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Ionic Intravenous Contrast AgentsInfoSheet: - Contrast Agents - 
Intro, Overview, 
Characteristics, 
Types of, 
etc.MRI Resource Directory:
 - Contrast Agents -
 
Intravenous contrast agents used in MRI are distributed in the extracellular spaces of the body before being excreted. In this sense they are similar to iodinated X-ray contrast media. However, contrast agents used for MRI are quite different from conventional radiographic contrast media in structure and function and there is no known cross sensitivity between these types of contrast agents. Common MRI contrast agents use metal ions (e.g., gadolinium or manganese) complexed with organic molecules.
Gd-DTPA, an ionic linear molecule complex (gadopentetate dimeglumine) was the first marketed MRI contrast agent. Although the osmolality of this substances can be relatively high (up to 1940 mOsm/kg H2O) compared with plasma, adverse reactions and side effects are very rare. The used doses are smaller compared with radiographic contrast media.

See also Nonionic Intravenous Contrast Agents, Dotarem®, and Magnevist®.
 
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Further Reading:
  Basics:
FDA Approves First Macrocyclic and Ionic Gadolinium-Contrast Agent for MRI
Friday, 22 March 2013   by www.itnonline.com    
  News & More:
Spurious Hypocalcemia After Omniscan- or OptiMARK-Enhanced Magnetic Resonance Imaging: An Algorithm for Minimizing a False-Positive Laboratory Value
   by arpa.allenpress.com    
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Nonionic Intravenous Contrast AgentsInfoSheet: - Contrast Agents - 
Intro, Overview, 
Characteristics, 
Types of, 
etc.MRI Resource Directory:
 - Contrast Agents -
 
Radiographic low-osmolar nonionic contrast agents have less side effects and fewer nephrotoxicity than ionic, high-osmolar agents. Gadolinium-based MRI contrast agents have a different formulation from iodinated X-ray contrast media, and there is no known cross sensitivity between these two types of contrast agents. Intravenous MRI contrast agents, specifically the gadolinium chelates have a high safety and lack of nephrotoxicity compared with X-ray contrast media.
The used gadolinium chelates differ in following properties: linear (e.g., gadodiamide and gadoversetamide have nonionic linear structures) vs. macrocyclic cores, and ionic vs. nonionic types. The nonionic molecules have lower osmolality and viscosity, which increase digestibility at greater concentrations, and make faster bolus injections conceivable. The macrocyclic molecules (e.g., gadoteridol has a nonionic macrocyclic ring structure) are more stable and show fewer tendencies to dissociate free Gd.

See also ProHance®, Omniscan®, OptiMARK®, Ionic Intravenous Contrast Agents.

See also the related poll result: 'MRI will have replaced 50% of x-ray exams by'
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Further Reading:
  News & More:
Spurious Hypocalcemia After Omniscan- or OptiMARK-Enhanced Magnetic Resonance Imaging: An Algorithm for Minimizing a False-Positive Laboratory Value
   by arpa.allenpress.com    
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Nephrogenic Systemic FibrosisForum -
related threads
 
(NSF) Nephrogenic systemic fibrosis is a rare and highly debilitating disorder that involves extensive thickening and hardening of the skin with fibrotic nodules and plaques.
MRI contrast media have very low side effects, but accumulating data indicate that gadolinium-based contrast agents increase the risk for the development of NSF among patients with severe renal insufficiency or renal dysfunction due to the hepato-renal syndrome or in the perioperative liver transplantation period.
Due to this reason, gadolinium contrast agents are now considered contraindicated in patients with an estimated glomerular filtration rate fewer than 30 mL/min/1.73m2. In these patients, avoid use of gadolinium-based contrast agents unless the diagnostic information is essential and not available with non-contrast enhanced magnetic resonance imaging (MRI).

Recognized or possibly associated factors for NSF:
Severe renal failure;
high dose of gadolinium chelate;
high dose of erythropoietin;
high serum phosphate levels;
high serum calcium levels;
major surgery, infection, vascular event;
history of hypothyroidism;
metabolic acidosis.

When administering a gadolinium-based contrast agent, do not exceed the recommended dose and allow a sufficient period of time for elimination of the contrast medium from the body prior to any readminstration. Screen all patients for renal dysfunction by obtaining a history and/or laboratory tests.

See also Contrast Medium, Adverse Reaction, MRI Risks, MRI Safety, Ionic Intravenous Contrast Agents, Nonionic Intravenous Contrast Agents, and Contraindications.
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Further Reading:
  Basics:
Important Drug Warning for Gadolinium-Based Contrast Agents
Wednesday, 12 September 2007   by www.ismrm.org    
European Medicines Agency makes recommendations to minimise risk of nephrogenic systemic fibrosis with gadolinium-containing contrast agents
Friday, 20 November 2009   by www.ema.europa.eu    
Gadolinium-based MR Contrast Agents and Nephrogenic Systemic Fibrosis
Thursday, 1 March 2007   by radiology.rsna.org    
NSF-Active and NSF-Inert Species of Gadolinium: Mechanistic and Clinical Implications
Friday, 27 June 2008   by www.ajronline.org    
  News & More:
Questions and Answers on Gadolinium-Based Contrast Agents
Friday, 9 January 2009   by www.fda.gov    
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GadodiamideInfoSheet: - Contrast Agents - 
Intro, Overview, 
Characteristics, 
Types of, 
etc.
 
Short name: Gd-DTPA-BMA, generic name: Gadodiamide, chemical compound: Gd-diethylenetriaminepentaacetate-bis(methylamide), central moiety: Gd
A paramagnetic MRI contrast agent (nonionic) with a small molecular weight linear chelate. Due to the linkage of two DTPA molecules through amide bonds the molecule is uncharged and has a low osmolality. The substance is excreted almost exclusively by the kidneys.

See also Nonionic Intravenous Contrast Agents and Omniscan®.
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Magnevist®InfoSheet: - Contrast Agents - 
Intro, Overview, 
Characteristics, 
Types of, 
etc.MRI Resource Directory:
 - Contrast Agents -
 
Magnevist® is a paramagnetic ionic contrast agent for use in magnetic resonance imaging. Contrast enhanced MRI with Magnevist® allows additional diagnostic information of tumors, inflammation and vascular lesions and the determination or differentiation of such lesions.
The contrast enhancing effect is produced by the di-N-methylglucamine salt of gadopentetate (Gd-DTPA), the gadolinium complex of diethylenetriamine pentaacetic acid. Magnevist® has the strongest effect on T1 weighted images, by increasing T1 signal intensity in tissues where Magnevist® has accumulated.

WARNING: NEPHROGENIC SYSTEMIC FIBROSIS Gadolinium-based contrast agents increase the risk for nephrogenic systemic fibrosis (NSF) in patients with acute or chronic severe renal insufficiency (glomerular filtration rate less than 30 mL/min/1.73m2), or acute renal insufficiency of any severity due to the hepato-renal syndrome or in the perioperative liver transplantation period.

See also Ionic Intravenous Contrast Agents and Gadopentetate Dimeglumine.
Drug Information and Specification
CENTRAL MOIETY
Gd3+
CONTRAST EFFECT
T1, Predominantly positive enhancement
r1=3.4, r2=3.8, B0=1.0T
PHARMACOKINETIC
Intravascular, extracellular, renal excretion
1960 mosm/kgH2O
CONCENTRATION
0.5 mol/L
DOSAGE
0.1-0.3 mmol/kg / 0.2-0.6 mL/kg
PREPARATION
Finished product
INDICATION
Neuro/whole body
DEVELOPMENT STAGE
For sale
DISTRIBUTOR
See below
PRESENTATION
Vials of 5, 10, 15, 20 and 100 mL bulk package
Pre-filled syringes of 10, 15 and 20 mL
DO NOT RELY ON THE INFORMATION PROVIDED HERE, THEY ARE
NOT A SUBSTITUTE FOR THE ACCOMPANYING PACKAGE INSERT!
Distribution Information
TERRITORY
TRADE NAME
DEVELOPMENT
STAGE
DISTRIBUTOR
USA, Canada
Magnevist®
for sale
Asia
Magnevist®
for sale
EU
Magnevist®
suspended
Turkey
Magnevist®, Magnograf
for sale
Australia
Magnevist®
for sale
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Further Reading:
  Basics:
Magnevist Prescription Drug Discount Sources
   by www.institutedc.org    
Important Drug Warning for Gadolinium-Based Contrast Agents
Wednesday, 12 September 2007   by www.ismrm.org    
MAGNEVIST ® (brand of gadopentetate dimeglumine) Injection - WARNING: NEPHROGENIC SYSTEMIC FIBROSIS
May 2009   by berlex.bayerhealthcare.com    
Magnevist Package Insert
2000
  News & More:
EMA's final opinion confirms restrictions on use of linear gadolinium agents in body scans
Friday, 21 July 2017   by www.ema.europa.eu    
Gadolinium-containing contrast agents: removal of Omniscan and iv Magnevist, restrictions to the use of other linear agents
Friday, 5 January 2018   by www.gov.uk    
FDA Drug Safety Communication: FDA warns that gadolinium-based contrast agents (GBCAs) are retained in the body; requires new class warnings
Tuesday, 19 December 2017   by www.fda.gov    
Spurious Hypocalcemia After Omniscan- or OptiMARK-Enhanced Magnetic Resonance Imaging: An Algorithm for Minimizing a False-Positive Laboratory Value
October 2004   by www.findarticles.com    
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