Departmental Faculty of Medicine and Surgery, Unit of Diagnostic Imaging and Interventional Radiology, Università Campus Bio-Medico di Roma, Rome, Italy.
Section of Neuroradiology, Department of Radiology, Autonomous University of Barcelona and Hospital Vall d'Hebron, Passeig Vall d'Hebron, Barcelona, Spain.
Neuroradiology. 2020 Aug;62(8):925-934. doi: 10.1007/s00234-020-02434-8. Epub 2020 Apr 21.
Gadolinium is a rare-earth lanthanide metal that is known to have a direct neurotoxic effect. The scope of the present review is to summarize the current preclinical and clinical evidence on the association between exposure to gadolinium of the central nervous system and neurotoxicity.
A literature review was performed by searching for original research papers investigating on gadolinium exposure and neurotoxicity.
Gadolinium is neurotoxic through multiple mechanisms, mainly involving Ca homeostasis and mitochondrial functions, as shown by preclinical in vitro studies. The available evidence related to the four different classes of gadolinium-based contrast agents commonly applied in clinical practice (i.e., linear and macrocyclic based on ligand structure, and ionic and non-ionic based on their net molecular charge) suggests that serial intravenous injections of gadolinium-based contrast agents and gadolinium brain depositions are not associated to histological changes, as confirmed by preclinical animal and human (MR imaging and autopsy) studies.
To date, no cause-effect relationship has been demonstrated in patients between brain gadolinium exposure and clinical consequences specific to neurological toxicity.
钆是一种稀土金属元素，已知其具有直接的神经毒性作用。本综述的目的是总结目前关于中枢神经系统接触钆与神经毒性之间关联的临床前和临床证据。
通过搜索研究钆暴露和神经毒性的原始研究论文，进行文献回顾。
临床前体外研究表明，钆通过多种机制引起神经毒性，主要涉及钙稳态和线粒体功能。与临床上常用的四种不同类型的基于钆的造影剂（即基于配体结构的线性和大环，以及基于净分子电荷的离子型和非离子型）相关的现有证据表明，连续静脉注射基于钆的造影剂和钆在脑内沉积与组织学变化无关，这一点已被临床前动物和人体（磁共振成像和尸检）研究证实。
迄今为止，在患者中，尚未证明脑内钆暴露与特定于神经毒性的临床后果之间存在因果关系。
