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(PWI - Perfusion Weighted Imaging) Perfusion MRI techniques (e.g. PRESTO - Principles of Echo Shifting using a Train of Observations) are sensitive to microscopic levels of blood flow. Contrast enhanced relative cerebral blood volume (rCBV) is the most used perfusion imaging.
Both, the ready availability and the T2* susceptibility effects of gadolinium, rather than the T1 shortening effects make gadolinium a suitable agent for use in perfusion imaging. Susceptibility here refers to the loss of MR signal, most marked on T2* ( gradient echo)-weighted and T2 ( spin echo)-weighted sequences, caused by the magnetic field-distorting effects of paramagnetic substances.
T2* perfusion uses dynamic sequences based on multi or single shot techniques. The T2* ( T2) MRI signal drop within or across a brain region is caused by spin dephasing during the rapid passage of contrast agent through the capillary bed. The signal decrease is used to compute the relative perfusion to that region. The bolus through the tissue is only a few seconds, high temporal resolution imaging is required to obtain sequential images during the wash in and wash out of the contrast material and therefore, resolve the first pass of the tracer. Due to the high temporal resolution, processing and calculation of hemodynamic maps are available (including mean transit time (MTT), time to peak (TTP), time of arrival (T0), negative integral (N1) and index.
An important neuroradiological indication for MRI is the evaluation of incipient or acute stroke via perfusion and diffusion imaging. Diffusion imaging can demonstrate the central effect of a stroke on the brain, whereas perfusion imaging visualizes the larger 'second ring' delineating blood flow and blood volume. Qualitative and in some instances quantitative (e.g. quantitative imaging of perfusion using a single subtraction) maps of regional organ perfusion can thus be obtained.
Echo planar and potentially echo volume techniques together with appropriate computing power offer real time images of dynamic variations in water characteristics reflecting perfusion, diffusion, oxygenation (see also Oxygen Mapping) and flow.
Another type of perfusion MR imaging allows the evaluation of myocardial ischemia during pharmacologic stress. After e.g., adenosine infusion, multiple short axis views (see cardiac axes) of the heart are obtained during the administration of gadolinium contrast. Ischemic areas show up as areas of delayed and diminished enhancement. The MRI stress perfusion has been shown to be more accurate than nuclear SPECT exams. Myocardial late enhancement and stress perfusion imaging can also be performed during the same cardiac MRI examination. | | | | | | | | | | | | | | | | Further Reading: | | Basics:
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Drug Information and Specification T1, Predominantly positive enhancement PHARMACOKINETIC Intravascular, extracellular, renal excretion CONCENTRATION 0.5 mol/L, 279.3mg/ml PREPARATION Finished product INDICATION Neuro/whole body DEVELOPMENT STAGE For sale PRESENTATION Vials of 5, 10, 15 and 20 mL
Glass syringes of 5, 10, 15 and 17 mL DO NOT RELY ON THE INFORMATION PROVIDED HERE, THEY ARE NOT A SUBSTITUTE FOR THE ACCOMPANYING PACKAGE INSERT!
Distribution Information TERRITORY TRADE NAME DEVELOPMENT STAGE DISTRIBUTOR Australia ProHance® for sale | | | | • View the DATABASE results for 'ProHance®' (6).
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ABLAVAR™ (formerly named Vasovist™) is a blood pool agent for magnetic resonance angiography ( MRA), which opens new medical imaging possibilities in the evaluation of aortoiliac occlusive disease (AIOD) in patients with suspected peripheral vascular disease.
ABLAVAR™ binds reversibly to blood albumin, providing imaging with high spatial resolution up to 1 hour after injection, due to its high relaxivity and to the long lasting increased signal intensity of blood.
As with other contrast media: the possibility of serious or life-threatening anaphylactic or anaphylactoid reactions, including cardiovascular, respiratory and/or cutaneous manifestations, should always be considered.
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/1.73m 2), or acute renal insufficiency of any severity due to the hepato-renal syndrome or in the perioperative liver transplantation period.
See also Cardiovascular Imaging, Adverse Reaction, Molecular Imaging, and MRI Safety.
Drug Information and Specification
NAME OF COMPOUND
Diphenylcyclohexyl phosphodiester-Gd-DTPA, gadofosveset trisodium, MS-325
T1, predominantly positive enhancement
20-45 mmol-1sec-1, Bo=0,47T
PHARMACOKINETIC
Intravascular
CONCENTRATION
244 mg/mL, 0.25mmol/mL
DOSAGE
0.12 mL/kg, 0.03 mmol/kg
DEVELOPMENT STAGE
FDA approved
DO NOT RELY ON THE INFORMATION PROVIDED HERE, THEY ARE NOT A SUBSTITUTE FOR THE ACCOMPANYING
PACKAGE INSERT!
Distribution Information
TERRITORY
TRADE NAME
DEVELOPMENT STAGE
DISTRIBUTOR
USA, Canada, Australia
ABLAVAR™
Approved
| | | | • View the DATABASE results for 'ABLAVAR™' (3).
| | | • View the NEWS results for 'ABLAVAR™' (1).
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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. | | | | | | • View the DATABASE results for 'Abdominal Imaging' (11).
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Assessment of Female Pelvic Pathologies: A Cross-Sectional Study Among Patients Undergoing Magnetic Resonance Imaging for Pelvic Assessment at the Maternity and Children Hospital, Qassim Region, Saudi Arabia Saturday, 7 October 2023 by www.cureus.com | | |
Higher Visceral, Subcutaneous Fat Levels Predict Brain Volume Loss in Midlife Wednesday, 4 October 2023 by www.neurologyadvisor.com | | |
Deep Learning Helps Provide Accurate Kidney Volume Measurements Tuesday, 27 September 2022 by www.rsna.org | | |
CT, MRI for pediatric pancreatitis interobserver agreement with INSPPIRE Friday, 11 March 2022 by www.eurekalert.org | | |
Clinical trial: Using MRI for prostate cancer diagnosis equals or beats current standard Thursday, 4 February 2021 by www.eurekalert.org | | |
Computer-aided detection and diagnosis for prostate cancer based on mono and multi-parametric MRI: A review - Abstract Tuesday, 28 April 2015 by urotoday.com | | |
Nottingham scientists exploit MRI technology to assist in the treatment of IBS Thursday, 9 January 2014 by www.news-medical.net | | |
New MR sequence helps radiologists more accurately evaluate abnormalities of the uterus and ovaries Thursday, 23 April 2009 by www.eurekalert.org | | |
MRI identifies 'hidden' fat that puts adolescents at risk for disease Tuesday, 27 February 2007 by www.eurekalert.org |
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