed medically, and the remainder was treated surgically. Our experience shows that initial conservative blood pressure management of idiopathic MAS is feasible unless medical control of hypertension is unsatisfactory, renal function is at risk or there are symptoms of claudication or intestinal ischemia. Careful timing and planning of a surgical intervention is possible for most cases and may, in select cases, be considered after completion of puberty to allow growth to be completed.

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Section: Discussionmentioning

confidence: 99%

Idiopathic mid-aortic syndrome in children

et al. 2008

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“…Serum-creatinine levels were measured only once, 16-80 hr after MRI, to determine early CIN, thus overlooking any possible later peaks in Serum-creatinine concentrations. In addition, risk factors for AKI, such as congestive heart failure and administration of nephrotoxic drugs, were not evaluated (Steen and Schwenger, 2007).…”

Section: Discussionmentioning

confidence: 99%

“…However, the half-life of Gd has been shown longer in patients with end-stage renal disease (ESRD) than in healthy individuals. The safe dose of Gd is unknown in patients with mildly diminished renal failure (Perazella, 2009;Steen and Schwenger, 2007).…”

Section: Introductionmentioning

confidence: 99%

Comparison of nephrotoxicity between two gadolinium-contrasts, gadodiamide and gadopentetate in patients with mildly diminished renal failure

et al. 2017

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-Although gadolinium (Gd)-based contrast media have been found to be nephrotoxic, their nephrotoxicity, and the dependence of nephrotoxicity on chelate types, have not been assessed in patients with normal or mildly diminished renal failure. This prospective, randomized study compared the nephrotoxicity of low doses of the nonionic Gd-based contrast medium gadodiamide (Omniscan®) and the ionic Gd-based contrast medium gadopentetate (Magnevist®) in patients with serum creatinine < 1.6 mg/dL. Patients aged 20 to 80 years, weighing 45 to 70 kg and with normal or < 1.6 mg/dL Serumcreatinine in the 3 months prior to undergoing magnetic resonance imaging (MRI) of brain, were enrolled. Patients were randomized to receive 0.1 mol/kg gadodiamide or gadopentetate. Serum-creatinine, serum cystatin-C, estimated glomerular filtration rate (eGFR) using the Modification of Diet in Renal Disease (MDRD) formula, and estimated creatinine clearance rate (eCCr) using the Cockcroft-Gault formula were measured just before and 16-80 hr after MRI. Groups were compared statistically by Mann-Whitney U-tests and Wilcoxon signed-rank tests. There were no significant differences in clinical characteristics between the gadodiamide (n = 43) and gadopentetate (n = 59) groups. Serum-creatinine, eGFR and eCCr before and 16-80 hr after MRI did not differ significantly within either group or between the two groups. Serum cystatin-C was significantly higher 16-80 hr after than before MRI only in the gadodiamide group (0.79 ± 0.21 vs. 0.74 ± 0.14 mg/L, p = 0.028). The ionic contrast medium, gadopentetate, did not affect renal function during MRI, whereas the nonionic contrast medium, gadodiamide, affected renal function transiently.

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“…In the past, GBCAs were considered not to be nephrotoxic, and the doses escalated. As the doses increased, it became evident that GBCAs are nephrotoxic [28,59]. Gd is less radio-dense than iodine is, and higher doses are required to produce the same attenuation on standard X-ray imaging [60].…”

Section: Preventionmentioning

confidence: 99%

Nephrogenic systemic fibrosis and the use of gadolinium-based contrast agents

Penfield

2008

Pediatr Nephrol

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Nephrogenic systemic fibrosis (NSF) is a disease seen exclusively in patients with decreased renal function. The use of gadolinium-based contrast agents (GBCAs) has a strong association with NSF. Linear non-ionic GBCAs that are more prone to release free gadolinium are the more likely to cause NSF. The number of reported cases has increased recently, and there are currently nine pediatric cases, the patients ranging in age from 8 years to 19 years, and the oldest adult patient is 87 years of age. The most successful treatment is improvement of renal function with renal transplantation or with recovery of acute kidney injury. NSF can be severely debilitating and even fatal. Avoidance of a GBCA in patients at risk, or limitation of the dose in the patients who need gadolinium enhancement, is recommended.

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Good MRI images: to Gad or not to Gad?

Abstract: Gadolinium-based magnetic resonance imaging (MRI) contrast agents (Gad-CA) were formerly considered as alternatives to X-ray-employed iodinated media.

Cited by 19 publications

References 19 publications

Idiopathic mid-aortic syndrome in children

Idiopathic mid-aortic syndrome in children

Comparison of nephrotoxicity between two gadolinium-contrasts, gadodiamide and gadopentetate in patients with mildly diminished renal failure

Nephrogenic systemic fibrosis and the use of gadolinium-based contrast agents

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