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Contrast enhanced MRI is a commonly used procedure in magnetic resonance imaging. The need to more accurately characterize di fferent 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 di fferent 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 di fferent categories of contrast agents are currently available for clinical use.
Reasons for the use of contrast agents in MRI scans are:
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Relaxation characteristics of normal and pathologic tissues are not always di fferent enough to produce obvious di fferences in signal intensity.
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Pathology that is sometimes occult on unenhanced images becomes obvious in the presence of contrast.
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Enhancement significantly increases MRI sensitivity.
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In addition to improving delineation between normal and abnormal tissues, the pattern of contrast enhancement can improve diagnostic specificity by facilitating characterization of the lesion(s) in question.
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Contrast can yield physiologic and functional information in addition to lesion delineation.
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. | | | | | | | | | | | | | | | | Further Reading: | | Basics:
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News & More:
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FDA Approves Gadopiclenol for Contrast-Enhanced Magnetic Resonance Imaging Tuesday, 27 September 2022 by www.pharmacytimes.com | | |
Effect of gadolinium-based contrast agent on breast diffusion-tensor imaging Thursday, 6 August 2020 by www.eurekalert.org | | |
Artificial Intelligence Processes Provide Solutions to Gadolinium Retention Concerns Thursday, 30 January 2020 by www.itnonline.com | | |
Accuracy of Unenhanced MRI in the Detection of New Brain Lesions in Multiple Sclerosis Tuesday, 12 March 2019 by pubs.rsna.org | | |
The Effects of Breathing Motion on DCE-MRI Images: Phantom Studies Simulating Respiratory Motion to Compare CAIPIRINHA-VIBE, Radial-VIBE, and Conventional VIBE Tuesday, 7 February 2017 by www.kjronline.org | | |
Novel Imaging Technique Improves Prostate Cancer Detection Tuesday, 6 January 2015 by health.ucsd.edu | | |
New oxygen-enhanced MRI scan 'helps identify most dangerous tumours' Thursday, 10 December 2015 by www.dailymail.co.uk | | |
All-organic MRI Contrast Agent Tested In Mice Monday, 24 September 2012 by cen.acs.org | | |
A groundbreaking new graphene-based MRI contrast agent Friday, 8 June 2012 by www.nanowerk.com |
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(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 e ffect 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* e ffects 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. Di fferent 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 di fferent 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 e ffects. 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:
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3D MRA can be acquired in any plane, which means that
greater vessel coverage can be obtained at high
resolution with fewer slices (aorta, peripheral vessels);
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the possibility to perform a time resolved examination
(similarly to conventional angiography);
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no use of ionizing radiation; paramagnetic agents have a beneficial safety.
| | | | | | • View the DATABASE results for 'Contrast Enhanced Magnetic Resonance Angiography' (14).
| | | • View the NEWS results for 'Contrast Enhanced Magnetic Resonance Angiography' (2).
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A contrast medium (or contrast agent) is a chemical substance introduced to the anatomical or functional region being imaged, to increase the di fferences between di fferent tissues or between normal and abnormal tissue, by altering the relaxation times.
The chemical composition of the contrast media determines the specific usage. Similar to nuclear imaging is the intention in development of MR contrast media a high affinity to di fferent organs or even tumors (e.g. necrosis avid contrast agent).
In 'contrast' to nuclear imaging contrast agents MR contrast media do not contain radiopharmaceuticals and the concentrations are about 100 times higher. Nuclear imaging contrast agents are direct contrast agents;; they are directly visible caused by their radioactivity. MR contrast agents a ffect the targeted tissue; they are indirect contrast agents.
See also Contrast Agents, the info sheet gives an overview and more in-depth information about di fferent types of MRI contrast medium. | | | | | | • View the DATABASE results for 'Contrast Medium' (26).
| | | • View the NEWS results for 'Contrast Medium' (2).
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The Dixon technique is a MRI method used for fat suppression and/or fat quantification. The di fference in magnetic resonance frequencies between fat and water-bound protons allows the separation of water and fat images based on the chemical shift e ffect.
This imaging technique is named after Dixon, who published in 1984 the basic idea to use phase di fferences to calculate water and fat components in postprocessing. Dixon's method relies on acquiring an image when fat and water are 'in phase', and another in 'opposed phase' ( out of phase). These images are then added together to get water-only images, and subtracted to get fat-only images. Therefore, this sequence type can deliver up to 4 contrasts in one measurement: in phase, opposed phase, water and fat images. An additional benefit of Dixon imaging is that source images and fat images are also available to the diagnosing physician.
The original two point Dixon sequence (number of points means the number of images acquired at di fferent TE) had limited possibilities to optimize the echo time, spatial resolution, slice thickness, and scan time; but Dixon based fat suppression can be very e ffective in areas of high magnetic susceptibility, where other techniques fail. This insensitivity to magnetic field inhomogeneity and the possibility of direct image-based water and fat quantification have currently generated high research interests and improvements to the basic method (three point Dixon).
The combination of Dixon with gradient echo sequences allows for example liver imaging with 4 image types in one breath hold. With Dixon TSE/FSE an excellent fat suppression with high resolution can be achieved, particularly useful in imaging of the extremities.
For low bandwidth imaging, chemical shift correction of fat images can be made before recombination with water images to produce images free of chemical shift displacement artifacts. The need to acquire more echoes lengthens the minimum scan time, but the lack of fat saturation pulses extends the maximum slice coverage resulting in comparable scan time. | | | | • View the DATABASE results for 'Dixon' (8).
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Flow phenomena are intrinsic processes in the human body. Organs like the heart, the brain or the kidneys need large amounts of blood and the blood flow varies depending on their degree of activity. Magnetic resonance imaging has a high sensitivity to flow and o ffers accurate, reproducible, and noninvasive methods for the quantification of flow. MRI flow measurements yield information of blood supply of of various vessels and tissues as well as cerebro spinal fluid movement.
Flow can be measured and visualized with di fferent pulse sequences (e.g. phase contrast sequence, cine sequence, time of flight angiography) or contrast enhanced MRI methods (e.g. perfusion imaging, arterial spin labeling).
The blood volume per time (flow) is measured in: cm3/s or ml/min. The blood flow-velocity decreases gradually dependent on the vessel diameter, from approximately 50 cm per second in arteries with a diameter of around 6 mm like the carotids, to 0.3 cm per second in the small arterioles.
Di fferent flow types in human body:
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Behaves like stationary tissue, the signal intensity depends on T1, T2 and PD = Stagnant flow
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Flow with consistent velocities across a vessel = Laminar flow
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Laminar flow passes through a stricture or stenosis (in the center fast flow, near the walls the flow spirals) = Vortex flow
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Flow at different velocities that fluctuates = Turbulent flow
See also Flow Effects, Flow Artifact, Flow Quantification, Flow Related Enhancement, Flow Encoding, Flow Void, Cerebro Spinal Fluid Pulsation Artifact, Cardiovascular Imaging and Cardiac MRI. | | | | | | • View the DATABASE results for 'Flow' (113).
| | | • View the NEWS results for 'Flow' (7).
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