MRI - side effects with dye and effectiveness without?

  Dear Drs,
  I've had anterior disectomy and fusion C5-6. Still have
  significant herniations at other levels.  I had another MRI
  after surgery (4 months after) with dye because technicians
  said that the imaging would not be effective without it.
  I had severe chest pains after the MRI with dye injection.
  Now, doctor wants me to have another MRI done.  I will
  not allow the dye to be injected in me.  My question then,
  is will the MRI be of any diagnostic value?  Are there
  any other side effects of the MRI itself?  Since surgery
  by blood pressure is high.  Thank you for your response.
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Thanks for your question.  The "contrast" substance used in MRI, namely the Gadolinium, is very different from the Iodine-derived contrast used during the CT-scans or other X-ray type techniques.  Very extensive clinical studies have clearly shown that Gadolinium has a much smaller incidence of side-effects when compared to the Iodine-derived dyes.  Furthermore, Gadolinium has much smaller impact on the renal (kidney) function.  A possible explanation for your chest discomfort during your prior MRI scan would be an episode of anxiety caused by the tight physical environment of all MRI scanners (with the exception of the so-called "open MRI scanners").  Regarding the second part of your question, Gadolinium is used during the MRI scan to highlight possible lesions where there is a break-down of the blood-tissue barrier, thus causing the "leakage" of the Gadolinium from the blood vessels into the tissue.  The resulting MRI images will show up as a "bright" spot.  It is clearly indicated in cases where there is suspicion of tumors, intrinsic spinal cord disease (e.g. in Multiple Sclerosis), infectious abscess, etc.  Its indication is less clear if the suspected problem is a vertebral disc protrusion (as mentioned in your message).  The MRI scan without Gadolinium can provide a wealth of information, but if your physician is considering an "atypical" cause for your spine problems, then the Gadolinium scans can be invaluable.
I hope this information is helpful.  Best of luck.

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