Zhang Hong Lei, Ersoy Hale, Prince Martin R
Department of Radiology, Weill Medical College of Cornell University, 416 East 55th Street, New York, NY 10022, USA.
J Magn Reson Imaging. 2006 Mar;23(3):383-7. doi: 10.1002/jmri.20517.
To investigate the in vivo effects of gadodiamide (Gd-DTPA-BMA) and gadopentetate dimeglumine (Gd-DTPA) on the laboratory measurements of serum calcium, magnesium, and creatinine.
Medical records from 1993 to 2004 were reviewed to identify inpatients for whom laboratory data were available regarding serum calcium, creatinine, and magnesium levels before and within one day after gadodiamide and gadopentetate dimeglumine enhanced MRI. Patients who underwent both gadolinium (Gd)-enhanced MRI and iodinated contrast-enhanced examinations on separate days within a six-month period were also identified to compare changes in serum creatinine.
Serum creatinine did not increase in 2788 cases following gadopentetate dimeglumine and gadodiamide injection. By comparison, serum creatinine increased from 1.21 to 1.28 mg/dL following iodinated contrast, and there were 20 cases (2.6%) of contrast-induced nephrotoxicity (P < 0.01). Gadopentetate dimeglumine did not affect serum calcium or magnesium measurements. Following 1157 gadodiamide-enhanced examinations, measured serum calcium spuriously dropped from 8.65 to 8.33 mg/dL (P < 0.0001) and 34 patients had spurious critical hypocalcemia (<6 mg/dL). Of 60 patients with high-dose gadodiamide injection and renal insufficiency, 36.7% (N = 22) had spurious critical hypocalcemia immediately post MRI. In 216 patients with renal insufficiency, the mean serum magnesium level increased slightly from 1.69 to 1.77 mEq/L following gadodiamide injection (P < 0.0001).
Gd-based contrast agents are safe for MRI and MR angiography (MRA), and do not induce nephrotoxicity. However, gadodiamide interferes with serum calcium and magnesium measurements-particularly at high doses and/or with renal insufficiency.
研究钆双胺（Gd-DTPA-BMA）和钆喷酸葡胺（Gd-DTPA）对血清钙、镁和肌酐实验室检测结果的体内影响。
回顾1993年至2004年的病历，以确定那些在钆双胺和钆喷酸葡胺增强MRI检查前及检查后一天内有血清钙、肌酐和镁水平实验室数据的住院患者。还确定了在六个月内不同日期接受钆（Gd）增强MRI和碘化对比剂增强检查的患者，以比较血清肌酐的变化情况。
注射钆喷酸葡胺和钆双胺后，2788例患者的血清肌酐未升高。相比之下，注射碘化对比剂后血清肌酐从1.21mg/dL升至1.28mg/dL，有20例（2.6%）发生对比剂诱导的肾毒性（P<0.01）。钆喷酸葡胺不影响血清钙或镁的检测结果。在1157例钆双胺增强检查后，测得的血清钙从8.65mg/dL假性下降至8.
