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Association between exposure to gadolinium-based contrast agents and neurotoxicity in patients who have undergone contrast MRI in a tertiary care hospital
Corresponding Author(s) : Arul.S
International Journal of Allied Medical Sciences and Clinical Research,
Vol. 9 No. 3 (2021): 2021 Volume - 9 Issue - 3
Abstract
Background
Magnetic resonance imaging (MRI) is the wildest emerging non invasive diagnostic modalities in medicine. It hires ground-breaking techniques and the latest discoveries, which are harmless actual, but even so it is tough to evade drawbacks particularly concerning lasting significances. The protection of gadolinium is now the most regularly deliberated.
Objectives
- To see if there's a link between gadolinium contrast and neurotoxicity
- Identification of newly developed neurotoxicity symptoms following the use of an MRI contrast agent
- Identifying changes in frequency and magnitude of pre-existing neurotoxicity symptoms that are linked to pre- and post-contrast medical history.
- To see if a single or many doses of intravenous gadolinium contrast are linked to new neurotoxicity symptoms and maybe additional side effects
Materials and Methods
The present study is a Retrospective study conducted among 45 patients selected by convenience sampling who undergo MRI brain contrast examination in the Department of Radiology for a period of one year.
Results
Majority of the study population were in the age group of 41-60 years (38%) Mean age is 48.76 and standard deviation is 7.86. There is no association between age and neurotoxicity. About 58% were males and 42% were females. About 78% of study participants were alive. Headache is the most common symptom (22%) followed by vision loss (18%). About 9% had memory loss and 7% had paralysis. About 4% had numbness and 4% had altered sensation. Among 10 patients with headache,2 developed it in the same day,6 within a week, and 2 within a month. Among numbness 1 developed in the same day and 1 in a week. Among vision loss 2 within a week and 6 developed within a month. Symptoms of neurotoxicity were present in 29% of study participants.
Conclusion
There are some associations between exposure to gadolinium based contrast agents and neurotoxicity. These neurotoxicity symptoms frequency and magnitude varying from number of time patients undergone MRI contrast study. Which may leading to gadolinium retention, gadolinium deposition disease and nephrogenic systemic fibrosis.
Keywords
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[1] Tamburrini O, Aprile I, Falcone C, et al. (2011) Off-label use of intravascular iodinated organic and MR contrast media. Radiol Med 116: 1–14.
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[7] Malayeri AA, Brooks KM, Bryant LH, et al. (2016) National Institutes of health perspective on reports of gadolinium deposition in the brain. J Am Coll Radiol 13: 237–241.
[8] Weinmann HJ, Brasch RC, Press WR, et al. (1984) Characteristics of gadolinium-DTPA complex: a potential NMR contrast agent. Am J Roentgenol 142: 619–624.
References
[2] Meloni MM, Barton S, Xu L, et al. (2017) Contrast agents for cardiovascular magnetic resonance imaging: an overview. J Mater Chem B 5: 5714–5725.
[3] Lauffer RB (1987) Paramagnetic metal complexes as water proton relaxation agents for NMR imaging: theory and design. Chem Rev 87: 901–927.
[4] Schörner W, Kazner E, Laniado M, et al. (1984) Magnetic resonance tomography (MRT) of intracranial tumours: Initial experience with the use of the contrast medium gadolinium-DTPA. Neurosurg Rev 7: 303–312.
[5] Essig M, Anzalone N, Combs SE, et al. (2012) MR imaging of neoplastic central nervous system lesions: review and recommendations for current practice. Am J Neuroradiol 33: 803–817.
[6] Anzalone N, Gerevini S, Scotti R, et al. (2009) Detection of cerebral metastases on magnetic resonance imaging: intraindividual comparison of gadobutrol with gadopentetate dimeglumine. Acta Radiol 50: 933–940.
[7] Malayeri AA, Brooks KM, Bryant LH, et al. (2016) National Institutes of health perspective on reports of gadolinium deposition in the brain. J Am Coll Radiol 13: 237–241.
[8] Weinmann HJ, Brasch RC, Press WR, et al. (1984) Characteristics of gadolinium-DTPA complex: a potential NMR contrast agent. Am J Roentgenol 142: 619–624.