How do MRI contrast materials affect the body. What are the potential side effects of gadolinium-based contrast agents. Who should avoid MRI contrast dyes. When should you seek medical attention after an MRI with contrast.

Understanding MRI Contrast Materials and Their Role in Imaging

Magnetic Resonance Imaging (MRI) is a powerful diagnostic tool used by medical professionals to visualize internal body structures with exceptional detail. To enhance the clarity and diagnostic value of MRI scans, contrast materials are often employed. These substances, also known as contrast agents or contrast media, play a crucial role in highlighting specific areas of interest within the body.

Contrast materials work by altering the magnetic properties of tissues, allowing for improved visibility of certain structures or abnormalities. The most commonly used contrast agents for MRI contain gadolinium, a rare earth metal. Between 1995 and 2017, the Food and Drug Administration (FDA) approved nine different gadolinium-based contrast agents (GBCAs) for use in MRI procedures.

Types of MRI Contrast Agents

MRI contrast agents are typically categorized into three main groups:

• Extracellular agents: These are the most commonly used contrast materials, which distribute throughout the extracellular space.
• Blood pool agents: These agents remain in the blood vessels for an extended period, making them useful for vascular imaging.
• Hepatobiliary agents: These are specifically designed to enhance liver imaging and are taken up by liver cells.

Each type of contrast agent has its unique properties and applications, allowing radiologists to choose the most appropriate option based on the specific diagnostic needs of the patient.

The Safety Profile of Gadolinium-Based Contrast Agents

While gadolinium is highly toxic in its free form, the contrast agents used in MRI are designed to minimize this risk. Manufacturers encapsulate the gadolinium ions within organic molecules called chelates, which form a stable complex. This chelation process allows the gadolinium to perform its contrast-enhancing function while significantly reducing its potential toxicity to the human body.

Despite these safety measures, it’s important to note that some patients may still experience side effects from MRI contrast materials. The severity of these side effects can range from mild to severe, though most individuals only experience mild, if any, adverse reactions.

Are MRI contrast agents safe for everyone?

MRI contrast agents are generally considered safe for most patients. However, certain groups of individuals may be at higher risk for adverse reactions or complications. These include:

• People with kidney problems or kidney failure
• Individuals with liver disease
• Those who have undergone a kidney transplant
• Pregnant women
• Individuals with a history of allergic reactions to contrast materials

It’s crucial for patients to inform their healthcare providers about any pre-existing conditions or concerns before undergoing an MRI with contrast.

Common Side Effects of MRI Contrast Materials

Most people who receive MRI contrast agents experience no side effects at all. However, when side effects do occur, they are typically mild and short-lived. The most frequently reported mild side effects include:

• Nausea and vomiting
• Headache
• Dizziness
• A feeling of warmth or coldness at the injection site
• Mild skin rashes or hives
• Itching
• A metallic taste in the mouth

These mild side effects usually resolve on their own within a short period after the MRI procedure. If they persist or worsen, patients should consult their healthcare provider.

How common are allergic reactions to MRI contrast?

Allergic reactions to MRI contrast agents are relatively rare, occurring in less than 1% of patients. Most allergic reactions are mild and may include symptoms such as hives, itching, or sneezing. Severe allergic reactions, including anaphylaxis, are extremely rare but can be life-threatening if they occur.

Moderate to Severe Reactions: Understanding the Risks

While uncommon, some patients may experience more severe reactions to MRI contrast materials. These reactions can affect various body systems and may include:

• Severe allergic reactions (anaphylaxis)
• Difficulty breathing or respiratory distress
• Cardiac arrhythmias or arrest
• Seizures
• Nephrogenic Systemic Fibrosis (NSF) in patients with severe kidney dysfunction

It’s important to note that these severe reactions are extremely rare, occurring in less than 0.01% of patients receiving gadolinium-based contrast agents.

What is Nephrogenic Systemic Fibrosis (NSF)?

Nephrogenic Systemic Fibrosis is a rare but serious condition that has been associated with the use of gadolinium-based contrast agents in patients with severe kidney dysfunction. NSF causes thickening and hardening of the skin, potentially affecting internal organs as well. The risk of NSF has been significantly reduced in recent years due to increased awareness and the development of newer, more stable contrast agents.

Long-Term Concerns: Gadolinium Retention in the Body

In recent years, there has been growing concern about the potential for gadolinium to be retained in the body long after an MRI procedure. Studies have shown that small amounts of gadolinium can be detected in brain tissue and other organs months or even years after administration of contrast agents.

In response to these findings, the FDA required manufacturers to include a warning about gadolinium retention on the labels of all gadolinium-based contrast agents in 2017. However, it’s important to note that the clinical significance of this retention remains unclear, and no adverse health effects have been conclusively linked to gadolinium retention in patients with normal kidney function.

Should patients be concerned about gadolinium retention?

While the discovery of gadolinium retention has raised some concerns, the medical community generally agrees that the benefits of contrast-enhanced MRI scans outweigh the potential risks for most patients. A 2019 article from the American Association for Cancer Research emphasized that the risk of missing a life-threatening diagnosis far outweighs the theoretical risks associated with gadolinium retention.

Nevertheless, ongoing research continues to investigate the long-term effects of gadolinium retention, and healthcare providers are encouraged to use contrast agents judiciously, considering the individual needs and risk factors of each patient.

Special Considerations for Specific Patient Groups

Certain groups of patients require special consideration when it comes to the use of MRI contrast agents. These include:

Pregnant and Breastfeeding Women

The safety of gadolinium-based contrast agents during pregnancy has not been conclusively established. While there is no evidence of harm to the fetus, healthcare providers generally recommend avoiding contrast-enhanced MRI scans during pregnancy unless absolutely necessary.

For breastfeeding mothers, the American College of Radiology states that it is safe to continue breastfeeding after receiving gadolinium-based contrast agents. However, if a mother feels uncomfortable, she may choose to pump and discard breast milk for 24-48 hours after the procedure.

Patients with Kidney Problems

Individuals with kidney dysfunction are at higher risk for adverse reactions to gadolinium-based contrast agents, particularly the development of Nephrogenic Systemic Fibrosis. For these patients, healthcare providers may consider alternative imaging techniques or use the lowest possible dose of the most stable contrast agent if contrast-enhanced MRI is deemed necessary.

Patients with Known Allergies

Patients with a history of allergic reactions to contrast materials or other substances should inform their healthcare provider before undergoing an MRI with contrast. In some cases, premedication with antihistamines or corticosteroids may be recommended to reduce the risk of an allergic reaction.

Minimizing Risks: Best Practices for MRI Contrast Use

To ensure the safest possible use of MRI contrast agents, healthcare providers and patients should follow these best practices:

• Thorough patient screening: Healthcare providers should conduct a comprehensive review of the patient’s medical history, including kidney function, allergies, and previous reactions to contrast materials.
• Informed consent: Patients should be fully informed about the risks and benefits of contrast-enhanced MRI and given the opportunity to ask questions.
• Appropriate agent selection: Radiologists should choose the most appropriate contrast agent based on the specific diagnostic needs and the patient’s individual risk factors.
• Optimal dosing: The lowest dose of contrast agent necessary to achieve diagnostic quality images should be used.
• Post-procedure monitoring: Patients should be observed for a short period after the MRI to ensure no immediate adverse reactions occur.

By following these guidelines, healthcare providers can maximize the diagnostic benefits of contrast-enhanced MRI while minimizing potential risks to patients.

When to Seek Medical Attention After an MRI with Contrast

While most patients tolerate MRI contrast agents well, it’s important to be aware of potential signs of adverse reactions. Patients should seek immediate medical attention if they experience:

• Difficulty breathing or shortness of breath
• Swelling of the face, lips, tongue, or throat
• Severe hives or itching
• Chest pain or palpitations
• Dizziness or lightheadedness
• Severe nausea or vomiting

These symptoms could indicate a severe allergic reaction or other serious complication and require prompt medical evaluation.

How long after an MRI with contrast can side effects occur?

Most adverse reactions to MRI contrast agents occur within the first hour after administration. However, delayed reactions can occur up to several days after the procedure. Patients should be advised to report any unusual symptoms to their healthcare provider, even if they occur days after the MRI.

In conclusion, while MRI contrast agents play a crucial role in enhancing diagnostic imaging, it’s important for both healthcare providers and patients to be aware of the potential risks and side effects associated with their use. By understanding these risks, following best practices, and maintaining open communication, the benefits of contrast-enhanced MRI can be maximized while minimizing potential harm to patients.

What to know about MRI contrast side effects

Contrast materials can help highlight areas of interest in MRI scans. Contrast injections may cause side effects like mild rashes and hives, but it is also possible for a person to have a serious reaction to them.

An MRI is a type of imaging test. Doctors may order one to get a better view of internal structures or processes to help diagnose or assess various health conditions. For example, an MRI may help a doctor identify and stage a tumor.

In some cases, an MRI involves the use of contrast material, also known as contrast agents, contrast dyes, or contrast media. Contrast material allows the MRI to produce a clearer picture of the area.

From 1995 to 2017, the Food and Drug Administration (FDA) approved nine different dyes for use during MRIs. Most contain a rare earth metal called gadolinium. Experts often group them into three categories: extracellular, blood pool, and hepatobiliary.

Because gadolinium is highly toxic, dyes contain other materials to help reduce side effects.

However, people may still experience side effects from these contrast materials. They can range in severity from mild to severe, but most people will experience only mild side effects.

This article describes the potential contrast material side effects, drug interactions, interactions with other health conditions, and when to speak with a doctor about MRI contrast material side effects.

The gadolinium within MRI contrast dyes is toxic. However, when manufacturers create MRI dyes, they surround the gadolinium with another crystal-like chemical to keep it trapped.

This allows the gadolinium to perform its job while protecting the person from its toxic effects.

Mild side effects

Most people will not experience side effects due to MRI contrast materials.

When they do occur, they are often mild — common side effects include hives and a rash.

According to a 2016 review that looked at the effects of gadolinium-based contrast material in children, the most common side effects were nausea and vomiting.

Moderate to severe reactions

Less commonly, a person may experience more severe reactions from MRI contrast, such as:

• the development of nephrogenic systemic fibrosis, most common in people with kidney issues
• respiratory or cardiac arrest
• anaphylactic shock
• respiratory distress

Gadolinium can affect several major systems throughout the body, including the:

• gastrointestinal tract
• nervous system
• cardiovascular system
• respiratory system
• skin
• brain

In rare cases, a severe reaction can be fatal.

Other concerns

Some evidence suggests that gadolinium may remain in a person’s system long after an MRI.

In 2017, the FDA required manufacturers to include a warning about the potential for contrast dye to remain in a person’s system for months to years following an MRI.

An American Association for Cancer Research article in 2019 notes that the risk of contrast remaining in the system does not outweigh the risk of missing life threatening cancer or other serious diagnoses.

A person can discuss their medications with the doctor recommending an MRI. They may recommend that the individual temporarily stop using certain medications or that the MRI does not involve the use of contrast material.

People who are pregnant or breastfeeding also need to let a doctor and MRI technician know. A doctor can help determine if the potential benefit of the scan and contrast dye is worth the risk to the pregnancy.

People can continue breastfeeding after a contrast MRI. However, if a person feels more comfortable not breastfeeding afterward, they can pump extra milk and resume breastfeeding 24–48 hours following the injection of the dye.

MRI contrast is not safe for everyone. People with a history of the following should let the doctor and technician know so they can avoid the use of contrast material:

• kidney failure
• liver disease
• kidney transplant
• kidney disease

A person with kidney issues may experience nephrogenic systemic fibrosis after receiving a contrast dye injection. This condition causes a person to develop thickened skin. It often affects the arms and legs but can also affect the trunk.

In severe cases, it can become systemic and negatively affect internal organs such as the heart. The condition is potentially life threatening.

People who are pregnant or breastfeeding need to let a doctor or technician know before an MRI. An MRI without dye is safer for the developing fetus.

A person may wish to speak with a doctor if they experience long lasting or severe reactions to the MRI contrast material, such as signs of an allergic reaction. If symptoms seem life threatening, individuals need to seek immediate emergency medical attention.

A person may also want to check with a doctor before the test. They may want to review their unique situation, including:

• their pregnancy or breastfeeding status
• any current medications they are taking
• any supplements they are taking
• any underlying health conditions or concerns

MRI contrast is generally safe for most people. However, individuals with kidney disease and those who are pregnant should let their doctor know before getting an MRI with contrast.

Common side effects of contrast materials are generally mild and may include a rash, nausea, and vomiting. More severe reactions can include anaphylactic shock or nephrogenic systemic fibrosis.

A person needs to let a doctor know about any underlying conditions, medications they are taking, and any concerns they may have before the MRI with contrast. A doctor can help determine if the benefit of the MRI contrast dye injection is worth the risk.

How to Stay Safe When Getting an MRI > News > Yale Medicine

You should be aware of potential safety issues when you undergo MRI, a common imaging procedure.

The magnetic resonance imaging (MRI) machine is frequently used to help diagnose a wide range of diseases and medical conditions, ranging from cancer and heart disease to disorders of the bones and joints. “An MRI allows you to see internal anatomy in detail, and also to differentiate between normal and abnormal tissues,” says Jeffrey Weinreb, MD, chief of the MRI service at Yale Medicine.

Rather than using radiation, as X-rays do, the MRI machine uses magnetic fields and radio waves to generate images.This makes it safer, overall. 

However, the prospect of getting an MRI scan causes anxiety for some patients. Not only is the machine noisy and confining, but it does not interact well with some metals in the body. Patients with medical implants or other metal in or on their bodies are often unable to undergo the exam in most hospitals; Yale Medicine physicians have developed strategies that often solve this problem. In this article, we examine the issues that might exist in a variety of scenarios—and how Yale Medicine physicians deal with them. They include:

• Cardiac pacemaker or defibrillator
• Braces on your teeth, a retainer or dental fillings
• Embedded bullets, BB’s, shrapnel, shotgun pellets or metal filings
• Pins or plates in or on your bones, including metallic joint
• Body piercings, jewelry, metal on or in clothing
• Medical devices with magnets, such as a cochlear implant or chest expanders
• Tattoos
• Surgical clips, including aneurysm clips
• Stents

Cardiac pacemaker or defibrillator

Yale Medicine is able to offer MRI scans for many people with these devices implanted in their bodies in situations where most others hospitals can’t do them.  Patients with some modern versions of cardiac pacemakers and defibrillators can safely undergo an MRI, but most people have older devices, which aren’t FDA-approved for use in an MRI scanner. “We screen these patients very carefully, and have their devices evaluated,” Dr.  Weinreb says. “If they unequivocally need the MRI, and there’s no satisfactory alternative for it, we will often do the scans.”

To ensure the patient’s safety, Yale Medicine gathers a multidisciplinary group, including radiologists, cardiologists, electrophysiology nurses and the MRI team. The cardiac device is set so it won’t malfunction in the MRI scanner, and the scanner is set so it won’t exceed specific speeds and intensity limits. The patient is carefully monitored during the MRI. After the test, the implanted device is checked and, if necessary, reprogrammed. “We’ve done hundreds of these safely, and we’re still the only ones in New England doing them on a routine basis,” Dr. Weinreb says.

Braces, retainers or dental fillings

Most metal tooth fillings or other permanent dental implants won’t cause a problem. If you have detachable metal braces or a retainer, you should take them out before you get an MRI. Having a lot of metal in your mouth can distort images if you need an MRI of your head or neck, making the scan less useful for diagnosis and treatment. In those situations, if you have braces that aren’t easily detachable, our physician may ask you to have your braces removed in advance by an orthodontist.

Bullets, BB’s, shrapnel, shotgun pellets or metal filings

A number of factors help determine if an MRI is safe for you if you have pieces of metal in your body. They include where the metal is, its size, its shape, and whether it’s near a vital organ or structure. At Yale Medicine, you might get an X-ray first to answer those questions. “The vast majority of the time, there’s no problem and we’ll go right ahead and do the MRI scan,” Dr. Weinreb says. But the scan may not be possible if the metal is lodged near the eye or an artery in the neck. In those situations, the danger is that the metal might heat up and damage sensitive tissues.  

Pins, plates and metallic joints

Metal that is well secured to the bone, such as hip and knee joint replacements, will not be affected by an MRI. The metal won’t heat up or move in response to the machine. But if the metal is near an organ, such as the prostate, distortion could be a problem. At Yale Medicine, your doctors will determine whether an MRI is the appropriate examination, or “if there is something else that would be satisfactory or might even be better,” Dr. Weinreb says.

Jewelry, piercings, buckles or keys

You shouldn’t go into an MRI scanning room wearing jewelry or clothing with metal parts. At Yale Medicine, patients are required to change into a hospital gown before undergoing an MRI. (That’s not true everywhere. But we play it safe.) Our patients are asked to remove body piercings, and, if they can’t remove one, they might be asked to place an ice pack (also called a heat sink) over it during the MRI, to keep the metal cool. 

Electronic medical devices or magnets

Some medical devices, including cochlear implants for hearing, contain magnets. Other implants, such as tissue expanders used for breast reconstruction, have magnetic components.  “We have to check them out and see if they’ve been tested and are safe in an MRI environment,” Dr. Weinreb says. Some patients carry a card with information about their devices, or their doctors have it on file. “If we’re not certain, we’re prudent. We don’t want to hurt somebody,” Dr. Weinreb says. Radiologists might postpone the MRI until the safety of the device is determined, or recommend another course of action, such as a different type of scan. Even if MRI is deemed safe, the item may distort the images created by the scan.

Tattoos

It’s possible that your tattoo could heat up during an MRI and burn you. This is a greater concern with older tattoos, some of which were made with metallic ink. Of course, tattoos are very common, and they won’t keep you from getting an MRI. If there’s a concern about burning, the MRI technician will provide an ice bag to keep your tattoo from getting hot.

Surgical clips

For the most part, surgical clips are not a problem because modern clips aren’t ferromagnetic. The exception is surgical clips used to repair a brain aneurysm. These can be dangerous, says Dr. Weinreb. “f the clip moves during an MRI, it could cause bleeding in the brain.” At Yale Medicine, the MRI staff will determine the make and model of your brain aneurysm clip before an MRI is approved.

Surgical stents

Coronary artery stents, the most common type, are considered MRI-safe because they are not typically made of ferromagnetic metal. When stents are elsewhere in the body, especially in a precarious location, such as an artery in the neck, Yale Medicine caregivers investigate before they do a scan. The concern is that the stent could migrate, perhaps opening up the blood vessel. Safety information for each type of surgical stent is carefully researched before a scan is performed. 

More news from Yale Medicine

Is MRI harmful to health? Let’s figure it out.

Magnetic resonance imaging (full name nuclear magnetic resonance imaging) is a non-invasive examination method, since it does not cause any punctures and the introduction of foreign objects into the body. By definition, it is safer than any invasive diagnostic methods, such as classical angiography or endoscopy. The principle of operation of MRI is based on the phenomenon of nuclear magnetic resonance. During the examination, the patient’s body is exposed to a strong magnetic field and radio frequency pulses. Under the influence of the electromagnetic field, hydrogen nuclei in human cells line up in a certain direction for a short period of time, and then return to their original position. These changes are picked up by the detector of the tomograph and transmit the data to the computer. He digitizes the information and, on its basis, builds three-dimensional images of the area under study.

Since the diagnosis does not carry radiation exposure to the body and does not cause any harm to human health, the examination does not require a referral from a doctor and MRI scanning can be done an unlimited number of times with any time interval. The patient can independently undergo MRI diagnostics for the prevention of many diseases. For example, modern high-field magnetic resonance imaging scanners make it possible to do an MRI of the whole body under the cancer screening program or to examine individual parts of the body:

What is the danger of MRI

Undesirable consequences during MRI can occur only in cases where the patient did not report the presence of metal objects and electronic devices in the body or neglected the list of contraindications

The MRI machine is a large and very powerful magnet. For this reason, during the study, the magnetic field of the tomograph can either move metal objects in the body or heat them, thereby causing serious harm to human health in the form of internal bleeding or burns. You cannot enter the MRI room with metal jewelry or accessories on the body, such as earrings, chains, hairpins, watches, zippers. Any metal object can be attracted to the scanner.

MRI is dangerous for patients with certain pacemakers. The magnetic field of the tomograph can interfere with the operation of electronic devices. Therefore, patients with pacemakers, hearing implants and artificial pacemakers are contraindicated in MRI if their implant passport does not contain a note – “there are no contraindications for MRI”.

MRI examinations are sometimes difficult for patients who are afraid of closed spaces. The claustrophobic must be psychologically prepared for because he will be in a closed noisy space for a while. To avoid panic, you can take sedatives and ask a loved one to be with you during the study.

The MRI machine makes a fairly loud noise during operation. The more powerful the tomograph, the higher the noise. To protect the ears, the patient will be asked to use earplugs or noise-canceling headphones.

Is MRI dangerous for children? For this reason, it is sometimes difficult to perform an MRI examination on a child, as it is difficult for young children to lie still, and doctors have to apply sedatives or perform a drug sleep procedure.

The magnetic field of the tomograph cannot cause any harm to the health of the child. However, when undergoing an MRI procedure under general anesthesia, the risks of anesthetic management must be taken into account. To assess the ability of the child’s body to cope with the additional load, a small patient is sent to do a series of blood and urine tests, an ECG, to consult a pediatrician, a neurologist and an anesthesiologist.

Is MRI with contrast harmful?

A doctor may prescribe an MRI study with contrast to increase the information content of the examination, to detect the exact location of tumor processes and to understand their benign or malignant nature. MRI contrast is based on the rare earth metal gadolinium. According to statistics, the contrast agent rarely causes an allergic reaction, only in 0.01% of cases.

Unlike iodine or barium, which are used in CT, gadolinium has a minimal number of contraindications, the main of which is a serious kidney disease. In chronic renal failure, in order to avoid the threat of developing nephropathy, the patient is asked to take a blood test for creatinine before a contrast study. According to its results, the doctor can give a clear answer whether it is dangerous to do an MRI with contrast for this patient.

Is MRI dangerous for pregnant women

Native MRI can be done for pregnant women. For 40 years of active use of magnetic resonance imaging for diagnostic purposes, not a single fact of the negative impact of MRI on the health of the mother and fetus has been identified. In the last 10 years, with the advent of new generation devices, MRI has been actively used in prenatal diagnostics.

• Fetal MRI can be performed with high-field units
• MR fetometry
• MP pelvimetry
• MRI of the newborn

As a precautionary measure, pregnant women are advised not to have an MRI in the first trimester of pregnancy to avoid unnecessary disturbance. They try not to perform MRI with contrast in pregnant women, since at the moment there is no evidence of the danger or safety of gadolinium for fetal development. For the same reason, an MRI with contrast requires a break from breastfeeding. The woman is asked to interrupt lactation for 36 hours so that the contrast composition is completely eliminated from the body and does not enter breast milk.

What is more harmful than CT or MRI

Computed tomography is an X-ray examination method, and it is associated with radiation exposure to the body. Therefore, CT is more dangerous for the patient’s health than MRI, the procedure, and it is better to do it strictly according to the direction of the doctor if there are medical indications. With MRI, there is no radiation exposure of the body, therefore, there is no harm associated with radiation.

Author: Shcherbena Alina Olegovna

Specialization: MRI and CT doctor 9Bryukhanov A.V. Magnetic resonance imaging in osteology / A. V. Bryukhanov, ALO. Vasiliev. M., 2006. – S.20-44; 50-65.

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How MRI affects the body

How MRI affects the body – Mediunion Blog

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08.08.2022

To increase the accuracy of the study, the doctor may prescribe an MRI with contrast. It is carried out according to certain indications – to detect cancer or infections. A special substance is administered intravenously in order to increase the visibility of the vessels. Since such pathologies are fed through a network of small blood vessels, their presence is clearly visible on images with contrast.
Is magnetic resonance imaging dangerous?
Tomography equipment does not negatively affect the human body – the magnetic resonance field is dangerous no more than radiation from household appliances and mobile phones. Diagnosis is prescribed even for children.
For diagnostics with contrast, modern preparations are used that are completely safe for human health and allow enhancing the visualization of the smallest details.
MRI in Krasnoyarsk addresses, prices in the multidisciplinary medical center “Medunion”. MRI equipment ensures high accuracy of the results, and experienced doctors issue a conclusion and interpretation of the results within 15-20 minutes after the procedure.