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Update and good practice in the contrast media uses
Available online 20 November 2024
Extracellular gadolinium-based contrast agents
Medios de contraste basados en gadolinio de distribución extracelular
R. Soler-Fernández
Corresponding author
rafaelasoler@telefonica.net

Corresponding author.
, C. Méndez-Díaz, E. Rodríguez-García
Servicio de Radiología, Complejo Hospitalario Universitario A Coruña (CHUAC), A Coruña, Spain
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Tables (4)
Table 1. Extracellular gadolinium-based contrasts: biostructure, ionic charge and relaxivity in plasma at 37 °C.
Table 2. ESUR classification and recommendations on the use of GBCAs in cases of nephrogenic systemic fibrosis.12
Table 3. ACR classification and recommendations on the use of GBCAs in cases of nephrogenic systemic fibrosis.2
Table 4. Typical administration routes, doses and flow rates of extracellular GBCAs in specific clinical indications.
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Abstract

Extracellular gadolinium-based contrast agents (GBCA) are commonly used in magnetic resonance imaging (MRI) because they increase the detection of alterations, improve tissue characterisation and enable a more precise differential diagnosis. GBCAs are considered to be safe but they are not risk-free. When using GBCAs, it is important to be aware of the risks and to know how to react in different situations (pregnancy, breastfeeding, kidney failure) including if complications occur (extravasations, adverse, allergic or anaphylactic reactions). The article describes the characteristics of the gadolinium molecule, the differences in the biochemical structure of these GBCA, their biodistribution and the effect on the MRI signal. It also reviews safety aspects and the most common clinical applications.

Keywords:
Gadolinium
Magnetic resonance imaging
Contrast media
Patient safety
Resumen

Los contrastes de gadolinio (CGd) de distribución extracelular se utilizan frecuente-mente en resonancia magnética (RM) porque aumentan la detección de alteraciones, mejoran la caracterización tisular y permiten un diagnóstico diferencial más preciso.

Los CGd se consideran seguros, pero no están exentos de riesgo. Conocer los ries-gos, saber qué actitud adoptar en diferentes situaciones (embarazo, lactancia, insufi-ciencia renal) y cómo reaccionar si se producen complicaciones (extravasaciones, re-acciones adversas, alérgicas y anafilácticas) es imprescindible para el uso adecuado de los CGd.

Se presentan las características de la molécula de gadolinio, las diferencias en la es-tructura bioquímica, su biodistribución y el efecto sobre la señal de RM. Se revisan los aspectos de seguridad y las aplicaciones clínicas más frecuentes.

Palabras clave:
Gadolinio
Resonancia magnética
Medios de contrastes
Seguridad del paciente

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