(Mn-DPDP) This agent, mangafodipir trisodium, is a hepatocyte specific MRIcontrast agent. Manganese is very toxic, so it has to be chelated and put in the form of a vitamin B6 analog, which is taken up by normal hepatocytes to some extent.
Teslascan® was developed in the early 1980's, went through clinical trials in the early 1990's, and was approved in 1997. One problem with assessing the efficacy of this agent is the fact that the phase III trials finished in the early 1990's, and the techniques used for MR today are very different from the techniques used almost a decade ago.
This contrast agent shortens the T1relaxation time. On T1 weighted pictures it makes a normal liver look brighter. Since metastases, for example, do not generally take up this agent, the contrast between the enhancing liver and the non-enhancing lesions will increase on T1 weighted pictures. It does not have much effect on T2 weighted images.
(TOF) The time of flight angiography is used for the imaging of vessels. Usually the sequence type is a gradient echosequences with short TR, acquired with slices perpendicular to the direction of blood flow.
The source of diverse flow effects is the difference between the unsaturated and presaturated spins and creates a bright vascular image without the invasive use of contrast media. Flowing blood moves unsaturated spins from outside the slice into the imaging plane. These completely relaxed spins have full equilibriummagnetization and produce (when entering the imaging plane) a much higher signal than stationary spins if a gradient echo sequence is generated. This flow related enhancement is also referred to as entry slice phenomenon, or inflow enhancement.
Performing a presaturationslab on one side parallel to the slice can selectively destroy the MR signal from the in-flowing blood from this side of the slice. This allows the technique to be flow direction sensitive and to separate arteriograms or venograms. When the local magnetization of moving blood is selectively altered in a region, e.g. by selective excitation, it carries the altered magnetization with it when it moves, thus tagging the selected region for times on the order of the relaxation times.
For maximum flow signal, a complete new part of blood has to enter the slice every repetition (TR) period, which makes time of flight angiography sensitive to flow-velocity. The choice of TR and slice thickness should be appropriate to the expected flow-velocities because even small changes in slice thickness influences the performance of the TOF sequence.
The use of sequential 2 dimensional Fourier transformation (2DFT) slices, 3DFT slabs, or multiple 3D slabs (chunks) are depending on the coverage required and the range of flow-velocities.
3D TOF MRA is routinely used for evaluating the Circle of Willis.