Contrast agents in MRI

Despite the excellent inherent tissue contrast in MR images, intravenous contrast medium is often given to highlight abnormal tissue. Chelates of the paramagnetic substance gadolinium are used - they shorten the relaxation times of nearby protons which results in high signal on Tl-weighted images. Gadolinium has similar pharmacokinetics to the iodinated contrast media used in CT - it is distributed throughout the intra- and extravascular spaces, does not cross the intact blood-brain barrier, is hyperosmolar and excreted renally - caution is needed in patients with renal failure. The frequency of adverse reactions is around 2-5%, although most are mild (nausea, urticaria, etc.). Anaphylactoid reactions are rare, but have been reported.

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