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Contrast Enhanced Gradient Echo SequenceInfoSheet: - Sequences -
Intro, Overview, 
Types of, 
etc.
 
Contrast enhanced GRE sequences provide T2 contrast but have a relatively poor SNR. Repetitive RF pulses with small flip angles together with appropriate gradient profiles lead to the superposition of two resonance signals.
The first signal is due to the free induction decay FID observed after the first and all ensuing RF excitations.
The second is a resonance signal obtained as a result of a spin echo generated by the second and all addicted RF-pulses.
Hence it is absent after the first excitation, it is a result of the free induction decay of the second to last RF-excitation and has a TE, which is almost 2TR. For this echo to occur the gradients have to be completely symmetrical relative to the half time between two RF-pulses, a condition that makes it difficult to integrate this pulse sequence into a multiple slice imaging technique. The second signal not only contains echo contributions from free induction decay, but obviously weakened by T2-decay. Since the echo is generated by a RF-pulse, it is truly T2 rather than T2* weighted. Correspondingly it is also less sensitive to susceptibility changes and field inhomogeneities.
Companies use different acronyms to describe certain techniques.
Different terms (see also acronyms) for these gradient echo pulse sequences:
CE-FAST Contrast Enhanced Fourier Acquired Steady State,
CE-FFE Contrast Enhanced Fast Field Echo,
CE-GRE Contrast Enhanced Gradient-Echo,
DE-FGR Driven Equilibrium FGR,
FADE FASE Acquisition Double Echo,
PSIF Reverse Fast Imaging with Steady State Precession,
SSFP Steady State Free Precession,
T2 FFE Contrast Enhanced Fast Field Echo (T2 weighted).

In this context, 'contrast enhanced' refers to the pulse sequence, it does not mean enhancement with a contrast agent.
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• View the DATABASE results for 'Contrast Enhanced Gradient Echo Sequence' (4).Open this link in a new window

Contrast Enhanced Magnetic Resonance AngiographyInfoSheet: - Sequences -
Intro, Overview, 
Types of, 
etc.MRI Resource Directory:
 - MRA -
 
(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:
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);
the possibility to perform a time resolved examination (similarly to conventional angiography);
no use of ionizing radiation; paramagnetic agents have a beneficial safety.
 
Images, Movies, Sliders:
 CE-MRA of the Carotid Arteries  Open this link in a new window
    
SlidersSliders Overview

 CE MRA of the Aorta  Open this link in a new window
    
SlidersSliders Overview

 CE-MRA of the Carotid Arteries Colored MIP  Open this link in a new window
    
SlidersSliders Overview

 
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• View the NEWS results for 'Contrast Enhanced Magnetic Resonance Angiography' (2).Open this link in a new window.

• View the DATABASE results for 'Contrast Enhanced Magnetic Resonance Angiography' (14).Open this link in a new window

 
Further Reading:
  Basics:
Contrast-Enhanced MR Angiography(.pdf)
   by ric.uthscsa.edu    
CONTRAST ENHANCED MR ANGIOGRAPHY – PRINCIPLES, APPLICATIONS, TIPS AND PITFALLS(.pdf)
  News & More:
CONTRAST-ENHANCED MRA OF THE CAROTIDS(.pdf)
PERIPHERAL VASCULAR MAGNETIC RESONANCE ANGIOGRAPHY(.pdf)
CONTRAST ENHANCED MRI OF THE LIVER STATE-OF-THE-ART(.pdf)
MRI Resources 
Liver Imaging - Jobs pool - Diffusion Weighted Imaging - Movies - Patient Information - Devices
 
Contrast Enhanced MR VenographyInfoSheet: - Sequences -
Intro, Overview, 
Types of, 
etc.MRI Resource Directory:
 - MRA -
 
(CEMRV) A 3D dynamic contrast enhanced magnetic resonance venogram with acquisition timing to account for the later arrival of the contrast agent in the venous system. The pulse sequence used, is an enhanced 3D fast gradient echo sequence, the same sequence that is used for MR angiography.

For Ultrasound Imaging (USI) see Venous Ultrasound at Medical-Ultrasound-Imaging.com.
 
Images, Movies, Sliders:
 CE-MRA of the Carotid Arteries Colored MIP  Open this link in a new window
    
SlidersSliders Overview

 PCA-MRA 3D Brain Venography Colored MIP  Open this link in a new window
    

 
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• View the DATABASE results for 'Contrast Enhanced MR Venography' (3).Open this link in a new window

Contrast Enhanced MRIInfoSheet: - Contrast Agents - 
Intro, Overview, 
Characteristics, 
Types of, 
etc.MRI Resource Directory:
 - Contrast Enhanced MRI -
 
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:
Relaxation characteristics of normal and pathologic tissues are not always different enough to produce obvious differences in signal intensity.
Pathology that is sometimes occult on unenhanced images becomes obvious in the presence of contrast.
Enhancement significantly increases MRI sensitivity.
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.
Contrast can yield physiologic and functional information in addition to lesion delineation.
Imaging of arteries and veins with contrast enhanced angiography (CE MRA).

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.
 
Images, Movies, Sliders:
 Delayed Myocardial Contrast Enhancement from Infarct  Open this link in a new window
      

Courtesy of  Robert R. Edelman
 Left Circumflex Ischemia First-pass Contrast Enhancement  Open this link in a new window
      

Courtesy of  Robert R. Edelman

 Normal Lung Gd Perfusion MRI  Open this link in a new window
 MRI of the Brain Stem with Temoral Bone and Auditory System  Open this link in a new window
    
SlidersSliders Overview

 Breast MRI Images T1 Pre - Post Contrast  Open this link in a new window
 
Radiology-tip.comradContrast Enhanced Computed Tomography
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Medical-Ultrasound-Imaging.comContrast Enhanced Ultrasound,  Contrast Enhanced Doppler Imaging
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• View the NEWS results for 'Contrast Enhanced MRI' (8).Open this link in a new window.

• View the DATABASE results for 'Contrast Enhanced MRI' (14).Open this link in a new window

 
Further Reading:
  Basics:
Optimal k-Space Sampling for Dynamic Contrast-Enhanced MRI with an Application to MR Renography
Thursday, 5 November 2009   by www.ncbi.nlm.nih.gov    
  News & More:
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    
Contrast Enhanced Timing Robust Angiography
 
(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.
 
Images, Movies, Sliders:
 CE-MRA of the Carotid Arteries  Open this link in a new window
    
SlidersSliders Overview

 
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