Fretellier Nathalie, Idée Jean-Marc, Rasschaert Marlène, Factor Cécile, Van der Molen Aart J
GUERBET, Research Division, Roissy CDG, France (F.N., I.J-M., R.M., F.C.); Contrast Media Safety Research Group, Department of Radiology C-2S, Leiden University Medical Center, Leiden, The Netherlands (V.d.M.A.J.).
Invest Radiol. 2025 Nov 1;60(11):722-744. doi: 10.1097/RLI.0000000000001208.
Over the past 15 years, significant advancements have been made in understanding the pharmacology and toxicology of gadolinium-based contrast agents (GBCAs), widely used in magnetic resonance imaging (MRI). This review focuses on the fate of gadolinium cation (Gd 3+ ) in bone tissues. The evidence indicates that Gd 3+ can persist in bone for extended periods, with higher retention observed for GBCAs with linear ligand structures as opposed to macrocyclic ones. The prolonged presence of Gd, with a significant proportion in species other than the initial intact injected GBCA form, raises concerns about potential toxicological effects, although no direct clinical consequences on bone physiology have been reported so far. This review discusses the complex interactions between Gd 3+ and bone matrix components, such as hydroxyapatite, collagen, and proteoglycans, which might contribute to the mechanisms of Gd retention. It also explores the potential for Gd to interfere with bone remodelling processes and cellular functions, as suggested by in vitro studies, and in comparison with that known for other rare earth elements (REE).
在过去15年里，人们对广泛用于磁共振成像（MRI）的钆基造影剂（GBCAs）的药理学和毒理学的理解取得了重大进展。本综述聚焦于钆阳离子（Gd3+）在骨组织中的去向。证据表明，Gd3+可在骨中长时间存留，与大环结构的GBCAs相比，线性配体结构的GBCAs有更高的潴留率。钆的长期存在，且很大一部分以初始完整注射的GBCA形式以外的其他形式存在，引发了对潜在毒理学效应的担忧，尽管目前尚未报告对骨生理有直接临床后果。本综述讨论了Gd3+与骨基质成分（如羟基磷灰石、胶原蛋白和蛋白聚糖）之间的复杂相互作用，这可能有助于解释钆潴留的机制。它还探讨了如体外研究所表明的，钆干扰骨重塑过程和细胞功能的可能性，并与其他稀土元素（REE）的已知情况进行了比较。
