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.

In simple ultrafast GRE imaging, TR and TE are so short, that tissues have a poor imaging signal and - more importantly - poor contrast except when contrast media enhanced (contrast enhanced angiography). Therefore, the magnetization is 'prepared' during the preparation module, most frequently by an initial 180° inversion pulse.
In the pulse sequence timing diagram, the basic ultrafast gradient echo sequence is illustrated. The 180° inversion pulse is executed one time (to the left of the vertical line), the right side represents the data collection period and is often repeated depending on the acquisition parameters.
See also Pulse Sequence Timing Diagram, there you will find a description of the components.
Ultrafast GRE sequences have a short TR,TE, a low flip angle and TR is so short that image acquisition lasts less than 1 second and typically less than 500 ms. Common TR: 3-5 msec, TE: 2 msec, and the flip angle is about 5°. Such sequences are often labeled with the prefix 'Turbo' like TurboFLASH, TurboFFE and TurboGRASS.
This allows one to center the subsequent ultrafast GRE data acquisition around the inversion time TI, where one of the tissues of interest has very little signal as its z-magnetization is passing through zero.
Unlike a standard inversion recovery (IR) sequence, all lines or a substantial segment of k-space image lines are acquired after a single inversion pulse, which can then together be considered as readout module. The readout module may use a variable flip angle approach, or the data acquisition may be divided into multiple segments (shots). The latter is useful particularly in cardiac imaging where acquiring all lines in a single segment may take too long relative to the cardiac cycle to provide adequate temporal resolution.
If multiple lines are acquired after a single pulse, the pulse sequence is a type of gradient echo echo planar imaging (EPI) pulse sequence.

See also Magnetization Prepared Rapid Gradient Echo (MPRAGE) and Turbo Field Echo (TFE).

(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:

(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.

From Siemens Medical Systems; Received FDA clearance in 2013.
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