Gadolinium MRI

Gadolinium is a paramagnetic metal ion. Paramagnetic ions, such as gadolinium, move differently within a magnetic field. This trait makes gadolinium useful for magnetic resonance imaging (MRI). GBCAs are approved by FDA for use with MRI as a contrast agent to provide an improved image of body organs and tissues. Patients who have severe renal insufficiency (severe kidney disease)are at risk and the FDA recommends that if a physician has requested an MRI or MRA study with a contrast agent, ask if the use of the contrast agent is essential.

Gadolinium Risks and Nephrogenic Systemic Fibrosis (NSF)

NSF was first described in the medical literature in 2000. The first case of NSF was identified in 1997. The cause of NSF is unknown but it has been reported only in patients who have severe kidney disease. NSF causes fibrosis of the skin and connective tissues throughout the body. Patients develop skin thickening that may prevent bending and extending joints, resulting in decreased mobility of joints. NSF usually starts in the lower extremities. Fibrosis can also develop in the diaphragm, muscles in the thigh and lower abdomen, and lung vessels. Over time, NSF becomes worse and can cause death.

Gadolinium MRI Effects

allergic reactions

rash

sweating

itching

hives

facial swelling

Gadolinium MRI History

Since December of 2006, the FDA has continued to investigate reports of nephrogenic systemic fibrosis (NSF) in patients who received gadolinium-based contrast agents (GBCAs) to help define risk factors for NSF.

In May of 2007, the FDA requested that manufacturers include a new boxed warning on the product labeling of all gadolinium-based contrast agents which are used to enhance the quality of magnetic resonance imaging (MRI). The requested warning would state that patients with severe kidney insufficiency who receive gadolinium-based agents are at risk for developing a debilitating, and a potentially fatal disease known as nephrogenic systemic fibrosis (NSF). In addition, it would state that patients just before or just after liver transplantation, or those with chronic liver disease, are also at risk for developing NSF if they are experiencing kidney insufficiency of any severity.

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