The provider's guide to decide: contrast vs non-contrast MRI?

How to decide if contrast needed or not when ordering an MRI is the topic of this video, will explain how will we decide based on the indication of the MRI, I will also explain to you what an MRI sequence and MRI protocol are, multiple clinical scenarios to make this very clear to you will be provided in this video
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Link to contrast vs non-contrast CT video: • The provider's guide: ...
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[@tarafox6618]

Gadolinium allergy? How would we know until after injected?

[@nnnnguyen7889]

Caution on MRI with contrast gadolinium. I am a MRI w /Contrast's victim in 2020 : Next day of an abdomen MRI with contrast Gadolinium injection : muscle, joints, nerves pain, feet and hands and fingers tingling electric, fogging memory. The cost of an MRI is about $4,000- $6,000, They order me to a CT scan, then an MRI and an MRI with contrast together. Then more problem to your health, they send you to others specialists to get more treatment , then no cure available.The pain last for ever to today almost 4 years. I have notified FDA, but no help. They did not warn me before the injection, but oblige me to sign on the brochure when I came to pickup the DVD of MRI result. Please FDA help protect our human citizen. The Physician have to warn, explain to patient before ordering MRI with contrast. In Europe they forbid the MRI contrast gadolinium. Date 8/4/2003' ( see Gadolinium Toxicity, Gadolinium Deposition Disease).

[@hakeemfb3]

I'm sorry to hear you went through that nightmare of health issues after the contrast injection it's good you commenting an Warning others of the incident, how are you doing now?

[@rare6499]

Gadolinium is still present in the UK and Europe unfortunately

[@phyllishumes8431]

I am very sorry for the pain you encountered. What was the diagnosis? What were they looking for. Thank you for all this information and God bless you.

[@calebhollen5316]

Gadolinium... a heavy metal. Even with chelation some of the Heavy metal is left behind. I have a GBM and the gadolinium is killing my kidneys. Contrast should be used rarely. Would you have lead or mercury injected into the body?

[@user-sv1uw3ru1f]

GBCA is an industry lie right from its invention. They go over body’s to make a few bucks more.

[@carlh287]

Thank you so much your Answer the exact question that I needed to be answered I was terrified of getting contrast and now I know I don’t have to thank you so much

[@BritteLowtherTRAILS]

Dr. Al...you are killing it! (nice graphics). Thanks for this video. Especially helpful knowing when NPO is necessary

[@srikishankandakatla6135]

Llama 🦙 I will do it

[@jodettehattori4177]

Is pelvic MRI with contrast even necessary before the operative hysteroscopy? They saw some polyps during the diagnostic hysteroscopy and im asked to do MRI with contrast but im afraid of the side effects of gandolinium to my body and for my fertility journey (ivf)

[@josannelochanmd]

I love the cases to really cement what you explained before. Thank you.

[@Hospitalista]

Glad you found it helpful

[@syedarmaghanhassan4652]

Thanks for sharing. what about the headache? What kind of MRI would be appropriate there?

[@ericmckelvey1264]

I'm allergic to a lot. I might need a lower lumbar spine mri. I need an effective alternative. No injection or any contrast fluids taken.

[@LarryIsHere2Help]

I'm 42, going for a non contrast MRI for my brain. I past out and hit my head, I've been dealing with constant dizziness for over 30 days now. The neurologist mentioned possible concussion syndrome and ordered an MRI with no contrast. He's willing to add contrast if I feel strongly about it, but doesnt think in my case that I need it? Thoughts, thanks in advance.

[@Py16777216]

Kind of up to you. Use contrast in my opinion, no significant reason not to unless your allergic, may have to do contrast anyway unless you have bad kidney function. BTW anything significant noted on your MRI? Still have constant dizziness? Lesion or little stroke in your cerebellum perhaps? Best of luck to you.

[@areufkingkiddingme]

You don’t need it

[@jackiearmenta798]

Very informative video 👍 I will be having a MRI with contrast I. Two weeks. I’ve been having stomach pain that travels to my back and my side. Lab work was done and it turns out I have fatty liver and 3cm gallstone. But I was doing my own research on kidney disease and decided to check my lab results and eGFR shows as > 59 which I read it’s at stage 3 moderate GFR. My question is. Can my kidneys be affected or worsen with taking the contrast for the MRI?

[@Hospitalista]

Hi Jackie and thanks for reaching out, as you probably know that I can’t offer any clinical advice right here, I highly recommend that you discuss this with your doctor. I apologize for any inconvenience!

[@isobelcarson6096]

Apparently it depends on the contrast they use. If you eGFR is over 30 some IV contrast are safe. Ask your nephrologist to be sure.

[@petronellaflorenca4920]

Yes yes stay away

[@periklisgiannopoulos5273]

I am 48 years old and i have arythmia. Should i take agent or not?

[@Hospitalista]

I am sorry that I can’t give a specific clinical advice here as every patient is different! In general the type of the MRI we order depends on the type of headache or symptoms you have! Your doctor would be the best one to decide on that.

[@daze8326]

Incredible, thank you!

[@Hospitalista]

You are welcome!

[@petronellaflorenca4920]

I had a bad experience at hospital Xanit on benalmadena Spain Had a no contrast MRI PRESCRIPTION ABD THE NURSE 😮😮😮😮 DONE A NOT HONEST THONG ENDED UP WITH CONTRAST NOW DEALLING WITH VERY BAD SIDE EFFECTS IM SO DISAPPOINTED REGARDING THE SiTUATION I

[@djbettylou]

This was Great!!

[@dayshade6711]

Hello, thank you so much for your informative videos. Really excellent. In January I had an ultrasound scan detected b-lateral hydronephrosis, mild on the left mild to moderate on the right. Also, several non-shadowing hyperechoic foci measuring 7mm in my spleen. Which would be the safest for me to order - MRI or CT and with or without contrast dye? I should add I had a UTI infection in October. I will consult my medical practitioner, but you have detailed knowledge and I would appreciate your opinion. Thank you so much.

[@Hospitalista]

Thanks for reaching out but Am sorry to say that I can’t give any clinical advice as this is an educational channel, just follow up with your physician and let him decide what kind of CT suits your case

[@dayshade6711]

@@Hospitalista I appreciate your position and thank you for your reply. Kind regards.

[@Hospitalista]

Thanks for understanding

[@adil.abrahim8154]

I got an appendectomy, can the MRI affect the staples, thank you Dr.

[@Hospitalista]

It depends on how long these staples have been in? I highly recommend to check with your surgeon as he would the best one to guide you on this.

[@doctorrenee9420]

Excellent!

[@marieldejesus1989]

Hello! To check scaphoid, which one do you recommend sir? With or without contrast? Thanks in advance sir

[@Hospitalista]

Hi, thanks for reaching out! My apologies I can’t provide any specific clinical advice here! But in general, it’s all depends what are they looking for? Fracture? Infection?…etc. for fracture, contrast is typically not required. I highly recommend you follow your doctor advice

[@danielleg2616]

Mra of brain for pulsatile tinnitus. Do I have to use contrast? I don't want it but need to check for aneurysm

[@Hospitalista]

This’s not by any mean a medical advice. But in general, a special type of MRI called MRA is typically needed to check for aneurysm. MRA can be done with or without contrast but with contrast is highly superior and more informative.

[@kimaegaii]

I'm reading contradictory things. I read contrast is not necessary to find MS, however, in @9:00 it shows "yes" that one should use contrast in the situation. Would MS lesions not show with no contrast? Thanks!

[@Hospitalista]

There’s no contradiction, MS patients usually require brain and spinal cord MRI with and without contrast, the contrast is necessary to detect the active lesions

[@kimaegaii]

@@Hospitalista OK thanks. So an MRI without contrast would at least pick up whether there were lesions or not?

[@Hospitalista]

I have to say without contrast isn’t standard of care, you will miss any active lesions, also not sure if non-contrast study can definitively differentiate MS from other inflammatory processes

[@sonic-fm1gw]

@@Hospitalista What about muscle atrophy and muscle strains. Which mri can differentiate between new tissue formation after an injury?

[@gerryboyyyy]

hello doc, im having my right ankle mri due to my achilles injury. do i need contrast? or to have a non contrast mri. thanks

[@Hospitalista]

Hi, thanks for reaching out! My apologies I can’t give you any specific clinical advice here! In general, pure musculoskeletal issues typically don’t require contrast! I highly recommend you follow your doctor advice.

[@MorkusReX]

Hi, I've been having headaches for the past two months, mainly pressure on the sides of my brain and dizziness. I have a brain/head MRI tomorrow but do I need contrast? They told me yes, but I'm worried.

[@Hospitalista]

I hope you feel better soon, I highly recommend you go with your doctor advice.

[@MorkusReX]

@@Hospitalista I did a lot of reading.. Read most of the info on FDA website. I decided that if they use Linear Contrast, I won't take it, and if it's Macrocyclic, I will take it. I asked and they said that they stopped using Linear Contrast agents for good and they only use Macrocyclic (Tel Aviv hospital).. So I did the MRI with contrast . Now waiting for analysis. Thank you!

[@snowplays259]

@@MorkusReX update ?

[@MorkusReX]

@Luisa Gabriela Mendivelso Silva Can you explain? What happened after taking it? How many times did you take the Contrast before?

[@MorkusReX]

@Luisa Gabriela Mendivelso Silva How many contrast MRIs did you do before?

[@anupamabai8770]

Focal seizure what type MRI to do

[@K-XYA07__]

Can someone answer my question. I am a 14 year old kid and my nipples are leaking out yellow liquid (Endocrine glands) my pro lactin is over 1000 and I am getting an mri soon, am I gonna have a contrast or not?

[@Hospitalista]

I am sorry that I can’t give any specific individualized clinical advice to a patient on this platform! I advise you to ask your doctor about this. In general, a contrast MRI of the brain is preferred when looking for prolactin-producing adenoma.

[@sk00977]

@Hospitalista Can rectovaginal fistula show up on plain pelvis MRI? Does plain pelvis MRI give any findings of it ?

[@Hospitalista]

Yes it can reliably show the fistula without contrast. This is by no mean a clinical advice or recommendation as each patient is different. Please follow your doctor recommendations

[@captainadams7569]

Contrast, or no contrast heart MRI for a person suspected of having AL Amyloidosis?

[@Hospitalista]

CMR (Cardiovascular magnetic resonance) is usually done with contrast including for amyloidosis

[@johannaflores6907]

my daughter has high prolactin levels dr ordered mri without contrast. is contrast preferred?

[@Hospitalista]

Hi Johanna, I apologize that I can’t give any clinical advice right here, your daughter’s doctor is in a much better situation to make such decisions. In general -as I explained in the video- evaluation for prolactinoma is better done with contrast. Thanks for reaching out!

[@kaxar6954]

Can a MRI with/without contrast be done to image fibroids in a 40yr old woman?

[@goldenlifelove7251]

Yes it can. Im 48 & have fibroids and am getting an mri with & without contrast on November 1st for my fibroids.

[@googleuser806]

So we can do it without contrast ? I’m allergic to the CT scan contrast is MRI contrast the same contrast?

[@kaxar6954]

@@googleuser806 Yep..Gadolinium is use in MRI. You can request not to have contrast. Scan might not be as clear. Just keep still when they ask you to.

[@aiswaisw4517]

Is fasting is required for brain and spine mri with contrast?

[@Hospitalista]

Thanks for reaching out! My apologies I can’t give any specific clinical advice on this platform! In general brain and spine MRIs with or without contrast don’t typically require the patient to be NPO! I highly recommend you follow your doctor advice.

[@pinkahboo925]

I refuse to get contrast, I need an mri done for my neck is there a way to get out of contrast?

[@Hospitalista]

It depends why you need it, I recommend you follow your doctor advice. Good luck

[@-Hooman-]

I have an MRI with contrast in 3 weeks I'm not looking forward to it

[@Hospitalista]

All I can say you should listen to your doctor

[@amabonds]

Non contrast MRI is how many minutes

[@adenvalento]

Good question

[@bollywoodscenesandudayansh5947]

30 minutes

[@johnnyjohnson7642]

Unless Drs. A properly licence and trained to detect ecchocentric and other imaging shades& shadow of bone tissue cellular density sensitivity qualitative analysis contrast can cause kidney poisoning,damage to other organs,not to be used in all scans,willynilly,for$$ profit motive

[@ebbs3099]

It also accumulated in brain for year's, these docs never explain negative side effects to patients, it's heavy metal u not supposed to have in ur body

[@FirstClass-]

Gadolinium has literally ruined my life…

[@mustafaisbilen3695]

How

[@FirstClass-]

@@mustafaisbilen3695 Huge concentrated deposits were found not only in my brain, but in my kidneys which activated an abnormal immune response, causing severe permanent inflammation and thus bizarre symptoms. I took part in an FDA study back in 2012 where it was found the Gad isn’t fully excreted as once thought. In fact the FDA issued a MedWatch Alert about it back in 2014, placed a black boxed warning on the DataSheet and instructed doctors not to use it when possible. Also imaging centers must now warn patients in a consent form of these severe adverse medical events, but people fail to read what they sign these days.

[@hakeemfb3]

Can you please specify?!

[@FirstClass-]

@@hakeemfb3 My response was very "specific". What are you looking for?.. and be specific?

[@PinkyMB]

How has it ruined your life? Did it make you ill? Interested as I'm due to have an MRI with contrast very soon.

[@paulerschen1022]

It's difficult to concentrate on what you are saying in this video because you have a barking dog in the background! Didn't you think about that?

[@Hospitalista]

Actually that wasn’t a barking dog rather than sound effects I added when an image or a text appears on the screen! I should have picked a different sound effects or removed all of them.

[@tishguerrero]

It’s the slide sound effects

[@jothePianoMaster13]

Good information thank you but the dog barking in the background is very distracting to what you're saying!

[@Hospitalista]

My apologies. I made sure no noise distractions in my videos after that

[@doctorrenee9420]

Excellent!

[@Hospitalista]

Glad you found it helpful