Angiography means the imaging of veins and arteries. Magnetic resonance angiography (MRA) has a lower invasion than conventional angiography with catheter and X-ray contrast agent. Time of flight angiography (inflow) and phase contrast angiography works without contrast agents. Only in contrast enhanced magnetic resonance angiography is the use of contrast agents necessary, but the lack of side effects is an advantage of MRI contrast agents, just as the smaller dosage as used in X-ray angiography techniques.

See also the related poll result: 'MRI will have replaced 50% of x-ray exams by'

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(July 20, 2009 - EPIX Pharmaceuticals, Inc. announced today that, in light of the company's lack of capital and inability to obtain additional financing or consummate a strategic transaction, it has entered into an Assignment for the Benefit of Creditors, effective immediately, in accordance with Massachusetts law).
EPIX has been a specialty pharmaceutical firm developing targeted contrast agents to improve the capability of MRI as a diagnostic tool for a variety of diseases. Gadofosveset trisodium (formerly MS-325, Vasovistâ„¢, now ABLAVARtâ„¢), is an injectable intravascular contrast agents designed for multiple vascular imaging applications, including peripheral vascular disease and coronary artery disease. EPIX conducted a pivotal Phase III trial for the detection of peripheral vascular disease, as well as a Phase II feasibility trial for coronary artery disease diagnosis.
To ensure rapid development and adoption of gadofosveset trisodium into clinical practice upon regulatory approval, EPIX pursued an aggressive product development plan and commercialization strategy. The Company established an exclusive, worldwide sales and marketing agreement with Bayer Schering Pharma AG. EPIX also established corporate collaborations with GE Healthcare, Philips Medical Systems and Siemens Medical Systems, the three leading MRI manufacturers, which together account for approximately 80 percent of the MRI machines installed worldwide.
EPIX had other MRI contrast agents under development, most significantly a novel prototype blood clot agent (EP-2104R). Potential clinical applications for this type of agent include detection of deep venous thrombosis, pulmonary embolism and blood clots in the coronary and carotid arteries. Currently, there is no high resolution imaging technique to directly visualize blood clots in patients with suspected cardiovascular disease.

Gadovist® is an extracellular, neutral macrocyclic (gadolinium (Gd) complex) MRI contrast agents for central nervous system indications, particularly suited for studies in which high doses are required or advantageous. Gadovist® (also Gadograf) was available in two concentrations, currently only Gadovist® 1.0 is marketed.
The product was approved in Switzerland in 1999 and in Germany in 2000. Gadovist® 1.0 is in USA currently in the drug development and approval process, particularly for magnetic resonance angiography.

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.

See also Paramagnetic Contrast Agents and Gadobutrol.

Rectal staging is necessary for the preoperative assessment of intra- and extramural tumor infiltration or the decision for adjuvant radio-chemotherapy. One indication of MRI with luminal contrast enhancement is small bowel enteroclysis after duodenal intubation for visualization of inflammatory bowel wall thickening and other complications.
"Double contrast" enhancement of the bowel lumen is the administration of plain water or water with methylcellulose along with heavily T2 weighted sequences or contrast enhanced T1 weighted sequences.
Several oral contrast agents have been used for small bowel MRI: Mannitol, metamucil, locust bean gum, and PEG. All provide sufficient bowel distension and homogeneity, but suffer from side effects such as diarrhea. The volume of PEG or mannitol administered must be not too large in order to achieve the best compromise between distension and acceptance by the patient.
MR colonography with positive bowel lumen enhancement requires higher concentrations of paramagnetic agents compared to the available dedicated enteral contrast agents, IV compounds are used to dope water enemas for this purpose.
Some investigators advocate negative bowel enhancement with Contrast Agents to suppress high signal bowel content in MRCP ( Magnetic resonance cholangiopancreaticography ). The use of a mixture of metamucil and 20 ml of gadolinium chelate provides good homogeneity and good tolerance without diarrhea.

Macromolecular Gd labeled albumins are a new class of contrast agents with a wide range of use e.g., MR angiography, breast MRI, perfusion MRI, Lung perfusion, etc.
Marketed gadolinium-based albumin-bound contrast media are e.g., MultiHance®, and Vasovist™; other prototypes are in development. Malignant tumors often show an increased uptake and metabolism of plasma proteins, especially albumin. Contrast agents with large molecules are delivered to all tissues, but only accumulate in those with leaky vessels by tumor capillaries (tumor neovessels). MRI tumor perfusion studies with Gd labeled albumin can show the success of tumor therapy by quantitative decrease in MR signal of the malignant tissue after therapy compared to before. In addition, the study of tumor sensitivity to a therapy with drug-labeled albumins seems possible.
After renal transplantation, MRI may diagnose albuminuria caused by glomerular disease with an albumin-bound blood pool contrast agent

See also Blood Pool Agents, Intravascular Contrast Agents, Contrast Enhanced MRI.