Contrast medium

Contrast agents are substances used in imaging diagnostics to improve the representation of certain structures in order to answer specific questions about diseases. A different contrast medium is used depending on the method used. In MRI, a distinction is made between extracellular contrast agents, i.e. contrast agents that do not penetrate cells, and intracellular contrast agents, which mainly accumulate in cells and tissue.

Extracellular is most commonly used, typically gadolinium, which is excreted via the kidneys. Since the accumulation of this contrast medium depends on the kidney function, it is very important to check the kidney values before administering the agent, because if their function is restricted, the contrast medium may accumulate too much and possibly lead to kidney damage. This contrast medium leads to a brightening of the affected areas.

These are mainly vessels that then light up brightly in the image. The intracellular contrast medium varies depending on the imaging of the organ. Iron oxide particles are suitable for imaging the liver, while manganese compounds mainly lighten the pancreas.

Contrast media can also lead to side effects. Even when injected into the vein via an access, it can cause a burning and itching sensation on the skin or even the contrast medium can leak into the arm, which can lead to painful swelling. In itself, the MRI contrast medium is better tolerated than iodine-containing X-ray contrast media, but in rare cases they trigger allergic reactions, which most often manifest themselves on the skin.

In the case of a medically justifiable indication, the MRI of the spinal column is financed by health insurance companies in Germany. Depending on whether it is private insurance or statutory health insurance, radiologists are billed differently by the financing institutions, whereby the return for the physician is higher for private payers than for those with statutory health insurance. The costs of an MRI of the entire spine are practically made up of individual costs of the respective spinal column sections: cervical, thoracic and lumbar spine.The images are combined individually to form a whole, since the individual images offer a better resolution than an image of the entire spine.

The costs of an MRI of the respective sections for private patients are at least 244,81€, but maximum 612,08€. The increase in costs occurs when, in addition to simple imaging, the images are taken in different positions, contrast media are used, computer reconstruction is necessary and the radiologist reports the images. The longer and more complex the examination in the complete package, the higher the costs. For those with statutory health insurance, the costs are 124.60€ per section.