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The Link Between MRI Gadolinium Contrast Media and Nephrogenic Systemic Fibrosis Presented in Patients with Renal Insufficiency

Jeff Berry, MS, RT(R)(CT) and Melony Green, BS, RT(R)

*Assistant Professor, Radiography Program Director, University of Oklahoma Health Sciences Center, College of Allied Health, Department of Medical Imaging and Radiation Sciences, Oklahoma City, Oklahoma.
Radiologic Technologist, Fort Worth, Texas.

Address correspondence to: Jeff Berry, MS, RT(R)(CT), Assistant Professor, Radiography Program Director, University of Oklahoma Health Sciences Center, 1200 North Stonewall, AHB-3021, Oklahoma City, OK 73117. E-mail: Jeff-Berry@ouhsc.edu

Disclosure Statement: The authors report having no significant financial or advisory relationships with corporate organizations related to this activity.


Nephrogenic systemic fibrosis (NSF) is a new disease that has raised concerns within magnetic resonance imaging (MRI) and the medical community. With the advancements in technology and imaging capabilities of MRI in the past decade, the use of gadolinium contrast agents has increased significantly in magnetic resonance angiography procedures, potentially leading to the sudden onset of NSF symptoms. The majority of NSF cases in the literature are associated with single or multiple doses of gadolinium contrast materials after a patient undergoes an MRI procedure. It has been suspected that gadolinium contrast media enables a metal toxic event that occurs systemically in skin, muscle, and organ tissues stimulating fibrosing characteristics. This disease is focused particularly in patient populations who have kidney disease or renal insufficiencies stemming from the decreased function of the glomerular filtration system. There are many possible causes of NSF, but the chief attribute is focused on gadolinium contrast agents: types, chemical stability, and the toxic transmetallation process. Over 90% of NSF cases can be linked to a previous MRI gadolinium contrast exam throughout research findings which has heightened apprehension within the US Food and Drug Administration and medical imaging facilities.

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