Radiology:动物试验表明钆剂无神经毒性

2022-01-04 影像小生 MedSci原创

在大鼠模型中,在超诊断剂量钆造影剂暴露后,没有观察到神经毒性的临床证据。

MRI在临床医学诊断中发挥着不可估量的临床作用。MRI检查提供优越的软组织轮廓,而没有暴露于电离辐射固有的其他诊断成像方式。钆造影剂(GBCA)进一步扩大了MRI在各种疾病过程检测中的应用,这些疾病过程在非增强MRI或其他成像模式下无法检测到。

 由于人们担心静脉注射钆造影剂后残留在脑组织中的钆可能具有神经毒性,导致了全球范围内钆的使用发生了明显的变化,但其临床后遗症尚不清楚。

Jennifer Ayers-Ringler等在Radiology杂志发表研究文章,探讨了不同剂量钆造影剂对大鼠临床和神经系统的影响及潜在的神经毒性。

 从2017年3月至2018年7月,183只雄性Wistar大鼠接受了20次静脉注射,每公斤体重2.5 mmol(80人当量剂量)各种GBCA (gadodiamide, gadobate, gadodentate, gadoxetate, gadobutrol, gadoteridol)或生理盐水,时间为4周。 注射后6周和34周对大鼠进行5项行为学试验,对大鼠尿液、血清、脑脊液(CSF)、基底神经节、齿状核和肾脏标本进行感应耦合血浆质谱、透射电镜和组织病理学检查。 采用Dunnett事后检验和Wilcoxon秩和检验比较各组间的差异。

动物处理组(133只实验大鼠vs 50只对照大鼠)采用程序或采样时间点

 无论是在第6周还是第34周,暴露于GBCA和照组大鼠的任何行为测试都没有观察到差异的证据(P = 0.08至0.99)。 

注射后6周和34周组织内钆水平

在6周和34周时,线性GBCA在两个神经解剖部位的钆浓度均高于大环GBCA暴露大鼠(P < 0.001)。随着时间的推移,钆布醇清除率最大(中位数: 基底节区62%,齿状核70%),而钆二胺没有实质性清除。 在34周时,钆二胺、钆苯二酸、钆酸盐和钆丁烯醇的大鼠的脑脊液和血清中大部分钆被清除,特别是大环试剂(范围:脑脊液清除率为70%-98%,血清清除率为34%-94%),并且从尿液中几乎被完全清除(范围:清除率为96%-99%)。 

注射后6周和34周组织液钆含量

透射电子显微镜和X射线能谱证实的钆沉积组织的数量和类型

透射电镜检测线性暴露于GBCA的脑组织中的钆沉积,但没有观察到任何GBCA的组织病理学差异。

与注射生理盐水的大鼠对照组相比,没有在暴露于钆造影剂(GBCA)的大鼠中观察到神经毒性的临床或组织病理学证据。

原文出处

Ayers-Ringler J, McDonald JS, Connors MA, et al. Neurologic Effects of Gadolinium Retention in the Brain after Gadolinium-based Contrast Agent Administration [published online ahead of print, 2021 Dec 21]. Radiology. 2021;210559. doi:10.1148/radiol.210559

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    2022-08-29 ms9000000232218438

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    2022-01-04 ms6000000656440728

    安全安全!

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    2022-01-04 yiwacaidi

    学习

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