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Gadolinium Brain MRI

Julian A Rees, Gauthier J-P Deblonde, Dahlia D An, Camille Ansoborlo, Stacey S Gauny, Rebecca J Abergel
Several MRI contrast agent clinical formulations are now known to leave deposits of the heavy metal gadolinium in the brain, bones, and other organs of patients. This persistent biological accumulation of gadolinium has been recently recognized as a deleterious outcome in patients administered Gd-based contrast agents (GBCAs) for MRI, prompting the European Medicines Agency to recommend discontinuing the use of over half of the GBCAs currently approved for clinical applications. To address this problem, we find that the orally-available metal decorporation agent 3,4,3-LI(1,2-HOPO) demonstrates superior efficacy at chelating and removing Gd from the body compared to diethylenetriaminepentaacetic acid, a ligand commonly used in the United States in the GBCA Gadopentetate (Magnevist)...
March 13, 2018: Scientific Reports
João Ferreira, Ana Franco, Tiago Teodoro, Miguel Coelho, Luísa Albuquerque
Vernet syndrome is a unilateral palsy of glossopharyngeal, vagus, and accessory nerves. Varicella zoster virus (VZV) infection has rarely been described as a possible cause. A 76-year-old man presented with 1-week-long symptoms of dysphonia, dysphagia, and weakness of the right shoulder elevation, accompanied by a mild right temporal parietal headache with radiation to the ipsilateral ear. Physical examination showed signs compatible with a right XI, X, and XI cranial nerves involvement and also several vesicular lesions in the right ear's concha...
March 12, 2018: Journal of Neurovirology
Ryan T Fitzgerald, Vikas Agarwal, Jenny K Hoang, Frank Gaillard, Andrew Dixon, Emanuel Kanal
RATIONALE AND OBJECTIVES: Brain deposition of gadolinium following the administration of gadolinium-based contrast agents (GBCAs) was initially reported in 2014. Gadolinium deposition is now recognized as a dose-dependent consequence of exposure. The potential clinical implications are not yet understood. The purpose of this study was to determine radiologists' reporting practices in response to gadolinium deposition. MATERIALS AND METHODS: An electronic survey querying radiologists' practices regarding gadolinium deposition was distributed by Radiopaedia...
February 7, 2018: Current Problems in Diagnostic Radiology
Richard Pullicino, Mark Radon, Shubhabrata Biswas, Maneesh Bhojak, Kumar Das
Over the past 3 years, gadolinium-based contrast agents have been linked to MRI signal changes in the brain, which have been found to be secondary to gadolinium deposition in the brain, particularly in the dentate nuclei and globus pallidus even in patients having an intact blood-brain barrier and a normal renal function. This tends to occur more in linear agents than with macrocyclic agents. Nonetheless, there has been no significant evidence that this has any clinical consequence. We reviewed the current evidence related to this new phenomenon and the precautionary approach taken by regulatory agencies...
March 9, 2018: Clinical Neuroradiology
Nghi C Nguyen, Melissa K Yee, Abuzar M Tuchayi, John M Kirkwood, Hussein Tawbi, James M Mountz
Introduction: This pilot study aimed at exploring the utility of the proliferation tracer F-18 fluorothymidine (FLT) and positron-emission tomography (PET)/magnetic resonance imaging (MRI) (FLT-PET/MRI) for early treatment monitoring in patients with melanoma brain metastasis (MBM) who undergo targeted therapy or immunotherapy. Material and Methods: Patients with newly diagnosed MBM underwent baseline and follow-up FLT-PET/MRI scans at 3-4 weeks of targeted therapy or immunotherapy...
2018: Frontiers in Oncology
Satoshi Namitome, Seigo Shindo, Kuniyasu Wada, Tadashi Terasaki, Makoto Nakajima, Yukio Ando
A 14-year-old girl developed transient disturbance of consciousness, dysarthria, and clumsiness of the right upper limb 4 months after herpes zoster ophthalmicus. Brain MRI showed acute cerebral infarction in the left middle cerebral artery (MCA) territory. CT angiography demonstrated mild stenosis in the top of the left internal carotid artery and the proximal side of the MCA. Cerebrospinal fluid (CSF) examination showed slightly mononuclear pleocytosis (6/μl). Titer of the anti-varicella zoster virus (VZV) IgG antibodies in CSF was increased, and gadolinium-enhanced brain MRI (T1 -weighted imaging) revealed enhancement of the vessel walls at the stenotic lesions...
February 28, 2018: Rinshō Shinkeigaku, Clinical Neurology
Lei Pei, Jingjing Xu, Minming Zhang
OBJECTIVE: To explore the correlation between the number of previous gadolinium-based contrast agent administrations and high signal intensity (SI) in the cerebrum nucleus on unenhanced T1 -weighted magnetic resonance images. METHODS: Thirty-nine patients who previously underwent at least three contrast-enhanced brain MRI examinations were enrolled in the study. The right globus pallidus, right thalamus, right dentate nucleus, pons and white matter of right frontal lobe were selected as region of interests (ROI)...
May 25, 2017: Zhejiang da Xue Xue Bao. Yi Xue Ban, Journal of Zhejiang University. Medical Sciences
Hannah Aucott, Johan Lundberg, Henna Salo, Lena Klevenvall, Peter Damberg, Lars Ottosson, Ulf Andersson, Staffan Holmin, Helena Erlandsson Harris
BACKGROUND: Neuroinflammation triggered by infection or trauma is the cause of central nervous system dysfunction. High-mobility group box 1 protein (HMGB1), released from stressed and dying brain cells, is a potent neuroinflammatory mediator. The proinflammatory functions of HMGB1 are tightly regulated by post-translational redox modifications, and we here investigated detailed neuroinflammatory responses induced by the individual redox isoforms. METHODS: Male Dark Agouti rats received a stereotactic injection of saline, lipopolysaccharide, disulfide HMGB1, or fully reduced HMGB1, and were accessed for blood-brain barrier modifications using magnetic resonance imaging (MRI) and inflammatory responses by immunohistochemistry...
February 23, 2018: Journal of Innate Immunity
Justyna Rogowska, Ewa Olkowska, Wojciech Ratajczyk, Lidia Wolska
Since the 1980 s, gadolinium based contrast agents (GBCA) are routinely used in magnetic resonance imaging (MRI) as stable chelates of the Gd3+ ion, without toxic effects. Generally, GBCAs are considered as some of the safest contrast agents. However, it has been observed that they can accumulate in patients tissue, bone and probably in brain (causing nephrogenic systemic fibrosis in patients with kidney failure, insufficiency and disturbance of calcium homeostasis in the organism). The GBCAs are predominantly removed renally without metabolization...
February 23, 2018: Environmental Toxicology and Chemistry
Caroline Bund, Benoît Lhermitte, Jérôme De Seze, Stéphane Kremer, Izzie-Jacques Namer
A 64-year-old man was admitted for expressive aphasia with lack of words. He had been diagnosed with Waldenström 4 years before. At that time, he received 6 cycles of single-agent fludarabine, and remission was obtained. Because of acute expressive aphasia, he underwent brain MRI, which showed frontoparietal and insular subcortical gadolinium enhancement; Bing-Neel syndrome was suspected. Fronto-temporo-insular hypometabolism and left parietal hypometabolism were highlighted on FDG PET/CT. Structural and functional brain imaging revealed impairment of brain areas due to white matter changes and reinforced the diagnosis...
February 21, 2018: Clinical Nuclear Medicine
R Pullicino, K Das
Gadolinium-based contrast agents have greatly expanded the capability of magnetic resonance imaging and have been used extensively in neuroradiology over the past 30 years. When initially developed they were thought to be relatively harmless; it was later discovered they are associated with nephrogenic systemic fibrosis and should be used with caution in certain patient groups, especially those with renal failure. Lately it has been found that the use of these contrast agents may result in deposition of gadolinium in the brain even in patients with an intact blood-brain barrier...
September 2017: Journal of the Royal College of Physicians of Edinburgh
Michael Karsy, Daxa M Patel, Robert J Bollo
Magnetic resonance imaging-guided stereotactic laser ablation of intracranial targets, including brain tumors, has expanded dramatically over the past decade, but there have been few reports of complications, especially those occurring in a delayed fashion. Laser ablation of subependymal giant cell astrocytomas (SEGAs) is an attractive alternative to maintenance immunotherapy in some children with tuberous sclerosis complex (TSC); however, the effect of treatment on disease progression and the nature and frequency of potential complications remains largely unknown...
February 16, 2018: Journal of Neurosurgery. Pediatrics
Enhao Gong, John M Pauly, Max Wintermark, Greg Zaharchuk
BACKGROUND: There are concerns over gadolinium deposition from gadolinium-based contrast agents (GBCA) administration. PURPOSE: To reduce gadolinium dose in contrast-enhanced brain MRI using a deep learning method. STUDY TYPE: Retrospective, crossover. POPULATION: Sixty patients receiving clinically indicated contrast-enhanced brain MRI. SEQUENCE: 3D T 1 -weighted inversion-recovery prepped fast-spoiled-gradient-echo (IR-FSPGR) imaging was acquired at both 1...
February 13, 2018: Journal of Magnetic Resonance Imaging: JMRI
Alexander Klistorner, Chenyu Wang, Con Yiannikas, John Parratt, Michael Dwyer, Joshua Barton, Stuart L Graham, Yuyi You, Sidong Liu, Michael H Barnett
Objective: Using diffusion tensor imaging (DTI), we examined chronic stable MS lesions, peri-lesional white matter (PLWM) and normal appearing white matter (NAWM) in patients with relapsing-remitting multiple sclerosis (RRMS) for evidence of progressive tissue destruction and evaluated whether diffusivity change is associated with conventional MRI parameters and clinical findings. Method: Pre- and post-gadolinium T1, T2 and DTI images were acquired from 55 consecutive RRMS patients at baseline and 42...
2018: NeuroImage: Clinical
Asuka Asanome, Kohei Kano, Kae Takahashi, Tsukasa Saito, Jun Sawada, Takayuki Katayama
A 58-year-old female was admitted to our hospital because of recurrent multiple cranial neuropathy (right facial palsy followed by involvement of the left trigeminal, facial, acoustic, pharyngeal, and vagal nerves and the right abducens nerve). Brain MRI showed gadolinium enhancement of the right abducens, bilateral facial/acoustic, and left pharyngeal/vagal nerves, and 18F-Fluorodeoxyglucose (FDG)-positron emission tomography revealed abnormal FDG uptake in the right facial, acoustic, pharyngeal, and vagal nerves and the left cervical lymph nodes...
January 31, 2018: Rinshō Shinkeigaku, Clinical Neurology
Antoine P Fournier, Maxime Gauberti, Aurélien Quenault, Denis Vivien, Richard Macrez, Fabian Docagne
An alteration of parenchymal cerebrospinal fluid circulation (CSF) has been proposed to take part in the pathophysiology of multiple sclerosis. By using an intragate T1-weighted high-resolution MRI of the spinal cord of freely breathing mice injected with a gadolinium chelate in the cisterna magna, we show that a parenchymal CSF circulation exists in the spinal cord, in addition to that originally described in the brain. In experimental autoimmune encephalomyelitis, a model of multiple sclerosis, we show a reduction of parenchymal CSF circulation specifically in the spinal cord but not in the brain...
January 1, 2018: Journal of Cerebral Blood Flow and Metabolism
Min-Chi Ku, Sonia Waiczies, Thoralf Niendorf, Andreas Pohlmann
The integrity of the blood-brain barrier (BBB) can be noninvasively monitored by magnetic resonance imaging (MRI). Conventional MR contrast agents (CAs) containing gadolinium are used in association with MRI in routine clinical practice to detect and quantify BBB leakage. Under normal circumstances CAs do not cross the intact BBB. However due to their small size they extravasate from the blood into the brain tissue even when the BBB is partially compromised. Here we describe an MR method based on T1-weighted images taken prior to and after CA injection...
2018: Methods in Molecular Biology
Liuyu Yu, Jianhong Sun, Jiayu Sun, Jiangbo Li, Yang Dong, Xiaoyue Zhou, Andreas Greiser, Yuchi Han, Qing Zhang, Qibing Xie, Yucheng Chen
BACKGROUND: Polymyositis (PM) and dermatomyositis (DM) are common types of idiopathic inflammatory myopathy (IIM), wherein patients are prone to adverse cardiovascular events. PURPOSE: To explore the value of cardiac magnetic resonance imaging (MRI) for detecting cardiac involvement in PM/DM patients using a T1 mapping technique. STUDY TYPE: Prospective observational study. POPULATION: In all, 25 PM/DM patients free of cardiovascular symptoms and preserved ventricular systolic function and 25 healthy volunteers matched for age and sex served as controls...
January 12, 2018: Journal of Magnetic Resonance Imaging: JMRI
Pietro Maggi, Martina Absinta, Matteo Grammatico, Luisa Vuolo, Giacomo Emmi, Giovanna Carlucci, Gregorio Spagni, Alessandro Barilaro, Anna Maria Repice, Lorenzo Emmi, Domenico Prisco, Vittorio Martinelli, Roberta Scotti, Niloufar Sadeghi, Gaetano Perrotta, Pascal Sati, Bernard Dachy, Daniel S Reich, Massimo Filippi, Luca Massacesi
OBJECTIVES: In multiple sclerosis (MS), magnetic resonance imaging (MRI) is a sensitive tool for detecting white matter lesions, but its diagnostic specificity is still suboptimal; ambiguous cases are frequent in clinical practice. Detection of perivenular lesions in the brain (the "central vein sign") improves the pathological specificity of MS diagnosis, but comprehensive evaluation of this MRI biomarker in MS-mimicking inflammatory and/or autoimmune diseases, such as central nervous system (CNS) inflammatory vasculopathies, is lacking...
February 2018: Annals of Neurology
Michael J Potchen, Samuel D Kampondeni, Karl B Seydel, E Mark Haacke, Sylvester S Sinyangwe, Musaku Mwenechanya, Simon J Glover, Danny A Milner, Eric Zeli, Colleen A Hammond, David Utriainen, Kennedy Lishimpi, Terrie E Taylor, Gretchen L Birbeck
The hallmark of pediatric cerebral malaria (CM) is sequestration of parasitized red blood cells in the cerebral microvasculature. Malawi-based research using 0.35 Tesla (T) magnetic resonance imaging (MRI) established that severe brain swelling is associated with fatal CM, but swelling etiology remains unclear. Autopsy and clinical studies suggest several potential etiologies, but limitations of 0.35 T MRI precluded optimal investigations into swelling pathophysiology. A 1.5 T MRI in Zambia allowed for further investigations including susceptibility-weighted imaging (SWI)...
January 8, 2018: American Journal of Tropical Medicine and Hygiene
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