Use and Safety of Gadolinium Based Contrast Agents in Pediatric MR Imaging

Indian J Pediatr. 2019 Oct;86(10):961-966. doi: 10.1007/s12098-019-02891-x. Epub 2019 Feb 22.


Gadolinium-based contrast agents (GBCA) used for MR imaging are a valuable imaging resource that has benefited patient management over last three decades and largely have a high safety profile. However, recently, adverse effects related to GBCA like nephrogenic systemic fibrosis (NSF) and asymptomatic gadolinium deposition in tissues including brain are concerning. While NSF has largely stopped occurring due to precautions and guidelines to not use GBCA in patients with poor renal function, the long term effects of gadolinium deposition, especially in brain, are not known at this stage. Cautious approach needs to be taken with risk-benefit analysis in each patient to avoid its administration when not necessary. In this review, authors discuss basics of gadolinium, mechanism of enhancement, agents in clinical use and safety issues, and in the end, offer some solutions for safety concerns.

Keywords: Children; Gadolinium deposition; Gadolinium-based contrast agents; MRI; NSF.

Publication types

  • Review

MeSH terms

  • Brain / diagnostic imaging
  • Child
  • Contrast Media / administration & dosage
  • Contrast Media / adverse effects*
  • Contrast Media / standards
  • Drug-Related Side Effects and Adverse Reactions
  • Gadolinium / administration & dosage
  • Gadolinium / adverse effects*
  • Gadolinium / standards
  • Humans
  • Kidney
  • Magnetic Resonance Imaging / methods*
  • Nephrogenic Fibrosing Dermopathy / diagnostic imaging
  • Pediatrics*
  • Tomography, X-Ray Computed


  • Contrast Media
  • Gadolinium