A large network of interconnecting blood vessels at the base of the brain that when visualized resembles a circle, the arteries effectively act as anastomoses for each other. This means that if any one of the communicating arteries becomes blocked, blood can flow from another part of the circle to ensure that blood flow is not compromised.
The circle of Willis is formed by both the internal carotid arteries, entering the brain from each side and the basilar artery, entering posteriorly. The connection of the vertebral arteries forms the basilar artery. The basilar artery divides into the right and left posterior cerebral arteries. The internal carotid arteries trifurcate into the anterior cerebral artery, middle cerebral artery, and posterior communicating artery. The two anterior cerebral arteries are joined together anteriorly by the anterior communicating artery. The posterior communicating arteries join the posterior cerebral arteries, completing the circle of Willis.
The time of flight angiography MRI technique allows imaging of the circle of Willis without the need of a contrast medium (best results with high field MRI). A cerebrovasular contrast enhanced magnetic resonance angiography (MRA) depicts the circle of Willis in addition to the vessels of the neck (carotid and vertebral arteries) with one bolus injection of a contrast agent.

For Ultrasound Imaging (USI) see Cerebrovascular Ultrasonography at Medical-Ultrasound-Imaging.com.

Dotarem® is a paramagnetic ionic MRI contrast agent. Extracellular contrast agents like Dotarem®, can be bolus injected because of the relatively low rate of side effects. This contrast medium is useable to enhance signal intensity in magnetic resonance imaging for intracranial and spinal lesions with an abnormal blood brain barrier or abnormal vascularity, and in whole body imaging.

WARNING: NEPHROGENIC SYSTEMIC FIBROSIS Gadolinium-based contrast agents increase the risk for nephrogenic systemic fibrosis (NSF) in patients with acute or chronic severe renal insufficiency (glomerular filtration rate less than 30 mL/min/1.73m²), or acute renal insufficiency of any severity due to the hepato-renal syndrome or in the perioperative liver transplantation period.

From Hitachi Medical Systems America Inc.;
Hitachi expanded its portfolio with the Echelon™ 1.5T. The MRI scanner combines a compact magnet and a scalable 8-channel RF system with high-performance gradients and slew rate to select short echo times, small field of views, high matrices and thin slices. Standard features of the Echelon MRI system include higher-order active shim, RAPID (parallel imaging for use on brain MRI, body, cardiovascular imaging, and orthopedic coils), multiple coil ports, and an advanced reconstruction engine.

Eovist® (other brand name Primovist™) is a organ specific MRI contrast agent for the imaging, detection and characterization of liver conditions, including liver tumors, cysts, as well as other malignant and benign lesions. It is a water-soluble ethoxybenzyl derivative of Gd-DTPA. This compound is taken up by the hepatocytes (approximately 30% of the dose goes to the hepatocytes) and is equally excreted renal and biliary in humans. Excretion of Gd-EOB-DTPA in the bile may also permit visualization of both the gall bladder and the bile ducts.
Eovist® brightens the signal of T1 weighted MR images immediately after contrast administration. Dynamic and accumulation phase imaging can also be performed after bolus injection of Eovist®. The hepatocytes uptake will increase the signal intensity of normal liver parenchyma at 10 to 20 minutes after injection. This results in improved lesion-to-liver contrast because malignant tumors (metastases, the majority of hepatocellular carcinomas) do not contain either hepatocytes or their functioning is hampered.

WARNING: Gadolinium-based contrast agents increase the risk for nephrogenic systemic fibrosis (NSF) in patients with acute or chronic severe renal insufficiency (glomerular filtration rate less than 30 mL/min/1.73m²), or acute renal insufficiency of any severity due to the hepato-renal syndrome or in the perioperative liver transplantation period.

See also Drug Development and Approval Process USA, Contrast Medium, Hepatobiliary Contrast Agents, Tumor Specific Agents and Molecular Imaging.

Short name: Gd-BOPTA, generic name: Gadobenate dimeglumine
A paramagnetic MRI contrast agent (small molecular weight Gd-chelate) with 0.5 and 0.25 molar concentration.
The albumin-mediated relaxation enhancement may result in advantages for Gd-BOPTA over Gd-DTPA and other gadolinium agents in poorly vascularized, small, or lesions with low enhancement and in tumors with high concentrations of albumin. The substance is excreted partly by the kidneys (75-90%), partly by the biliary system (10-25%). The uptake in the liver is about 5% in humans. It is bolus injectable.

See Contrast Agents and MultiHance®.