- 日本小児放射線学会雑誌 (ISSN:09188487)
- vol.33, no.2, pp.91-96, 2017 (Released:2018-04-11)
Gadolinium (Gd)-based contrast agents (GBCA) are commonly used in magnetic resonance imaging (MRI), and are safe for the majority of patients. Adverse reactions to GBCA are classified into: 1) acute adverse reaction, which occurs within one hour of contrast medium injection, 2) late adverse reaction, which is defined as a reaction which occurs one hour to one week after contrast medium injection, and 3) very late adverse reaction, which is nephrogenic systemic fibrosis (NSF). The risk factors of acute adverse reaction include a history of acute reaction to GBCA, asthma, and atopy requiring medical treatment. The risk factors of NSF include dialysis, eGFR < 30 ml/min/1.73 m2, acute renal failure, and use of unstable linear-chelate GBCA. In recent studies, tissue retention of Gd after GBCA administration has been reported even in patients without renal dysfunction. Brain retention of Gd is able to be detected as an increased signal intensity of the brain tissue on T1-weighted images. Moreover, Gd retention has been detected in the skin, liver, kidney, lung, heart, and bones more often with linear-chelate GBCA than macrocyclic GBCA. In a study using pregnant mice, Gd was confirmed to be transferred to pups and was retained in their brain, leading to impaired brain development.