MR contrast agent
MR contrast media are generally very well tolerated and, in comparison, much better tolerated than X-ray contrast media. They are based on gadolinium and not iodine, which makes it unnecessary to determine the thyroid values prior to the examination.
Possible (very rare) side effects are
- Metallic taste in the mouth, headaches, nausea, skin reactions
- a (pseudo-)allergic reaction (much rarer than when using X-rays - KM; can be treated with medication accordingly)
Very strict indications for the administration of MR contrast media in:
- breastfeeding mothers (if the administration of MR contrast medium is unavoidable, breastfeeding of the child should be interrupted for at least 24 hours)
- Patients with known severe functional impairment of the kidneys (GFR ≤ 30ml/min kg bw) or who require dialysis
Risks depending on the type of MR contrast agent:
In the past 2 years, it has been shown that gadolinium can be deposited in the brain (putamen or globus pallidum) as a component of the contrast agent after multiple administration of isolated contrast agents during repeated MR examinations [literature].
Furthermore, the occurrence of nephrogenic systemic fibrosis (NSF) has been described in connection with the administration of MR contrast media [literature]. However, these were only a handful of patients worldwide with severe renal function impairment (stage 4 and 5 or GFR < 30 ml/min /1.73 m2) after the use of special MR contrast agents. This contrasts with hundreds of millions of complication-free MR examinations.
These specific risks only occurred, if at all, after the administration of linear MR contrast agents(Omniscan®, Optimark® and Magnevist®).
In contrast, the MR contrast agents we use (Dotarem®for cardio-MR examinations, Gadovist®for pelvic/leg angiographies) are considered particularly safe due to their chemical composition; neither cases of nephrogenic systemic fibrosis (NSF) nor contrast agent-induced nephropathy or gadolinium deposits in the brain have been described with these substances.
Nevertheless, contrast media should only be administered on a case-by-case basis and in the lowest possible dosage. We also ask that the renal retention parameters (creatinine, GFR) be determined prior to the examination.