indication

The administration of contrast medium in an MRI is used to better visualize structures such as arteries and veins. It helps to assess the function of an organ and supports the search for masses such as tumors.
There are different types of contrast agents that can be used in magnetic resonance imaging (MRI). There are contrast media that are injected and contrast media that can be swallowed or introduced through a probe to better visualize the gastrointestinal tract.

You can find a lot of general information about nuclear spin under our topic: MRI

Is that dangerous?

The most common contrast media that are injected contain gadolinium (chemical element), which belongs to the so-called "rare earths". It leads to a lighter contrast of, for example, blood vessels, tumors or the kidneys and urinary tract, since it is excreted via the kidneys. Gadolinium is actually poisonous, but for the investigation it is bound to carriers that render it harmless.
Iron oxide nanoparticles are less often used in MRIs of the liver, for a darker contrast in the liver, which makes metastases, tumors or other structures appear lighter, or manganese compounds for questions relating to the liver or pancreas.
Contrast media that are swallowed often also contain gadolinium or iron oxide nanoparticles. But pineapple or berry juices with a high iron / manganese content can also be responsible for a lighter contrast in the gastrointestinal tract.

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In rare cases - as with all drugs or medical interventions - side effects of the administration of contrast medium can occur. These include above all allergic reactions to the contrast medium or its components.
Serious complications can occur in patients with impaired function of the kidneys or liver (see below), which is why administration of contrast medium is generally excluded in these patients.

Risks

Although the MRI is available as a Low-radiation alternative to CT (Layer x-ray), the latest findings show that gadolinium may be deposited and accumulated in the brain after four times of administration. It is not yet known whether this is harmful or causes long-term damage. It cannot be ruled out that the deposits lead to neurodegenerative diseases such as dementia could lead. For this reason, the indication for an MRI examination with contrast medium should be made very narrow.

Due to gadolinium, it can be extremely rare in one impaired kidney or liver function or after a liver /Kidney transplant to a serious, untreatable one Connective tissue disease come, the so-called nephrogenic systemic fibrosis (NSF). This leads to a pathological increase in the connective tissue of the skin, the internal organs and the muscles. Joints can lose their mobility and, in the worst case, the disease can lead to death. Men and women are equally affected. So far, only 315 cases are known worldwide.

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Side effects

The administration of contrast media during an MRI examination can be rare allergic reaction trigger. This shows through Itchy skin, skin rash, Nausea, vomiting, headache, dizziness up to shortness of breath or an allergic shock, which in the worst case can lead to death. However, serious or permanent damage is very rare, and if the slightest sign of an intolerance or allergic reaction occurs, drugs can be injected to reduce the reaction.

Furthermore, there may be other complications typical of MRI, such as the Heating of metal parts in the body or the first appearance of fear of confined spaces (Claustrophobia). But also a MRI with claustrophobia is possible.

With older ones Tattoos and Permanent make up skin irritation or warming of the skin can occur if the dyes contain metal.

In extremely rare cases, ringing in the ears (Tinnitus), which often disappear after the examination, but very rarely can stay.

MRI with contrast medium and then headache

It can be followed by an MRI scan with or without a contrast agent mild to moderate headache come, which usually subside by themselves.

Contraindications

A poor creatinine level, which indicates poor kidney function, is a contraindication for an MRI examination with contrast agent. If you have had allergic reactions to contrast media in the past, you should weigh the risk of a new reaction before use. Is a allergy known, can preventive medication given when the examination needs to be carried out.

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There are also the Contraindicationsthat apply to all MRI exams such as metallic foreign bodies (War injury or similar) or Pacemaker, as well as fear of tight spaces (claustrophobia).

Fitness to drive

The fitness to drive is after a contrast agent administration not limited. If medication has been given to calm down, no vehicles should be driven or dangerous activities should be carried out for the following 24 hours.

MRI with knee contrast agent

At rheumatic, degenerative or chronic diseases of the knee joint Contrast media can complement the MRI examination, as previously damaged tissue, unlike healthy tissue, absorbs contrast media. Blood vessels can also be displayed well with contrast media. In most cases, and especially in the case of acute injuries, contrast agent is not administered.

MRI with contrast agent in children

Based on the latest findings that Gadolinium may be deposited in the brain and enriches, it should first be carefully weighed up whether a contrast agent is really necessary during the examination, since the Long-term consequences not clarified are. So far, no health damage or consequences are known, but the administration of gadolinium should be avoided if it is not absolutely necessary. And especially with children, these indications must be strictly set.

MRI with contrast media during pregnancy

The MRI is in contrast to CT and X-rays no x-rays one, which is why they are considered safe imaging in the pregnancy can be used. However, it is advised in early pregnancy no MRI for the first three months because the unborn child can be harmed.

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There are no guideline on the use of gadolinium-containing contrast media in pregnancy, however, harmful effects have been described because gadolinium is the Placental barrier penetrates. Contrast media should therefore only be used in an emergency during pregnancy and when no other examination is available.

It should at least Not breastfed 24 hours after administration of contrast medium become.

The MRI is often used to help with pregnancy Breeched child Measure the diameter of the small pelvis that the child has to pass through at birth, no contrast agent is required.

Procedure for an MRI with contrast agent

Before the examination, the patient is informed by the competent person Radiologists informed about possible complications and the creatinine level is checked, which shows how well the kidneys are working, as the contrast medium is excreted through the kidneys. As with a native MRI (no contrast agent), the patient must remove all metallic objects (Piercings, jewelry, etc.) and possibly take off your clothes if they have metallic parts (e.g. bras) that could interfere with the examination.

Then the patient is placed on a table and possibly coils are attached to better represent certain areas. The patient should do not cross your legs or armsotherwise burns may occur. During the examination, the patient should be dont move and breathe evenly. The patient gets an emergency bell in case something unexpected happens. For the administration of contrast medium a venous access be available, which is placed directly before the examination.

First, the sequences are run without contrast media. The patient is then informed by the examiner when contrast medium is being given. The contrast agent-supported sequences are then produced. After the examination, the Braunule is removed.

Duration of an MRI with contrast medium

The average examination time is around 20 to 40 minutes.


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