Kidney Institute of New Mexico, University of New Mexico Health Science Center, Albuquerque, NM, USA.
University of New Mexico Health Science Center, Albuquerque, NM, USA.
Sci Rep. 2023 Feb 4;13(1):2025. doi: 10.1038/s41598-023-28666-1.
The leitmotifs of magnetic resonance imaging (MRI) contrast agent-induced complications range from acute kidney injury, symptoms associated with gadolinium exposure (SAGE)/gadolinium deposition disease, potentially fatal gadolinium encephalopathy, and irreversible systemic fibrosis. Gadolinium is the active ingredient of these contrast agents, a non-physiologic lanthanide metal. The mechanisms of MRI contrast agent-induced diseases are unknown. Mice were treated with a MRI contrast agent. Human kidney tissues from contrast-naïve and MRI contrast agent-treated patients were obtained and analyzed. Kidneys (human and mouse) were assessed with transmission electron microscopy and scanning transmission electron microscopy with X-ray energy-dispersive spectroscopy. MRI contrast agent treatment resulted in unilamellar vesicles and mitochondriopathy in renal epithelium. Electron-dense intracellular precipitates and the outer rim of lipid droplets were rich in gadolinium and phosphorus. We conclude that MRI contrast agents are not physiologically inert. The long-term safety of these synthetic metal-ligand complexes, especially with repeated use, should be studied further.
磁共振成像（MRI）对比剂诱导并发症的主题包括急性肾损伤、与钆暴露相关的症状（SAGE）/钆沉积病、潜在致命性的钆性脑病和不可逆转的全身纤维化。钆是这些对比剂的有效成分，是一种非生理的镧系金属。MRI 对比剂诱导疾病的机制尚不清楚。用 MRI 对比剂处理小鼠。获得并分析了无对比剂和 MRI 对比剂治疗患者的人肾组织。用透射电子显微镜和带有 X 射线能量色散光谱的扫描透射电子显微镜评估肾脏（人和小鼠）。MRI 对比剂治疗导致肾上皮的单室囊泡和线粒体病。电子致密的细胞内沉淀物和脂滴的外边缘富含钆和磷。我们得出结论，MRI 对比剂不是生理惰性的。这些合成金属配体复合物的长期安全性，特别是在重复使用时，应进一步研究。
