Contrast agents are chemical substances introduced to the anatomical or functional region being imaged, to increase the differences between different tissues or between normal and abnormal tissue, by altering the relaxation times. MRI contrast agents are classified by the different changes in relaxation times after their injection.
The design objectives for the next generation of MR contrast agents will likely focus on prolonging intravascular retention, improving tissue targeting, and accessing new contrast mechanisms. Macromolecular paramagnetic contrast agents are being tested worldwide. Preclinical data shows that these agents demonstrate great promise for improving the quality of MR angiography, and in quantificating capillary permeability and myocardial perfusion.
Ultrasmall superparamagnetic iron oxide (USPIO) particles have been evaluated in multicenter clinical trials for lymph node MR imaging and MR angiography, with the clinical impact under discussion. In addition, a wide variety of vector and carrier molecules, including antibodies, peptides, proteins, polysaccharides, liposomes, and cells have been developed to deliver magnetic labels to specific sites. Technical advances in MR imaging will further increase the efficacy and necessity of tissue-specific MRI contrast agents.

See also Adverse Reaction and Nephrogenic Systemic Fibrosis.

See also the related poll result: 'The development of contrast agents in MRI is'

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.

Images obtained by a diffusion weighted sequence (e.g. the Stejskal-Tanner sequence) reflect the diffusion as an attenuation of signal intensity. The diffusion time is the time elapsed between the leading edges of the diffusion gradient lobes of this sequence.

(DWI) Magnetic resonance imaging is sensitive to diffusion, because the diffusion of water molecules along a field gradient reduces the MR signal. In areas of lower diffusion the signal loss is less intense and the display from this areas is brighter. The use of a bipolar gradient pulse and suitable pulse sequences permits the acquisition of diffusion weighted images (images in which areas of rapid proton diffusion can be distinguished from areas with slow diffusion).
Based on echo planar imaging, multislice DWI is today a standard for imaging brain infarction. With enhanced gradients, the whole brain can be scanned within seconds. The degree of diffusion weighting correlates with the strength of the diffusion gradients, characterized by the b-value, which is a function of the gradient related parameters: strength, duration, and the period between diffusion gradients.
Certain illnesses show restrictions of diffusion, for example demyelinization and cytotoxic edema. Areas of cerebral infarction have decreased apparent diffusion, which results in increased signal intensity on diffusion weighted MRI scans. DWI has been demonstrated to be more sensitive for the early detection of stroke than standard pulse sequences and is closely related to temperature mapping.
DWIBS is a new diffusion weighted imaging technique for the whole body that produces PET-like images. The DWIBS sequence has been developed with the aim to detect lymph nodes and to differentiate normal and hyperplastic from metastatic lymph nodes. This may be possible caused by alterations in microcirculation and water diffusivity within cancer metastases in lymph nodes.

See also Diffusion Weighted Sequence, Perfusion Imaging, ADC Map, Apparent Diffusion Coefficient, and Diffusion Tensor Imaging.

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.