Gadolinium-Assisted MRI / MRA

Gadolinium is a contrast agent used to enhance the results of MRI (magnetic resonance imaging) and MRA (magnetic resonance angiography) scans. MRI is used for studying internal organs and tissues, while an MRA is a special type of MRI used to study blood vessels. Gadolinium can greatly enhance the results of these scans by providing greater contrast between normal and abnormal tissue. This makes it easier for the doctor to diagnose and assess tumors and aneurysms, and to evaluate the extent of multiple sclerosis or a stroke.

Gadolinium is the only MRI contrast agent approved by the FDA. It has been used since 1988 to diagnose abnormal cell structures in both adults and children. Gadolinium-assisted MRI procedures typically consist of two sets of scans. First, the doctor obtains several regular MRI scans. Then the patient receives an injection of a gadolinium-based contrast agent and the MRI scans are repeated. By comparing the two sets of images, the doctor can acquire invaluable diagnostic information.

Side Effects of Gadolinium

While gadolinium is considered a relatively safe medical substance, some patients experience side effects after undergoing a gadolinium-assisted MRI. Common gadolinium side effects are mild inflammation and infection of the injection site. Some patients might develop a light headache, nausea and lightheadedness; and low blood pressure has also been reported as a short-term side effect of gadolinium. These symptoms usually improve on their own, but sometimes patients require oral medications and/or administration of intravenous fluids.

In addition, some patients are allergic to gadolinium. The allergic reaction is typically mild, but in extreme cases it can be severe and even result in fatalities. Signs of an allergic reaction to a gadolinium-based contrast agent are itchy eyes, hives, rash and facial swelling. Depending on the extent of the allergic reaction, the doctor might prescribe medication to manage it.

Severe Side Effects of Gadolinium: NSF / NFD

Of the side effects of gadolinium, the most severe condition is nephrogenic systemic fibrosis (NSF) or nephrogenic fibrosing dermopathy (NFD). While this disease afflicts a relatively small number of patients who undergo a gadolinium-assisted MRI, NSF / NFD is a particularly debilitating condition that can cause death. Scientists currently do not know exactly how gadolinium exposure causes NSF / NFD, but they have established a strong link between these two occurrences. For example, in 2006, the FDA reported 90 cases of patients who had developed NSF / NFD after undergoing a gadolinium-assisted MRI.

The most notable signs of NSF / NFD are tightening and swelling of the skin, usually in the extremities, but sometimes throughout the whole body. The patient may also notice red patches on the skin, yellow spots near the eyes, muscle weakness and deep bone pain. As the condition progresses, the skin may become “woody” and the soft tissue throughout the body may become increasingly hardened. As a result, victims might become unable to walk, extend their arms and legs or perform other everyday activities. Due to the hardening of the internal tissues of the body, breathing might become restricted and other body functions could rapidly deteriorate.

There is currently no cure for NSF / NFD. Certain therapies (such as steroids and ultraviolet light treatments) can slow the progression of this disease and even result in partial recovery. If the NSF / NFD progresses to the point where vital internal organs become compromised, the outcome is often lethal.

NSF / NFD Legal Recourse