Fast gradient echo sequences are used to study dynamic processes with time periods on the order of a second and allow continuous monitoring of most physiologic motions. A common use of dynamic scanning is the investigation of the time course of tissue contrast after injection of a paramagnetic contrast agent.

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.

Primovist™ (U.S brand name Eovist®) is a highly 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.
Primovist™ brightens the signal of T1 weighted MR images immediately after contrast administration. Dynamic scanning and imaging of the accumulation phase (best after 20 min.) can also be performed after bolus injection of Primovistâ„¢. The hepatocytes uptake will increase the signal intensity of normal liver parenchyma. 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.

From Philips Medical Systems; the Intera-family offers with this mid field system maximum efficiency, flexibility and performance. All Philips MR products contain SENSE (coil SENSitivity Encoding) technology - that increases scanning speed.

(MR mammography) Magnetic resonance imaging of the breast is particularly useful in evaluation of newly diagnosed breast cancer, in women whose breast tissue is mammographically very dense and for screening in women with a high lifetime risk of breast cancer because of their family history or genetic disposition.
Breast MRI can be performed on all standard whole body magnets at a field strength of 0.5 T - 1.5 Tesla. Powerful gradient strengths over 15 mT/m will help to improve the balance between spatial resolution, scanning speed, and volume coverage. The use of a dedicated bilateral breast coil is obligatory.
Malignant lesions release angiogenic factors that increase local vessel density and vessel permeability. Breast cancer is detectable due to the strong enhancement in dynamic breast imaging that peaks early (about 1-2 min.) after contrast medium injection. If breast cancer is suspected, a breast biopsy may be necessary to secure the diagnosis.

See also Magnetic Resonance Imaging MRI, Biopsy and MR Guided Interventions.

Requirements in breast MRI procedures:
For Ultrasound Imaging (USI) see Breast Ultrasound at Medical-Ultrasound-Imaging.com.

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