以往腎功能不佳的患者在接受顯影劑的影像學檢查時，多選擇核磁共振，因為它有著不會傷害腎功能的特性，但有愈來愈多的研究指出，這些患者潛藏著另一個嚴重的併發症- 腎因性全身纖維化(nephrogenic systemic fibrosis)，這是一種全新的疾病，在1997 年首次被發現，當時稱之為腎因性皮膚纖維化(nephrogenic fibrosing dermopathy)。此病之表徵主要為類硬皮症的皮膚纖維化，可能同時合併心、肺、肝、肌肉等全身器官的纖維化。這種疾病的標準診斷方式是皮膚切片，病理組織下會出現CD 34 陽性的紡錘細胞。發生腎因性全身纖維化的原因出在核磁共振顯影劑含的成分- 釓(gadolinium)，釓離子會造成組織的纖維化，特別是在腎臟
功能不全的患者，包括第四期和第五期的慢性腎臟病以及急性腎衰竭的患者，而使用劑量高
且不穩定的釓螯合物更會增加風險，如gadodiamide。也因為初期在皮膚表現上類似其他疾病，因此在鑑別診斷上臨床醫師應該更加小心，應考慮蜂窩性組織炎、過敏反應、黏液水腫以及
全身性硬化症的可能性。在治療方面，許多方法都有被嘗試過，包括紫外線、體外光除去法、血漿交換術以及靜脈注射免疫球蛋白等，沒有經證實有效的治療，因此更顯得預防的重要性。一般建議，當腎絲球濾過率小於30 毫升/ 分鐘時，儘可能避免使用含釓的核磁共振顯影劑，
假使必須使用時，也應該選擇穩定環狀結構的含釓顯影劑，將機率降到最低。而長期透析的
患者在使用含釓顯影劑後，應盡快安排兩次血液透析，將大部分的釓排除。

Magnetic Resonance Imaging (MRI) is the first choice of the imaging studies for patients with chronic kidney diseases in the past because it hardly injures kidneys. But increasing reports found that MRI in patients with chronic kidney diseases induces a potential complication –nephrogenic systemic fibrosis. This novel disease was reported in 1997 initially and named nephrogenic fibrosing dermopathy then. The manifestation of nephrogenic systemic fibrosis is skin fibrosis, similar to scleroderma, and it may be accompanied by heart, lung, liver and
muscle fibrosis. The gold standard of diagnosing the disease is skin biopsy with spindle cell and positive CD 34 stain in pathology. Its etiology is the component of MRI contrast – gadolinium. Gadolinium results in tissue fibrosis,especially in patients with chronic renal insufficiency, stage four to five chronic kidney diseases and acute kidney
injury. Furthermore, high dose and unstable gadolinium-based contrast media, such as gadodiamide, increase the risk. The initial dermal presentation of the disease mimics the other ones, such as cellulitis, allergic reaction,myxedema and systemic sclerosis, so clinicians should pay more attention to make differential diagnoses. Many therapies have been applied to treat this disease, including ultraviolet A,photopheresis, plasmapheresis and intravenous immunoglobulin, but no satisfied results are available. Therefore, prevention is the most important strategy. If the glomerular filtration rate is less than 30 mL/min, gadolinium-based contrast medium should be avoided as possible or should be composed of gadolinium with a stable cyclic structure to reduce the risk of nephrogenic systemic fibrosis. Twice hemodialysis should be arranged in long-term dialysis patients being exposed to gadolinium-based contrast medium to remove serum gadolinium.