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Is a Mixture of Gadolinium and Iodinated Contrast Material Safe During MR Arthrography?

Robert R. Brown1, David W. Clarke2 and Richard H. Daffner3

1 Department of Radiology, Cleveland Clinic — Florida, 3000 W. Cypress Creek Rd., Ft. Lauderdale, FL 33309.
2 Albany College of Pharmacy, Union University, 106 New Scotland AVe., Albany, NY 12208.
3 Department of Radiology, Allegheny General Hospital, 320 E. North Ave., Pittsburgh, PA 15212.



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  		Fig. 1. —Absorption spectra of methyl thymol blue and methyl thymol blue—gadolinium complex. Graph shows that absorption spectra of unbound methyl thymol blue (solid line) and methyl thymol blue—gadolinium (dashed line) differ. Free methyl thymol blue has maximum absorbency at 425 nm, coloring the solution yellow, whereas maximum absorbency for methyl thymol blue—gadolinium complex occurs at 605 nm, coloring the solution blue.

 


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  		Fig. 2. —Expected gadolinium titration curve using methyl thymol blue indicator. Graph shows that in region 1 of curve, added gadolinium ions would react with unbound diethylenetriamine pentaacetic acid and ethylenediamine tetraacetic acid complexing agents in solution. When all these ligands are combined in a solution, methyl thymol blue—gadolinium will start to form, and absorption at 605 nm will increase. In region 3, all of methyl thymol blue in solution has been consumed and no further increase in absorption will be seen. Transition from region 1 to region 2 (arrowhead) represents endpoint of titration.

 


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  		Fig. 3. —Scatterplot of experimental data shows absorbency measurements collected during titration. Data points from titrations were recorded on individual scatterplots like the one illustrated. Connecting lines were approximated on each chart individually, and experimental endpoint for each titration was determined.

 

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