Podcast 582:  Gadolinium - The Contrast of MRI

Podcast 582: Gadolinium - The Contrast of MRI

Contributor: Michael Hunt, MD

Educational Pearls:

  • Contrast agents are commonly used for X-rays and CT's to better characterize disease, but contrast doesn't work with MRI. That's where the element Gadolinium comes into play.
  • Gadolinium, element 64, is ferromagnetic (attracted to iron) below 68 degrees and above that temperature it's paramagnetic which makes it useful in MRI (Magnetic Resonance Imaging).
  • Gadolinium is toxic alone, but when paired with chelators it can be used in humans and allows for better characterization of tumors or abnormal tissue on MRI.
  • It helps identify this abnormal tissue because when MRI causes polarization of our body's cells, the gadolinium, which has the maximum number of unpaired electrons in its orbital shells, alters the rate of decay in abnormal tissue highlighting abnormalities on imaging.
  • Gadolinium can also be used in the treatment of cancers because it collects in the cells of abnormal tissue, allowing for more targeted therapies.
  • In people exposed to gadolinium, the anaphylaxis rate is low, below 1/1000, and in rare cases there are reports of kidney injury and nephrogenic systemic fibrosis which is why it's not recommended in renal failure patients.

References

1)Ibrahim MA, Hazhirkarzar B, Dublin AB. Magnetic Resonance Imaging (MRI) Gadolinium. [Updated 2020 Mar 9]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482487/

2)Pasquini L, Napolitano A, Visconti E, et al. Gadolinium-Based Contrast Agent-Related Toxicities [published correction appears in CNS Drugs. 2018 May 15;:]. CNS Drugs. 2018;32(3):229-240. doi:10.1007/s40263-018-0500-1

Summarized by Jackson Roos, MS4 | Edited by Erik Verzemnieks, MD

Jaksot(1145)

Episode 905: Oseltamivir (Tamiflu) for Influenza

Episode 905: Oseltamivir (Tamiflu) for Influenza

Contributor: Aaron Lessem MD Educational Pearls:  Oseltamivir (Tamiflu) is an antiviral medication used commonly to treat influenza Trials show that the medication reduces the duration of illness ...

27 Touko 20242min

Episode 904: Cardiovascular Risks of Epinephrine

Episode 904: Cardiovascular Risks of Epinephrine

Contributor: Aaron Lessen MD Educational Pearls: Epinephrine is essential in the treatment of anaphylaxis, but is epinephrine dangerous from a cardiovascular perspective? A 2024 study in the Journal o...

20 Touko 20242min

Episode 903: Treating Precipitated Opioid Withdrawal

Episode 903: Treating Precipitated Opioid Withdrawal

Contributor: Aaron Lessen MD Educational Pearls: Opioid overdoses that are reversed with naloxone (Narcan), a mu-opioid antagonist, can precipitate acute withdrawal in some patients Treatment of o...

13 Touko 20242min

Episode 902: Liver Failure and Cirrhosis

Episode 902: Liver Failure and Cirrhosis

Contributor: Travis Barlock MD Educational Pearls: How do you differentiate between compensated and decompensated cirrhosis? Use the acronym VIBE to look for signs of being decompensated. V-Volume ...

6 Touko 20243min

Episode 901: Underdosing in Status Epilepticus

Episode 901: Underdosing in Status Epilepticus

Contributor: Aaron Lessen MD Educational Pearls: Lorazepam (Ativan) is dosed at 0.1 mg/kg up to a maximum of 4 mg in status epilepticus Some ED protocols only give 2 mg initially The maximum r...

29 Huhti 20242min

Episode 900: Ketamine Dosing

Episode 900: Ketamine Dosing

Contributor: Travis Barlock MD Educational Pearls: Ketamine is an NMDA receptor antagonist with a wide variety of uses in the emergency department. To dose ketamine remember the numbers 0.3, 1, and 3....

22 Huhti 20242min

Episode 899: Thrombolytic Contraindications

Episode 899: Thrombolytic Contraindications

Contributor: Travis Barlock MD Educational Pearls: Thrombolytic therapy (tPA or TNK) is often used in the ED for strokes Use of anticoagulants with INR > 1.7 or  PT >15 Warfarin will reliably i...

15 Huhti 20243min

Episode 898: Takotsubo Cardiomyopathy

Episode 898: Takotsubo Cardiomyopathy

Contributor: Ricky Dhaliwal, MD Educational Pearls: Takotsubo cardiomyopathy, also known as "broken heart syndrome," is a temporary heart condition that can mimic the symptoms of a heart attack, inc...

10 Huhti 20243min

Suosittua kategoriassa Tiede

tiedekulma-podcast
rss-mita-tulisi-tietaa
rss-poliisin-mieli
docemilia
radio-antro
rss-duodecim-lehti
rss-ammamafia
rss-sosiopodi
utelias-mieli
ihanat-ipanat
mielipaivakirja
filocast-filosofian-perusteet
rss-bios-podcast
rss-tiedetta-vai-tarinaa