(Mn-DPDP) This agent, mangafodipir trisodium, is a hepatocyte specific MRI contrast 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 T1 relaxation 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.

General MRI of the abdomen can consist of T1 or T2 weighted spin echo, fast spin echo (FSE, TSE) or gradient echo sequences with fat suppression and contrast enhanced MRI techniques. The examined organs include liver, pancreas, spleen, kidneys, adrenals as well as parts of the stomach and intestine (see also gastrointestinal imaging). Respiratory compensation and breath hold imaging is mandatory for a good image quality.
T1 weighted sequences are more sensitive for lesion detection than T2 weighted sequences at 0.5 T, while higher field strengths (greater than 1.0 T), T2 weighted and spoiled gradient echo sequences are used for focal lesion detection. Gradient echo in phase T1 breath hold can be performed as a dynamic series with the ability to visualize the blood distribution. Phases of contrast enhancement include the capillary or arterial dominant phase for demonstrating hypervascular lesions, in liver imaging the portal venous phase demonstrates the maximum difference between the liver and hypovascular lesions, while the equilibrium phase demonstrates interstitial disbursement for edematous and malignant tissues.
Out of phase gradient echo imaging for the abdomen is a lipid-type tissue sensitive sequence and is useful for the visualization of focal hepatic lesions, fatty liver (see also Dixon), hemochromatosis, adrenal lesions and renal masses. The standards for abdominal MRI vary according to clinical sites based on sequence availability and MRI equipment. Specific abdominal imaging coils and liver-specific contrast agents targeted to the healthy liver tissue improve the detection and localization of lesions.
See also Hepatobiliary Contrast Agents, Reticuloendothelial Contrast Agents, and Oral Contrast Agents.

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

Cervical spine MRI is a suitable tool in the assessment of all cervical spine (vertebrae C1 - C7) segments (computed tomography (CT) images may be unsatisfactory close to the thoracic spine due to shoulder artifacts). The cervical spine is particularly susceptible to degenerative problems caused by the complex anatomy and its large range of motion.
Advantages of magnetic resonance imaging MRI are the high soft tissue contrast (particularly important in diagnostics of the spinal cord), the ability to display the entire spine in sagittal views and the capacity of 3D visualization. Magnetic resonance myelography is a useful supplement to conventional MRI examinations in the investigation of cervical stenosis. Myelographic sequences result in MR images with high contrast that are similar in appearance to conventional myelograms. Additionally, open MRI studies provide the possibility of weight-bearing MRI scan to evaluate structural positional and kinetic changes of the cervical spine.
Indications of cervical spine MRI scans include the assessment of soft disc herniations, suspicion of disc hernia recurrence after operation, cervical spondylosis, osteophytes, joint arthrosis, spinal canal lesions (tumors, multiple sclerosis, etc.), bone diseases (infection, inflammation, tumoral infiltration) and paravertebral spaces.
State-of-the-art phased array spine coils and high performance MRI machines provide high image quality and short scan time. Imaging protocols for the cervical spine includes sagittal T1 weighted and T2 weighted sequences with 3-4 mm slice thickness and axial slices; usually contiguous from C2 through T1. Additionally, T2 fat suppressed and T1 post contrast images are often useful in spine imaging.

See also Lumbar Spine MRI.

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.

(FISP) A fast imaging sequence, which attempts to combine the signals observed separately in the FADE sequence, generally sensitive about magnetic susceptibility artifacts and imperfections in the gradient waveforms. Confusingly now often used to refer to a refocused FLASH type sequence.
This sequence is very similar to FLASH, except that the spoiler pulse is eliminated. As a result, any transverse magnetization still present at the time of the next RF pulse is incorporated into the steady state. FISP uses a RF pulse that alternates in sign. Because there is still some remaining transverse magnetization at the time of the RF pulse, a RF pulse of a degree flips the spins less than a degree from the longitudinal axis. With small flip angles, very little longitudinal magnetization is lost and the image contrast becomes almost independent of T1. Using a very short TE (with TR 20-50 ms, flip angle 30-45°) eliminates T2* effects, so that the images become proton density weighted. As the flip angle is increased, the contrast becomes increasingly dependent on T1 and T2*. It is in the domain of large flip angles and short TR that FISP exhibits vastly different contrast to FLASH type sequences. Used for T1 orthopedic imaging, 3D MPR, cardiography and angiography.