TR is the pulse sequence repetition time. It is delineated by initiating the first RF pulse of the sequence then repeating the same RF pulse at a time t. Variations in the value of TR have an important effect on the control of image contrast characteristics. This formula is directly derived from the Bloch equations.

See also Scan Time.

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.

(PWI - Perfusion Weighted Imaging) Perfusion MRI techniques (e.g. PRESTO - Principles of Echo Shifting using a Train of Observations) are sensitive to microscopic levels of blood flow. Contrast enhanced relative cerebral blood volume (rCBV) is the most used perfusion imaging. Both, the ready availability and the T2* susceptibility effects of gadolinium, rather than the T1 shortening effects make gadolinium a suitable agent for use in perfusion imaging. Susceptibility here refers to the loss of MR signal, most marked on T2* (gradient echo)-weighted and T2 (spin echo)-weighted sequences, caused by the magnetic field-distorting effects of paramagnetic substances.
T2* perfusion uses dynamic sequences based on multi or single shot techniques. The T2* (T2) MRI signal drop within or across a brain region is caused by spin dephasing during the rapid passage of contrast agent through the capillary bed. The signal decrease is used to compute the relative perfusion to that region. The bolus through the tissue is only a few seconds, high temporal resolution imaging is required to obtain sequential images during the wash in and wash out of the contrast material and therefore, resolve the first pass of the tracer. Due to the high temporal resolution, processing and calculation of hemodynamic maps are available (including mean transit time (MTT), time to peak (TTP), time of arrival (T0), negative integral (N1) and index.
An important neuroradiological indication for MRI is the evaluation of incipient or acute stroke via perfusion and diffusion imaging. Diffusion imaging can demonstrate the central effect of a stroke on the brain, whereas perfusion imaging visualizes the larger 'second ring' delineating blood flow and blood volume. Qualitative and in some instances quantitative (e.g. quantitative imaging of perfusion using a single subtraction) maps of regional organ perfusion can thus be obtained.
Echo planar and potentially echo volume techniques together with appropriate computing power offer real time images of dynamic variations in water characteristics reflecting perfusion, diffusion, oxygenation (see also Oxygen Mapping) and flow.
Another type of perfusion MR imaging allows the evaluation of myocardial ischemia during pharmacologic stress. After e.g., adenosine infusion, multiple short axis views (see cardiac axes) of the heart are obtained during the administration of gadolinium contrast. Ischemic areas show up as areas of delayed and diminished enhancement. The MRI stress perfusion has been shown to be more accurate than nuclear SPECT exams. Myocardial late enhancement and stress perfusion imaging can also be performed during the same cardiac MRI examination.

A bolus is a rapid infusion of high dose contrast agent. Dynamic and accumulation phase imaging can be performed after bolus injection. Since the transit time of the bolus through the tissue is only a few seconds, high temporal resolution imaging can be required to obtain sequential images during the wash in and wash out of the contrast material and, therefore, resolve the first pass of the tracer.
For the same injected dose of contrast agent the injection rate (and, consequently, the total injected volume) modifies the bolus peak profile. Increasing the injection rate produces a sharpening of the peak (Cmax increase, Tmax decrease, peak length decrease). At a low injection rate, the first pass presents a plateau form. Substantial changes in the gadolinium concentrations during signal acquisition induce artifacts. Furthermore, the haemodynamic parameters (cardiac output, blood pressure) influence the bolus profile. The characteristics of gadolinium agents are favorable in the early bolus phase, whereas the advantages of large complexes (e.g. blood pool agents) and ultrasmall superparamagnetic iron oxide (USPIO) are most evident in the distribution phase.

Generic name: Liposomes, central moiety: different, contrast effect: paramagnetic, distribution: different
Liposomes are lipid containing nanoparticles, or fat molecules, surrounding a water core. Liposomes were the first type of nanoparticles created to be used as carriers for lipophilic MRI contrast agents with novel characteristics.
Liposomes loaded with gadolinium-containing chelates have potential as blood pool agents, caused by modifications of the surface (e.g., with polyethylene glycol) leading to longer blood retention times.
The incorporation of contrast agents into either the the bilayer membrane or the aqueous inner cavity is possible. These MRI contrast agents has been used to image the lymph nodes using liposomes containing Gd-DTPA as well as dextran coated iron oxide particles.
To image the liver or the hepatobiliary system, liposomes containing Gd-HPDO3A, or MnDPDP, have been tested.
Liposomes containing gadolinium were conjugated to antibodies and targeted to a specific organ system.
A method of targeting tumors with ultrasound that also uses MRI to watch the cell destroying, uses liposomes loaded with cytotoxic drugs and also with gadolinium to make them show up in MRI. As well as used as an imaging technique, ultrasound can also be used to destroy cancer cells. Once the drugs have been administered, focusing the ultrasound on the target area makes blood vessels permeable. The liposomes leak out of the blood vessel into the target area, watched by MRI, where the cytotoxic drug can then go to work.

See also Memosomes, Superparamagnetic Iron Oxide, Classifications, Characteristics, etc. and Mangafodipir Trisodium.