What are the contraindications for MRI IV contrast?

There are two main contraindications for the administration of gadolinium IV contrast: risk of nephrogenic systemic fibrosis (NSF) and allergy to gadolinium. To prevent NSF current Department of Radiology policy sets a cut off of eGFR > 30 ml/min/1.73m2 or > 40 ml/min/1.73m2 for severe liver disease (http://radiology.yale.edu/patientcare/policies/gadolinium.aspx). The attending ER Radiologist and the referring clinician may allow for patients with eGFR greater than those thresholds to receive intravenous gadolinium when the risks are felt to be outweighed by the benefits and there is a subsequent completed attending nephrology/hepatology consult prior to ordering the study. Anaphylactoid reactions to IV gadolinium are thought to be much less common than reactions to IV iodinated contrast. Nevertheless, allergic reactions do occur, and patients at risk should be premedicated according to Department of Radiology policy (http://radiology.yale.edu/patientcare/policies/premedication.aspx).