(Gd) Gadolinium is a Lanthanide element that is paramagnetic in its trivalent state.
This paramagnetic substance is used for MR imaging because of the effect of strongly decreasing the T1 relaxation times of the tissues to which gadolinium has access. When injected during magnetic resonance imaging, gadolinium will tend to change signal intensities by shortening the T1 time in its surroundings.
The relaxivity of gadolinium is an important measure of its efficacy, which is dependent on the chemical properties of the complex. The gadolinium ion cannot be used in its chloride, sulfate, or acetate forms because of poor tolerance and low solubility in water in the neutral pH range. Although toxic by itself, gadolinium can be given safely in a chelated form such as DTPA, that still retains much of its strong effect on relaxation times (relaxivity).

See also Dotarem®, Gadovist®, MultiHance®, Omniscan®, OptiMARK®, and Contrast Agents, the info sheet gives an overview and more in-dept information about different types of MRI contrast agents.

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.

The France-based Guerbet Group is highly specialized in contrast media for medical imaging. Its strategic goal is to be a key player in this market. Products include Dotarem (Magnetic Resonance Imaging) and Xenetix (X-ray Imaging).

MRI Contrast Agents:

(Hb) Haemoglobin is the major endogenous oxygen-binding molecule, responsible for binding oxygen in the lung and transporting it to the tissues by means of the circulation. Haemoglobin is contained in very high concentration in the red blood cells.
Haemoglobin is an Fe chelate tightly binding one Fe ion in its II oxidation state where it carries the charge 2+ (ferrous iron). If an oxygen molecule is bound to Hb, Hb is called oxyhaemoglobin, if no oxygen molecule is bound it is called deoxyhaemoglobin. When haemoglobin is oxidized (i.e. in a haematoma), Fe2+ is transformed into Fe3+. The resulting haemoglobin is then called metoxyhaemoglobin (Hb Fe3+).
Deoxyhaemoglobin and metoxyhaemoglobin act as paramagnetic contrast agents in MR, while oxyhaemoglobin is diamagnetic. This partly explains the special appearance of an aging haematoma in MR imaging and is also the basic of the blood oxygenation level dependent contrast (BOLD) used in functional magnetic resonance imaging of the brain (fMRI).