Question

I have been referred to a neurologist who has arranged for me to have an MRI scan. This will involve the use of a dye/contrast agent called gadolinium. Is this a safe procedure to have for people with ME/CFS? Can it be used to confirm a diagnosis of ME? And can MRI brain scans cause any adverse reactions?

Answer

There are no specific contra-indications that indicate problems for people with ME/CFS who undergo these methods of investigation. Brain scans (CT, MRI, PET etc.) can provide very useful information about what is happening in the brain and nervous system.

MRI scans may involve having an injection of contrast dye. This helps to make tissues and blood vessels show up more clearly and in greater detail on the scan. I would check through the patient information that you will have been given about this particular scan and raise any concerns that you may have, especially in relation to allergic reactions and possible side-effects to the contrast dye, with the radiologist in the department where this procedure is going to be carried out.

Sometimes the contrast dye can cause side effects – such as feeling or being sick, a skin rash, headache or dizziness. These side effects are usually mild and don’t last very long. It’s also possible for the contrast dye to cause tissue and organ damage in people with kidney disease. So, if you have a history of kidney disease, you should be given a blood test to determine how well your kidneys are functioning and whether it’s safe to proceed with the scan. You should also let the staff know if you have a history of allergic reactions or any blood clotting problems before having the injection. Although allergic reactions to gadolinium contrast agents are uncommon they do occasionally occur. Most occur during the injection or within the first hour following administration; however, some can occur up to several days later.

As you may already know, there have been a considerable number of research studies carried out in people with ME/CFS using neuroimaging/ brain scans in order to assess both the structure and function of the central nervous system. However, none of the abnormalities that have been identified so far are sufficiently robust or consistent to make them useful for diagnostic or management purposes. Their main value is in relation to research into what may be going wrong in the brain and the exclusion of other neurological diseases (e.g., multiple sclerosis) that can cause ME/CFS-like symptoms.

• Please let us know if you have had an MRI brain scan and been told that it has produced useful information about ME/CFS, or you have experienced some form of adverse reaction: Feedback@meassociation.org.uk

More information

• All of the neuroimaging studies that have been carried out in ME/CFS are summarised and referenced in the Research section of the ME Association Clinical and Research Guide (The ‘Purple Book').
• NHS information: MRI Scan: How it's performed | August 2018
• Guy's and St. Thomas's NHS Foundation Trust: Patient information sheet on MRI scans using gadolinium contrast dye.