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.

Magnetic resonance imaging of the heart is a diagnostic MRI procedure that is useful to evaluate the structures, the function and viability of the heart and the major blood vessels.

See also Cardiac MRI, Cardiovascular Imaging, MRA, Cardiac Stent, Myocardial Late Enhancement and Coronary Angiography.

The MRI device is located within a specially shielded room (Faraday cage) to avoid outside interference, caused by the use of radio waves very close in frequency to those of ordinary FM radio stations.
The MRI procedure can easily be performed through clothing and bones, but attention must be paid to ferromagnetic items, because they will be attracted from the magnetic field. A hospital gown is appropriate, or the patient should wear clothing without metal fasteners and remove any metallic objects like hairpins, jewelry, eyeglasses, clocks, hearing aids, any removable dental work, lighters, coins etc., not only for MRI safety reasons. Metal in or around the scanned area can also cause errors in the reconstructed images (artifacts). Because the strong magnetic field can displace, or disrupt metallic objects, people with an implanted active device like a cardiac pacemaker cannot be scanned under normal circumstances and should not enter the MRI area.
The MRI machine can look like a short tunnel or has an open MRI design and the magnet does not completely surround the patient. Usually the patient lies on a comfortable motorized table, which slides into the scanner, depending on the MRI device, patients may be also able to sit up. If a contrast agent is to be administered, intravenous access will be placed. A technologist will operate the MRI machine and observe the patient during the examination from an adjacent room. Several sets of images are usually required, each taking some minutes. A typical MRI scan includes three to nine imaging sequences and may take up to one hour. Improved MRI devices with powerful magnets, newer software, and advanced sequences may complete the process in less time and better image quality.
Before and after the most MRI procedures no special preparation, diet, reduced activity, and extra medication is necessary. The magnetic field and radio waves are not felt and no pain is to expect.
Movement can blur MRI images and cause certain artifacts. A possible problem is the claustrophobia that some patients experience from being inside a tunnel-like scanner. If someone is very anxious or has difficulty to lie still, a sedative agent may be given. Earplugs and/or headphones are usually given to the patient to reduce the loud acoustic noise, which the machine produces during normal operation. A technologist observes the patient during the test. Some MRI scanners are equipped with televisions and music to help the examination time pass.
MRI is not a cheap examination, however cost effective by eliminating the need for invasive radiographic procedures, biopsies, and exploratory surgery. MRI scans can also save money while minimizing patient risk and discomfort. For example, MRI can reduce the need for X-ray angiography and myelography, and can eliminate unnecessary diagnostic procedures that miss occult disease.

See also Magnetic Resonance Imaging MRI, Medical Imaging, Cervical Spine MRI, Claustrophobia, MRI Risks and Pregnancy.
For Ultrasound Imaging (USI) see Ultrasound Imaging Procedures at Medical-Ultrasound-Imaging.com.

See also the related poll result: 'MRI will have replaced 50% of x-ray exams by'

MS-325 is the formerly code name of gadofosveset trisodium (new trade name Vasovist). MS-325 belongs to a new class of blood pool agents for magnetic resonance angiography (MRA) to diagnose vascular disease. Gadofosveset trisodium has ten times the signal-enhancing power of existing contrast agents as well as prolonged retention in the blood. This enables the rapid acquisition of high resolution MRA's using standard MRI machines.
Gadofosveset trisodium, which is gadolinium-based, stays in the blood stream as a result of transient binding to albumin. Albumin binding offers an additional benefit beyond localization in the blood pool. The contrast agent begins to spin much more slowly, at the rate albumin spins, causing a relaxivity gain that produces a substantially brighter signal than would be possible with freely circulating gadolinium. MS-325 is an intravascular contrast agent intended for use in MRI as an aid in diagnosing aortoiliac occlusive disease in patients with known or suspected peripheral vascular disease (PVD) or abdominal aortic aneurysm (AAA).
Currently clinical trials completed for peripheral vascular disease and coronary artery disease. Additional trials are also being conducted to evaluate MS-325 as an aid in diagnosing breast cancer and suggested that it might be feasible to combine the use of MS-325, injected during peak stress, with delayed high-resolution imaging to identify myocardial perfusion defects.
Vasovist (MS-325) would compete with the contrast agents Ferumoxytol (Code 7228) from AMAG Pharmaceuticals, Inc. and NC100150 Injection from Nycomed Amersham, but their further development is uncertain.
Partners in development: EPIX Pharmaceuticals, Inc., Mallinckrodt Inc., and Bayer Schering Pharma AG. Bayer Schering Pharma has the worldwide marketing rights for the product.
Formerly known under the Mallinckrodt trademark name, AngioMARK®.

See also Classifications, Characteristics, etc.

(MRA) Magnetic resonance angiography is a medical imaging technique to visualize blood filled structures, including arteries, veins and the heart chambers. This MRI technique creates soft tissue contrast between blood vessels and surrounding tissues primarily created by flow, rather than displaying the vessel lumen. There are bright blood and black blood MRA techniques, named according to the appearance of the blood vessels. With this different MRA techniques both, the blood flow and the condition of the blood vessel walls can be seen. Flow effects in MRI can produce a range of artifacts. MRA takes advantage of these artifacts to create predictable image contrast due to the nature of flow.
Technical parameters of the MRA sequence greatly affect the sensitivity of the images to flow with different velocities or directions, turbulent flow and vessel size.
This are the three main types of MRA:
All angiographic techniques differentially enhance vascular MR signal. The names of the bright blood techniques TOF and PCA reflect the physical properties of flowing blood that were exploited to make the vessels appear bright. Contrast enhanced magnetic resonance angiography creates the angiographic effect by using an intravenously administered MR contrast agent to selectively shorten the T1 of blood and thereby cause the vessels to appear bright on T1 weighted images.
MRA images optimally display areas of constant blood flow-velocity, but there are many situations where the flow within a voxel has non-uniform speed or direction. In a diseased vessel these patterns are even more complex. Similar loss of streamline flow occurs at all vessel junctions and stenoses, and in regions of mural thrombosis. It results in a loss of signal, due to the loss of phase coherence between spins in the voxel.
This signal loss, usually only noticeable distal to a stenosis, used to be an obvious characteristic of MRA images. It is minimized by using small voxels and the shortest possible TE. Signal loss from disorganized flow is most noticeable in TOF imaging but also affects the PCA images.
Indications to perform a magnetic resonance angiography (MRA):
Conventional angiography or computerized tomography angiography (CT angiography) may be needed after MRA if a problem (such as an aneurysm) is present or if surgery is being considered.

See also Magnetic Resonance Imaging MRI.