Nephrogenic Systemic Fibrosis

For more than 10 years it has been believed that gadolinium-based contrast agents in doses used for magnetic resonance imaging (MRI) are relatively safe with regard to acute non-renal and renal adverse reactions and delayed reactions. However, recent observations have shown that it may not be the case in patients with reduced renal function as gadolinium-based contrast agents may trigger the development of fibrosis in all parts of the body so-called nephrogenic systemic fibrosis (NSF). Its primary predilection is the skin. Unrelated to the development of NSF, contrast-induced nephropathy may occur after administration of gadolinium-based contrast agents. The current review updates the recent developments regarding the severe delayed reaction. However, the fear of NSF should not lead to a denial of a well-indicated enhanced MRI examination.