Pursue Whether Gd Depositions are in the Brain on MRI?
I am not infrequently asked if someone should get their brain MRI looked at again to see if they have Gd deposition. My general response to this is no.
Gadolinium deposits are not described as lighting up after GBCA injection. They are essentially static high T1 signal foci in the Dentate Nucleus and Globus Pallidus. As I have written in prior blogs, there probably is no good correlation with brain deposition of Gd and symptoms of GDD. Brain deposition basically just means that a person received more than 5 linear GBCA injections within a certain period of time, maybe 2 years. The great majority of these subjects have simple GSC and are not symptomatic. Patients with GDD, probably the majority, do not have these deposition findings, as many have had macrocyclic agents or < 5 GBCA injections. A different question is what may enhancing white foci may be. This you could get a second opinion, by just seeing another neurologist and asking them to have the MR second read. MS is high on the list of diseases with enhancing white matter foci, but there is more in the differential diagnosis.
Also worth noting, as this also comes up, other imaging studies such as CT cannot recognize Gd deposition.. Atleast to the present time.
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