(NSF) Nephrogenic systemic fibrosis is a rare and highly debilitating disorder that involves extensive thickening and hardening of the skin with fibrotic nodules and plaques.
MRI contrast media have very low side effects, but accumulating data indicate that gadolinium-based contrast agents increase the risk for the development of NSF among patients with severe renal insufficiency or renal dysfunction due to the hepato-renal syndrome or in the perioperative liver transplantation period.
Due to this reason, gadolinium contrast agents are now considered contraindicated in patients with an estimated glomerular filtration rate fewer than 30 mL/min/1.73m². In these patients, avoid use of gadolinium-based contrast agents unless the diagnostic information is essential and not available with non-contrast enhanced magnetic resonance imaging (MRI).

Recognized or possibly associated factors for NSF:
When administering a gadolinium-based contrast agent, do not exceed the recommended dose and allow a sufficient period of time for elimination of the contrast medium from the body prior to any readminstration. Screen all patients for renal dysfunction by obtaining a history and/or laboratory tests.

See also Contrast Medium, Adverse Reaction, MRI Risks, MRI Safety, Ionic Intravenous Contrast Agents, Nonionic Intravenous Contrast Agents, and Contraindications.

ABLAVAR™ (formerly named Vasovistâ„¢) is a blood pool agent for magnetic resonance angiography (MRA), which opens new medical imaging possibilities in the evaluation of aortoiliac occlusive disease (AIOD) in patients with suspected peripheral vascular disease.
ABLAVARâ„¢ binds reversibly to blood albumin, providing imaging with high spatial resolution up to 1 hour after injection, due to its high relaxivity and to the long lasting increased signal intensity of blood.
As with other contrast media: the possibility of serious or life-threatening anaphylactic or anaphylactoid reactions, including cardiovascular, respiratory and/or cutaneous manifestations, should always be considered.

WARNING:
NEPHROGENIC SYSTEMIC FIBROSIS Gadolinium-based contrast agents increase the risk for nephrogenic systemic fibrosis (NSF) in patients with acute or chronic severe renal insufficiency (glomerular filtration rate less than 30 mL/min/1.73m²), or acute renal insufficiency of any severity due to the hepato-renal syndrome or in the perioperative liver transplantation period.

See also Cardiovascular Imaging, Adverse Reaction, Molecular Imaging, and MRI Safety.

Ultrasound imaging is the primary fetal monitoring modality during pregnancy, nevertheless fetal MRI is increasingly used to image anatomical regions and structures difficult to see with sonography. Given its long record of safety, utility, and cost-effectiveness, ultrasound will remain the modality of first choice in fetal screening. However, MRI is beginning to fill a niche in situations where ultrasound does not provide enough information to diagnose abnormalities before the baby's birth. Magnetic resonance imaging of the fetus provides multiplanar views also in sub-optimal positions, better characterization of anatomic details of e.g. the fetal brain, and information for planning the mode of delivery and airway management at birth.

Indications:
Modern fetal MRI requires no sedatives or muscle relaxants to control fetal movement. Ultrafast MRI techniques (e.g., single shot techniques like Half Fourier Acquisition Single shot Turbo spin Echo HASTE) enable images to be acquired in less than one second to eliminate fetal motion. Such technology has led to increased usage of fetal MRI, which can lead to earlier diagnosis of conditions affecting the baby and has proven useful in planning fetal surgery and designing postnatal treatments. As MR technology continues to improve, more advances in the prenatal diagnosis and treatment of fetal abnormalities are to expect. More advances in in-utero interventions are likely as well. Eventually, fetal MRI may replace even some prenatal tests that require invasive procedures such as amniocentesis.

For Ultrasound Imaging (USI) see Fetal Ultrasound at Medical-Ultrasound-Imaging.com.

(HASTE) A pulse sequence with data acquisition after an initial preparation pulse for contrast enhancement with the use of a very long echo train (Single shot TSE), whereat each echo is individually phase encoded. This technique is a heavily T2 weighted, high speed sequence with partial Fourier technique, a great sensitivity for fluid detection and a fast acquisition time of about 1 sec per slice. This advantage makes it possible for using breath-hold with excellent motionless MRI, e.g. used for liver and lung imaging.

See also Segmented HASTE.

(MRCP) This MR imaging technique takes advantage of the high signal intensity of body fluids and acquires heavy T2 weighted images of the gall bladder, the pancreas and parts of the liver. Due to the T2 weighting, the liver and other solid parenchyma are signal suppressed and only fluid-filled structures in addition to the gall bladder, the bile and pancreatic ducts retain important signal intensity. Hepatobiliary contrast agents (e.g. Gadoxetic Acid, CMC 001) can be useful for enhancement of the bile ducts and better imaging of the biliary tract.
A 2D cholangiogram, often only one thick slice (a volume with a thickness of 4 - 8 cm, mostly coronal planned) or 5 - 6 radial placed slices, shows a view like single slices. If a 3D acquisition is used, the postprocessing function maximum intensity projection (MIP) can show reconstructions from multiple sides.