Ablagerung von gadoliniumhaltigen Kontrastmitteln im Gehirn nach mehrfacher Anwendung: Konsequenzen für den Einsatz der MRT bei Diagnosestellung und Verlaufsbeurteilung der Multiplen Sklerose?

C. Lukas; R. Gold; J. Fiehler; S. Siemonsen; J. F. Kleine; F. Zipp; B. Hemmer; M. Mühlau

doi:10.1055/s-0042-102953

Aktuelle Neurologie 2016; 43(04): 237-241
DOI: 10.1055/s-0042-102953

Übersicht

Ablagerung von gadoliniumhaltigen Kontrastmitteln im Gehirn nach mehrfacher Anwendung: Konsequenzen für den Einsatz der MRT bei Diagnosestellung und Verlaufsbeurteilung der Multiplen Sklerose?

Accumulation of Gadolinium-based Contrast Agents in the Brain Due to Repetitive Contrast-enhanced MRI: Implications for the Use of MRI in the Diagnosis and Follow-up of Multiple Sclerosis Patients?

C. Lukas

¹Institut für Diagnostische und Interventionelle Radiologie, St. Josef-Hospital, Ruhr-Universität Bochum, Bochum

,

R. Gold

²Klinik für Neurologie, St. Josef Hospital, Universität Bochum, Bochum

,

J. Fiehler

³Neuroradiologie, University Medical Center Hamburg-Eppendorf, Hamburg

,

S. Siemonsen

³Neuroradiologie, University Medical Center Hamburg-Eppendorf, Hamburg

,

J. F. Kleine

⁴Abteilung für Neuroradiologie, Technische Universität, München

,

F. Zipp

⁵Klinik und Poliklinik für Neurologie, Universitätsmedizin Mainz, Johannes Gutenberg-Universität Mainz, Mainz

,

B. Hemmer

⁶Abteilung für Neurologie, Technische Universität, München

,

M. Mühlau

⁶Abteilung für Neurologie, Technische Universität, München

› Institutsangaben

Abstract

Zusammenfassung

Neue Studienergebnisse weisen auf einen Zusammenhang zwischen wiederholten kontrastmittel-unterstützen MRT-Untersuchungen und Ablagerung gadoliniumhaltiger Kontrastmittel im zentralen Nervensystem hin. Ein wesentlicher Faktor hierbei stellt möglicherweise die zum Einsatz kommende Kontrastmittelsubstanzklasse (linear bzw. makrozyklisch) dar. Über die letzten Jahrzehnte hat sich die MRT als ein unverzichtbarer Bestandteil in der Diagnostik, aber auch in der Verlaufsbeurteilung unterschiedlicher Erkrankungen etabliert. Dies gilt im besonderen Maße für chronische Erkrankungen, wie die Multiple Sklerose. Wiederholte MRT-Untersuchungen spielen hier insbesondere durch die zunehmenden Therapieoptionen eine wesentliche Rolle im Verlauf der Erkrankung. Im vorliegenden Artikel werden die derzeit vorhandenen Studienergebnisse über die Ablagerung gadoliniumhaltiger Kontrastmittel zusammengefasst und im Hinblick auf mögliche Konsequenzen für den Einsatz der MRT im Rahmen der Diagnose und insbesondere der Verlaufsbeurteilung der Multiplen Sklerose diskutiert.

Abstract

Recent studies have pointed towards a relationship between repetitive contrast- enhanced magnetic resonance imaging (MRI) and accumulation of gadolinium-based contrast agents. This relationship seems to be dependent on the subclass of contrast agents (linear vs. cyclic) used. Over the past decades, MRI has become one of the most valuable tools in the diagnosis and follow-up of a wide spectrum of disease entities. This holds true especially for chronic diseases such as multiple sclerosis. Given current strategies to establish MRI in treatment decision pathways due to the availability of more potential treatment options, repetitive MRI is frequently performed during the disease course of MS. In this article, we review currently available studies focusing on the accumulation of gadolinium-based contrast agents. Furthermore, consequences that may arise in the context of MR imaging in MS patients are discussed.

Schlüsselwörter

Magnetresonanztomografie - gadoliniumhaltige Kontrastmittel - Gadoliniumablagerung - Multiple Sklerose

Keywords

magnetic resonance imaging - gadolinium accumulation - multiple sclerosis - gadolinium-based contrast agents

Volltext

Referenzen

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