Radiology Practice Test

What potential risk is associated with gadolinium-based contrast agents used in MRI?

1. Radiation burn

2. Nephrogenic systemic fibrosis (NSF) in patients with renal impairment

3. Allergic reactions in all patients

4. Respiratory distress

The correct answer is: Nephrogenic systemic fibrosis (NSF) in patients with renal impairment

Gadolinium-based contrast agents are commonly used in magnetic resonance imaging (MRI) to enhance the visibility of internal structures. One significant risk associated with these agents, especially in patients with pre-existing kidney issues, is nephrogenic systemic fibrosis (NSF). NSF is a serious condition characterized by fibrosis of the skin and internal organs, which can develop in individuals with renal impairment after exposure to gadolinium. The risk of NSF arises because patients with compromised kidney function may struggle to eliminate gadolinium from their system, leading to its accumulation. This condition, first identified in the early 2000s, prompted stringent guidelines for the use of gadolinium-based agents in those with known renal diseases, particularly stages 4 and 5 chronic kidney disease. As a result, healthcare professionals are advised to assess renal function before administering gadolinium contrast, and alternatives may be considered for at-risk patients. Understanding this risk is crucial for practitioners to ensure patient safety and minimize the potential for serious adverse events following MRI procedures that involve contrast agents.