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.

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.

Any abnormal reaction of a patient to an examination or procedure, like for example claustrophobia or side effects of MRI contrast agents.
A claustrophobic attack is MRI scanner dependent and more rare with an open MRI. An adverse reaction with magnetic resonance imaging contrast medium is very infrequent. In general, adverse reactions increase with the quantity of contrast media (usual dose of paramagnetic contrast agents is 0.1 mmol/kg) and also with the osmolarity of the compound.
Most frequently encountered adverse reactions are heat sensation, dizziness, nausea, hypotension due to vasodilatation, which can progress to hypotensive shock and anaphylactic reactions.
See also MRI Safety, Contrast Enhanced MRI, Breast MRI, and Cardiac MR imaging.

The brain tissue is provided with a tight endothelial layer on vessels that acts as a filter for substances that reach the brain through the blood stream. This filter is called the blood brain barrier.
The blood brain barrier is responsible for the absence of contrast agent enhancement in normal brain tissue after administration of the iodinated or paramagnetic contrast media used in brain MRI and computed tomography (CT) diagnostic. The absence of contrast uptake in normal tissue provides the basis for differentiation from pathological brain tissue, which is conversely characterized by a disruption of the blood brain barrier.

See also Contrast Enhanced MRI, MRI Safety, Adverse Reaction.

Blood pool agents (intravascular contrast agents) remain in the blood for a prolonged time compared with conventional contrast agents, which diffuse quickly into the interstitial space. Magnetic resonance angiography (MRA), cardiovascular imaging, or contrast enhanced MRIs are possible over an hour or more. This advantage over conventional MRI contrast media allows also higher resolution MRA of several territories using respiratory or cardiac gating techniques with a single contrast bolus.
Different types of blood pool contrast agents:
Blood pool MRI contrast agents with their longer intravascular circulation can be designed to be targeted to necrotic myocardium, to assess myocardial viability, or tumor directed to provide better diagnostic information for various tumors. A disadvantage of the use of blood pool agents for MRA is that the separation of arteries and veins is more difficult because they are present in both and the overlapping of those vessels is disturbing. This can be solved by e.g. different MIP segmentation algorithms.

See also Necrosis Avid Contrast Agent, Tumor Specific Agents, Feruglose, Gadofosveset Trisodium (Vasovist), Ultrasmall Superparamagnetic Iron Oxide and Contrast Medium.