Contrast enhanced MRI is a commonly used procedure in magnetic resonance imaging. The need to more accurately characterize different types of lesions and to detect all malignant lesions is the main reason for the use of intravenous contrast agents.
Some methods are available to improve the contrast of different tissues. The focus of dynamic contrast enhanced MRI (DCE-MRI) is on contrast kinetics with demands for spatial resolution dependent on the application. DCE-MR imaging is used for diagnosis of cancer (see also liver imaging, abdominal imaging, breast MRI, dynamic scanning) as well as for diagnosis of cardiac infarction (see perfusion imaging, cardiac MRI). Quantitative DCE-MRI requires special data acquisition techniques and analysis software.
Contrast enhanced magnetic resonance angiography (CE-MRA) allows the visualization of vessels and the temporal resolution provides a separation of arteries and veins. These methods share the need for acquisition methods with high temporal and spatial resolution.
Double contrast administration (combined contrast enhanced (CCE) MRI) uses two contrast agents with complementary mechanisms e.g., superparamagnetic iron oxide to darken the background liver and gadolinium to brighten the vessels. A variety of different categories of contrast agents are currently available for clinical use.
Reasons for the use of contrast agents in MRI scans are:
Common Indications:
Brain MRI : Preoperative/pretreatment evaluation and postoperative evaluation of brain tumor therapy, CNS infections, noninfectious inflammatory disease and meningeal disease.
Spine MRI : Infection/inflammatory disease, primary tumors, drop metastases, initial evaluation of syrinx, postoperative evaluation of the lumbar spine: disk vs. scar.
Breast MRI : Detection of breast cancer in case of dense breasts, implants, malignant lymph nodes, or scarring after treatment for breast cancer, diagnosis of a suspicious breast lesion in order to avoid biopsy.

For Ultrasound Imaging (USI) see Contrast Enhanced Ultrasound at Medical-Ultrasound-Imaging.com. See also Blood Pool Agents, Myocardial Late Enhancement, Cardiovascular Imaging, Contrast Enhanced MR Venography, Contrast Resolution, Dynamic Scanning, Lung Imaging, Hepatobiliary Contrast Agents, Contrast Medium and MRI Guided Biopsy.

Macromolecular Gd labeled albumins are a new class of contrast agents with a wide range of use e.g., MR angiography, breast MRI, perfusion MRI, Lung perfusion, etc.
Marketed gadolinium-based albumin-bound contrast media are e.g., MultiHance®, and Vasovist™; other prototypes are in development. Malignant tumors often show an increased uptake and metabolism of plasma proteins, especially albumin. Contrast agents with large molecules are delivered to all tissues, but only accumulate in those with leaky vessels by tumor capillaries (tumor neovessels). MRI tumor perfusion studies with Gd labeled albumin can show the success of tumor therapy by quantitative decrease in MR signal of the malignant tissue after therapy compared to before. In addition, the study of tumor sensitivity to a therapy with drug-labeled albumins seems possible.
After renal transplantation, MRI may diagnose albuminuria caused by glomerular disease with an albumin-bound blood pool contrast agent

See also Blood Pool Agents, Intravascular Contrast Agents, Contrast Enhanced MRI.

Short name: PLLGd-DTPA, generic name: (Gd-DTPA)n-polylysine, chemical compound: Gd-DTPA poly(L-lysine-Gd-diethylenetriamine-N,N,N',N'',N''-pentaacetic acid), central moiety: Gd2+, relaxivity: r1=13.1, B0=0.23T
A polymeric MRI contrast agent under development (preclin., Bayer Schering Pharma AG, Berlin, Germany) with advantages in both MRA and in the differential diagnosis of tumors, particularly in perfusion studies of the myocardium and potential in MR lung perfusion. Dozens of the relatively small molecule Gd-DTPA is bound covalently to polylysine, a large molecular weight backbone. The stable, highly water-soluble agent does not diffuse through the endothelium of the vascular system; it is subject to renal elimination.

(Hb) Haemoglobin is the major endogenous oxygen-binding molecule, responsible for binding oxygen in the lung and transporting it to the tissues by means of the circulation. Haemoglobin is contained in very high concentration in the red blood cells.
Haemoglobin is an Fe chelate tightly binding one Fe ion in its II oxidation state where it carries the charge 2+ (ferrous iron). If an oxygen molecule is bound to Hb, Hb is called oxyhaemoglobin, if no oxygen molecule is bound it is called deoxyhaemoglobin. When haemoglobin is oxidized (i.e. in a haematoma), Fe2+ is transformed into Fe3+. The resulting haemoglobin is then called metoxyhaemoglobin (Hb Fe3+).
Deoxyhaemoglobin and metoxyhaemoglobin act as paramagnetic contrast agents in MR, while oxyhaemoglobin is diamagnetic. This partly explains the special appearance of an aging haematoma in MR imaging and is also the basic of the blood oxygenation level dependent contrast (BOLD) used in functional magnetic resonance imaging of the brain (fMRI).

(HASTE) A pulse sequence with data acquisition after an initial preparation pulse for contrast enhancement with the use of a very long echo train (Single shot TSE), whereat each echo is individually phase encoded. This technique is a heavily T2 weighted, high speed sequence with partial Fourier technique, a great sensitivity for fluid detection and a fast acquisition time of about 1 sec per slice. This advantage makes it possible for using breath-hold with excellent motionless MRI, e.g. used for liver and lung imaging.

See also Segmented HASTE.