Can Symptoms of GDD be Aggravated with MRI Even Without GBCA Administration?
This question has come up on a few occasions, and also a few individuals have remarked that they have experienced this. They were symptomatic with GDD and therefore underwent noncontrast MRI, but still had a worsening of symptoms afterwards. The entire subject of GDD is new, so this possibility is then ultra new. My initial thoughts are that it is difficult to explain how this could happen.
There are two possibilities:
1. the magnetic field may cause the deposited Gd to show micromovement, perhaps torsion in the magnetic field. This would be on a microscopic scale as Gd is paramagnetic and not magnetic (iron is magnetic).
2. authors have proposed that RF energy (RF is the transmission pulses used in MRI, an essential part of MRI in addition to the presence of a strong and fluctuating magnetic field) may aggravate issues with heavy metal depositions, in particular Gd. I have heard the occasional patient comment that the RF energy from cell phones also aggravated her condition.
So can this happen? Possibly. I am not at the point to state that even noncontrast MRI should be avoided in general, which is my firm opinion with GBCA injections, that they must be avoided. If you have GDD, you should never get another GBCA injection again. Noncontrast MRI should most often be ok. If however you have undergone noncontrast MRI and have experienced Flare type symptoms of your baseline GDD, whether it is due to micromovements or torsion of Gd by the magnetic field, or if it is heightened sensitivity to RF radiation, a combination, or something else altogether; good judgment would suggest that you never have any MRI again. I suspect this may be a small subset of GDD patients who experience this problem.
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