A pilot study to investigate the effect of a hydration regime upon immediate and 24 h delayed MRI contrast agent reactions

PurposeAdverse reaction rates to gadolinium based magnetic resonance imaging (MRI) contrast agents which occur immediately post-injection are well documented. However little research has investigated delayed reaction rates (i.e. 30 min–24 h). This study evaluated the rate of immediate and delayed adverse reaction rates to a gadolinium based MRI contrast agent (Dotarem®) and investigated the effect of a hydration regime on the rate of adverse events.MethodFifty-eight patients received no preparation, prior to administration of the contrast agent, whilst another 58 underwent a hydration protocol. The patients had their answers to a questionnaire recorded immediately after the scanning procedure and also via a follow-up telephone call 24 h later.ResultsIn the unprepared group 9 patients (15.5%) experienced immediate adverse events, i.e. within 0–30 min, whereas 24 (41.4%) experienced delayed reactions (30 min–24 h) after administration of the contrast agent. In the hydrated patient group 6 (10.3%) experienced an immediate adverse event, whilst 8 (13.7%) experienced delayed events post-injection. The difference in the total reaction rates for the unprepared and hydrated groups was statistically significant for immediate and delayed reactions. The difference in the rates of delayed headache, nausea, dizziness and problems with the injection site, for the unprepared and hydrated groups was statistically significant.ConclusionAn oral hydration regime administered to patients, both before and after MRI contrast agent administration significantly reduced the total number of immediate and delayed reactions. It also significantly reduced delayed headache, nausea, dizziness and problems at the injection site. Whilst this pilot study had methodological shortcomings, the strength of the relationship demonstrated are worthy of further investigation.