Keywords:
Musculoskeletal system, MR, Contrast agent-intravenous, Safety, Education and training
Authors:
A. Shah1, R. Botchu2; 1Leicester/UK, 2Birmingham/UK
DOI:
10.26044/essr2019/P-0090
Conclusion
Majority of Radiologists surveyed use gadolinium for extra-axial MSK imaging.
Gadolinium has a role as a problem solver and its use should be restricted to absolutely necessity and where the diagnosis or management is going to change.
For example,
gadolinium use for bone tumour imaging has negligible benefit as seen in Figure 11.
Furthermore,
patients will have bone scans for skip lesions and the contrast resolution and tissue characterisation of unenhanced MRI can often lead to appropriate diagnoses.
Ultrasound plays an important role in the work up of soft tissue lumps.
It can accurately demonstrate lesions which are solid or cystic and when correlation with MRI is made,
this often precludes the need to use gadolinium.
Lesions which are indeterminate will invariably undergo a biopsy.
The use of gadolinium can help diagnostic challenging cases or for certain clinical scenarios such as infection and post-surgical follow-up of soft tissue tumours.
With the increasing evidence of gadolinium retention,
albeit an unknown risk,
should make radiologists stop and think…..do I really need to give it?