{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T09:40:33Z","timestamp":1772271633711,"version":"3.50.1"},"reference-count":86,"publisher":"Ordem dos Medicos","issue":"1","license":[{"start":{"date-parts":[[2024,1,3]],"date-time":"2024-01-03T00:00:00Z","timestamp":1704240000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Med Port"],"abstract":"<jats:p>A esclerose m\u00faltipla \u00e9 a doen\u00e7a desmielinizante do sistema nervoso central mais frequente, caracterizando-se pelo in\u00edcio precoce e incapacidade progressiva. A resson\u00e2ncia magn\u00e9tica, pela elevada sensibilidade e especificidade na dete\u00e7\u00e3o de les\u00f5es desmielinizantes, \u00e9 o exame complementar mais \u00fatil nesta patologia, sendo a administra\u00e7\u00e3o de meios de contraste com gadol\u00ednio um importante contributo na interpreta\u00e7\u00e3o imagiol\u00f3gica. Embora o contraste seja imprescind\u00edvel no \u00e2mbito do diagn\u00f3stico, a sua utiliza\u00e7\u00e3o por rotina na monitoriza\u00e7\u00e3o da atividade de doen\u00e7a, resposta ao tratamento e respetivas complica\u00e7\u00f5es \u00e9 controversa. O objetivo deste artigo \u00e9 reunir as recomenda\u00e7\u00f5es atuais relativas \u00e0 utiliza\u00e7\u00e3o do gadol\u00ednio no seguimento imagiol\u00f3gico da esclerose m\u00faltipla e definir um protocolo cl\u00ednico efetivo e seguro. A revis\u00e3o da literatura foi conduzida na PubMed, recorrendo aos termos \u2018esclerose m\u00faltipla\u2019, \u2018resson\u00e2ncia magn\u00e9tica\u2019 e \u2018gadol\u00ednio\u2019 ou \u2018meio de contraste\u2019. Foram selecionados artigos publicados entre janeiro de 2013 e de 2023 relativos \u00e0 seguran\u00e7a do gadol\u00ednio e \u00e0 sua utiliza\u00e7\u00e3o na resson\u00e2ncia magn\u00e9tica de controlo dos doentes adultos com diagn\u00f3stico de esclerose m\u00faltipla. Apesar de nenhuma consequ\u00eancia biol\u00f3gica ou cl\u00ednica ter sido inequivocamente atribu\u00edda \u00e0 reten\u00e7\u00e3o cerebral do gadol\u00ednio, que foi reportada maioritariamente com agentes lineares, as autoridades de sa\u00fade t\u00eam vindo a recomendar a restri\u00e7\u00e3o do contraste a circunst\u00e2ncias cl\u00ednicas essenciais. Na esclerose m\u00faltipla, a dete\u00e7\u00e3o de les\u00f5es subcl\u00ednicas com capta\u00e7\u00e3o de gadol\u00ednio sem tradu\u00e7\u00e3o em les\u00f5es novas\/aumentadas nas sequ\u00eancias ponderadas em T2 ocorre raramente e com impacto na decis\u00e3o terap\u00eautica question\u00e1vel. Por outro lado, o gadol\u00ednio assume uma sensibilidade superior no diagn\u00f3stico diferencial de surtos cl\u00ednicos, na dete\u00e7\u00e3o de atividade inflamat\u00f3ria recente, antes e ap\u00f3s o in\u00edcio de uma terap\u00eautica e nos doentes com elevada carga lesional ou les\u00f5es difusas\/confluentes nas sequ\u00eancias ponderadas em T2. Contrariamente ao rastreio da leucoencefalopatia multifocal progressiva, a monitoriza\u00e7\u00e3o da s\u00edndrome inflamat\u00f3ria de reconstitui\u00e7\u00e3o imunol\u00f3gica beneficia tamb\u00e9m da inclus\u00e3o do gadol\u00ednio. \u00c9 exequ\u00edvel e segura a exclus\u00e3o do gadol\u00ednio no seguimento imagiol\u00f3gico de rotina da esclerose m\u00faltipla, apesar do seu contributo adicional em circunst\u00e2ncias cl\u00ednicas espec\u00edficas que devem ser do conhecimento articulado do neurologista e neurorradiologista.<\/jats:p>","DOI":"10.20344\/amp.20467","type":"journal-article","created":{"date-parts":[[2024,1,3]],"date-time":"2024-01-03T09:41:51Z","timestamp":1704274911000},"page":"53-63","source":"Crossref","is-referenced-by-count":2,"title":["Utiliza\u00e7\u00e3o de Gadol\u00ednio nas Resson\u00e2ncias Magn\u00e9ticas de Controlo em Doentes com Esclerose M\u00faltipla: Recomenda\u00e7\u00f5es Atuais"],"prefix":"10.20344","volume":"37","author":[{"given":"Andreia","family":"Cruz","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniela","family":"Pereira","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S\u00f3nia","family":"Batista","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"8464","published-online":{"date-parts":[[2024,1,3]]},"reference":[{"key":"4766","doi-asserted-by":"crossref","unstructured":"Kavaliunas A, Danylaite Karrenbauer V, Hillert J. 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