MRI in Pregnancy and Precision Medicine: A Review from Literature

Magnetic resonance imaging (MRI) offers excellent spatial and contrast resolution for evaluating a wide variety of pathologies, without exposing patients to ionizing radiations. Additionally, MRI offers reproducible diagnostic imaging results that are not operator-dependent, a major advantage over ultrasound. MRI is commonly used in pregnant women to evaluate, most frequently, acute abdominal and pelvic pain or placental abnormalities, as well as neurological or fetal abnormalities, infections, or neoplasms. However, to date, our knowledge about MRI safety during pregnancy, especially about the administration of gadolinium-based contrast agents, which are able to cross the placental barrier, is still limited, raising concerns about possible negative effects on both the mother and the health of the fetus. Contrast agents that are unable to cross the placenta in a way that is safe for the fetus are desirable. In recent years, some preclinical studies, carried out in rodent models, have evaluated the role of long circulating liposomal nanoparticle-based blood-pool gadolinium contrast agents that do not penetrate the placental barrier due to their size and therefore do not expose the fetus to the contrast agent during pregnancy, preserving it from any hypothetical risks. Hence, we performed a literature review focusing on contrast and non-contrast MRI use during pregnancy.

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Are There Differences between Macrocyclic Gadolinium Contrast Agents for Brain Tumor Imaging? Results of a Multicenter Intraindividual Crossover Comparison of Gadobutrol with Gadoteridol (the TRUTH Study)

American Journal of Neuroradiology ◽

10.3174/ajnr.a4154 ◽

2014 ◽

Vol 36 (1) ◽

pp. 14-23 ◽

Cited By ~ 15

Author(s):

K. R. Maravilla ◽

M. P. Smith ◽

J. Vymazal ◽

M. Goyal ◽

M. Herman ◽

...

Keyword(s):

Brain Tumor ◽

Contrast Agents ◽

Tumor Imaging ◽

Gadolinium Contrast ◽

Imaging Results ◽

Gadolinium Contrast Agents ◽

Crossover Comparison

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Allergic Interstitial Nephritis Manifesting as a Striated Nephrogram

Case Reports in Medicine ◽

10.1155/2015/250530 ◽

2015 ◽

Vol 2015 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Irfan Moinuddin ◽

Erika Bracamonte ◽

Bijin Thajudeen ◽

Amy Sussman ◽

Machaiah Madhrira ◽

...

Keyword(s):

Contrast Agents ◽

Interstitial Nephritis ◽

Elevated Serum ◽

Kidney Injury ◽

Gadolinium Contrast ◽

Drug Induced ◽

Contrast Enhanced ◽

Gadolinium Contrast Agents ◽

Proven Case ◽

Magnetic Resonance Imaging Mri

Allergic interstitial nephritis (AIN) is an underdiagnosed cause of acute kidney injury (AKI). Guidelines suggest that AIN should be suspected in a patient who presents with an elevated serum creatinine and a urinalysis that shows white cells, white cell casts, or eosinophiluria. Drug-induced AIN is suspected if AKI is temporally related to the initiation of a new drug. However, patients with bland sediment and normal urinalysis can also have AIN. Currently, a definitive diagnosis of AIN is made by renal biopsy which is invasive and fraught with risks such as bleeding, infection, and hematoma. Additionally, it is frequently unclear when a kidney biopsy should be undertaken. We describe a biopsy proven case of allergic interstitial nephritis which manifested on contrast enhanced Magnetic Resonance Imaging (MRI) as a striated nephrogram. Newer and more stable macrocyclic gadolinium contrast agents have a well-demonstrated safety profile. Additionally, in the presentation of AKI, gadolinium contrast agents are safe to administer in patients who demonstrate good urine output and a downtrending creatinine. We propose that the differential for a striated nephrogram may include AIN. In cases in which the suspicion for AIN is high, this diagnostic consideration may be further characterized by contrast enhanced MRI.

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