(TRICKS) Time resolved imaging of contrast kinetics is a MRI technique, which increases the temporal resolution of dynamic contrast enhanced magnetic resonance angiography (CE-MRA) sequences. The K-space is divided into regions by increasing the sampling rate at the lower spatial frequencies and by reducing the sampling rate at the higher spatial frequencies. Since the time duration between two frames is shortened, it can be observed how frequently and how quickly the images are repeated at the exact same location.
TRICKS is particularly useful for dynamic vascular studies with high temporal resolution. TRICKS improves the calculation of the contrast bolus arrival and improves the characterization of arterio-venous malformations (AVMs).

See also Automatic Bolus Detection, MRA, Cardiac MRI.

(CENTRA) A special form of k-space acquisition especially for contrast enhanced MRA. Longer scan times for high image resolution is possible, without a venous overlay, because the vast majority of contrast information is acquired only in the first seconds, the remaining scan time is used for resolution.

Diamagnetism occurs only by a substance in the presence of an externally applied magnetic field. Diamagnetic contrast agents are complexes in which the metal ion (e.g., Zn, Bi and Ca) is diamagnetic.
Potential diamagnetic materials in gastrointestinal MRI:
A suspension of clay minerals (Kaopectate with kaolin, a common over the counter drug) can be used as a negative oral contrast agent caused by the diamagnetic properties. By using this preparation as a gastrointestinal contrast agent e.g., in pancreas MRI or MRCP, the absence of signal is clearly visible in the stomach and duodenum. Barium sulfate commonly used as an X-ray contrast agent has also been tested for use in abdominal imaging. The diamagnetic properties of the barium particles are caused by a susceptibility effect around them, the resulting signal loss is strengthening by a replacement of water protons with barium.

See also Diamagnetism.

Paramagnetic substances, for example Gd-DTPA solutions, are used as MRI oral contrast agents in gastrointestinal imaging to depict the lumen of the digestive organs. Different Gd-DTPA solutions or zeolites containing gadolinium can be used e.g., for diagnosis of delayed gastric emptying, diagnosis of Crohn's disease etc.
Low concentrations of gastrointestinal paramagnetic contrast agents cause a reduction in T1 relaxation time; consequently, these agents act on T1 weighted images by increasing the signal intensity of the bowel lumen. High concentrations cause T2 shortening by decreasing the signal, similar to superparamagnetic iron oxide. Gd-DTPA chelates are unstable at the low pH in the stomach, therefore buffering is necessary for oral use.

See also Gadopentetate Gastrointestinal, Gadolinium Zeolite, Negative Oral Contrast Agents, Gastrointestinal Superparamagnetic Contrast Agents, and Ferric ammonium citrate.

(CE MRA) Contrast enhanced MR angiography is based on the T1 values of blood, the surrounding tissue, and paramagnetic contrast agent.
T1-shortening contrast agents reduces the T1 value of the blood (approximately to 50 msec, shorter than that of the surrounding tissues) and allow the visualization of blood vessels, as the images are no longer dependent primarily on the inflow effect of the blood. Contrast enhanced MRA is performed with a short TR to have low signal (due to the longer T1) from the stationary tissue, short scan time to facilitate breath hold imaging, short TE to minimize T2* effects and a bolus injection of a sufficient dose of a gadolinium chelate.
Images of the region of interest are performed with 3D spoiled gradient echo pulse sequences. The enhancement is maximized by timing the contrast agent injection such that the period of maximum arterial concentration corresponds to the k-space acquisition. Different techniques are used to ensure optimal contrast of the arteries e.g., bolus timing, automatic bolus detection, bolus tracking, care bolus. A high resolution with near isotropic voxels and minimal pulsatility and misregistration artifacts should be striven for. The postprocessing with the maximum intensity projection (MIP) enables different views of the 3D data set.
Unlike conventional MRA techniques based on velocity dependent inflow or phase shift techniques, contrast enhanced MRA exploits the gadolinium induced T1-shortening effects. CE MRA reduces or eliminates most of the artifacts of time of flight angiography or phase contrast angiography. Advantages are the possibility of in plane imaging of the blood vessels, which allows to examine large parts in a short time and high resolution scans in one breath hold. CE MRA has found a wide acceptance in the clinical routine, caused by the advantages: