Magnetic resonance imaging contrast agents: theory and application to the central nervous system

Restricted access

✓ The theoretical aspects of magnetic resonance (MR) imaging contrast agents are reviewed, and their current applications to the central nervous system (CNS) and their future applications are discussed. Profound differences exist between contrast agents used for MR imaging and computerized tomography (CT). In MR imaging, the contrast agents are not imaged directly but rather act on adjacent protons to shorten T1 and T2 relaxation times. This in turn results in signal intensity changes. The lanthanide metal, gadolinium, in the form of gadopentetate dimeglumine, has been found to be both safe and efficacious as the only currently approved contrast agent for MR imaging.

Magnetic resonance imaging revolutionized the detection and treatment of disease affecting the brain and spine. Initially, it was thought that signal characteristics on MR imaging would allow differentiation of specific pathology. It was soon found that MR studies were able to detect more abnormalities but were less able to characterize them. The recent development of contrast agents for MR imaging has allowed this modality to surpass CT for the evaluation of most CNS lesions.

At present, contrast-enhanced MR imaging is generally accepted as the study of choice for evaluating acoustic neurinomas, pituitary lesions, meningeal disease, primary and secondary brain tumors, active multiple sclerosis, intradural spinal neoplasms, intramedullary spinal disease, and postoperative states in both the spine and brain. Even when contrast-enhanced CT can detect the same abnormalities, evaluation of the lesions in multiple planes on MR imaging can sometimes yield invaluable information, especially prior to surgery. Future developments of contrast material for MR imaging include non-gadolinium compounds, intrathecal contrast media, cerebral blood flow and volume evaluation, and, possibly, antibody-labeled contrast agents.

Article Information

Address reprint requests to: Richard A. Bronen, M.D., Department of Diagnostic Radiology, Yale University School of Medicine, 333 Cedar Street, New Haven, Connecticut 06510.

© AANS, except where prohibited by US copyright law.

Headings

Figures

  • View in gallery

    Relationship of induced magnetism with an external magnetic field. Diamagnetic agents (D) have a weak negative magnetism while paramagnetic agents (P) have a positive magnetic effect. Superparamagnetic materials (SP) achieve a much greater positive magnetization than do paramagnetic materials. The arrows indicate that all three substances lose their magnetization completely when the external applied field is turned off. Ferromagnetic substances (F) retain positive magnetism even when the external field returns to zero (point a).

  • View in gallery

    Gadolinium-DTPA concentration versus signal intensity for T1-weighted (T1W) and T2-weighted (T2W) pulse sequences on a 1.0-tesla system. The relationship is nonlinear, with a decrease in signal at high concentrations. (Adapted from Runge VM, Schaible TF, Goldstein HA, et al: Gd-DTPA clinical efficacy. Radiographics 8:147–159, 1988, with permission.)

  • View in gallery

    Magnetic resonance images of a tentorial meningioma. Left: The meningioma (arrow) is isointense with gray matter on this short-TR/TE coronal image. It is not easily seen and impossible to differentiate from an intra-axial lesion. Right: With Gd-DTPA enhancement, the lesion is easily detected and definitely extra-axial. There is normal enhancement of the choroid plexus (large arrow) and pineal (small arrow).

  • View in gallery

    Magnetic resonance images of a hyperprolactin pituitary microadenoma: short-TR/TE coronal images of the pituitary glands. Left: Noncontrast image showing subtle enlargement of the left side of the gland without a focal signal abnormality. Right: Gadolinium-enhanced study, obtained immediately postinjection, clearly identifying the hypointense microadenoma with a hyperintense center on the left side of the gland (black arrows). It is easy to measure the size of the 6-mm microadenoma on this study. The adjacent normal pituitary tissue (white arrows) is markedly enhanced. There is normal enhancement of the cavernous sinus more laterally.

  • View in gallery

    Magnetic resonance images showing meningeal enhancement in bacterial meningitis. Upper: The noncontrast axial short-TR/TE (left) and long-TR/TE (right) images do not disclose a meningeal abnormality, although mild prominence of the ventricles is present. A shunt track is seen entering the right occipital horn. Lower Left: This postcontrast axial short-TR/TE image demonstrates marked enhancement of the meninges surrounding the entire brain (arrows). Enhancement of the falx may be a normal finding, although in this case the enhancement is pathological. Lower Right: After treatment with antibiotics, this follow-up postcontrast axial image shows resolution of the previously noted meningeal enhancement. If fibrous change in the meninges occurs, however, enhancement after meningitis or other meningeal pathology may be permanent. The contrast enhancement of vessels with slow-flowing blood and of the superior sagittal sinus walls is normal.

  • View in gallery

    Imaging of the residual cerebellar astrocytoma 1 year postoperatively. Upper: Axial contrast-enhanced computerized tomography (CT) scan showing abnormal tumor enhancement in the cerebellar vermis. As commonly encountered on CT, this scan of the posterior fossa is degraded by artifact from adjacent bone. Center: Noncontrast long-TR/short-TE (left) and long-TR/long-TE (right) magnetic resonance (MR) images. There is no clear distinction between residual tumor and postoperative changes. Lower: Short-TR/TE MR images without (left) and with (right) Gd-DTPA enhancement. Gadolinium easily detects the enhancing residual tumor nodules, with a cystic component. Enhancement of the cystic rim probably indicates neoplasm in the wall. Note the normal enhancement of the infundibulum (arrow).

  • View in gallery

    Magnetic resonance images of an anaplastic glioma. Left: Long-TR/TE axial MR image showing increased signal abnormality and associated mass effect in the right frontal and parietal lobes. It is impossible to separate “gross” lesion from edema. Center: Short-TR/TE coronal image demonstrating the mass effect on the right frontal sucli and right lateral ventricle. It is again difficult to separate the lesion from edema. Hyperintensity (arrow) at the posterior margin is consistent with hemorrhage. Right: Gadolinium-DTPA-enhanced short-TR/TE image revealing an enhancing lesion consistent with tumor. This contrast-enhanced scan clearly separates gross tumor from edema. Hemorrhage cannot be distinguished from enhancement.

  • View in gallery

    Magnetic resonance images of metastasis from lung. Metastatic lesions are not detected on the long-TR/TE image (left) or the long-TR/short-TE study (center), but are easily visualized on the Gd-DTPA-enhanced short-TR/TE image (right).

  • View in gallery

    Magnetic resonance images of an intracanalicular acoustic neurinoma. The noncontrast short-TR/TE coronal image (upper left) and long-TR/TE axial image (right) are unremarkable. No abnormality can be detected within the internal auditory canals. The postcontrast short-TR/TE coronal image (lower left), however, clearly shows an enhancing intracanalicular lesion (arrow) in the right internal auditory canal. Surgery confirmed the presence of an acoustic neurinoma.

  • View in gallery

    Axial magnetic resonance images in a case of multiple sclerosis. Left: Short-TR/TE image showing relative insensitivity to plaques, which are hypointense. Center: Long-TR image showing good sensitivity to plaques, which appear hyperintense. This study cannot distinguish active from inactive lesions. Right: Gadolinium-DTPA-enhanced short-TR/TE image revealing active plaques with disruption of the blood-brain barrier. Fewer lesions are identified than in the study shown center.

  • View in gallery

    Magnetic resonance images of metastases from a colon carcinoma. Left: Short-TR/TE sagittal image revealing multiple foci of hypointensity within the vertebral bodies (contrasted by adjacent normal hyperintense fatty marrow) consistent with known metastatic disease. Extension of the tumor at L-5 to the epidural space (arrow) is also appreciated. Center: Long-TR/TE cardiac-gated sagittal image demonstrating hyperintensity of the vertebral body metastases. Right: Gadolinium-DTPA-enhanced short-TR/TE sagittal image displaying varying degrees of enhancement of lesions. Some mildly enhancing lesions remain hypointense to normal marrow. Other lesions, especially at L-5, enhance enough to become isointense to the adjacent marrow. These isointense lesions would not be detected if the contrast-enhanced examination had been the only study performed. The epidural tumor also enhances to a similar extent as the adjacent tumor-infiltrated body of L-5. The enhancing thin line continuing in the anterior epidural space from L-5 superiorly to L-4 (arrowhead) may represent displaced enhancing epidural veins or extension of tumor. (Reprinted from Sze G, Krol G, Zimmerman RD, et al: Gadolinium-DPTA: malignant extradural spinal tumors. Radiology 167:217–233, 1988, with permission.)

  • View in gallery

    Magnetic resonance (MR) images of a case of failed-back syndrome. Upper Left: Short-TR/TE axial image 6 months postsurgery disclosing a large low-intensity region on the left at the operation site. Upper Right: Postcontrast short-TR/TE axial image demonstrating enhancement of only the rim (arrows) of the mass. The remainder of the mass appears as an area of low intensity. The patient underwent repeat surgery and a large disc fragment was found. Lower: Short-TR/TE axial MR images obtained 3 months later, when the patient developed recurrent pain. The precontrast image (left) again reveals a low-intensity mass in the same position as previously noted. The postcontrast image (right) demonstrates homogeneous enhancement of this lesion, consistent with scar formation. The nerve root sleeve passes through the center of the scar.

  • View in gallery

    Spinal imaging in a case of drop metastases from a cerebral glioblastoma. Upper Left: This noncontrast short-TR/TE sagittal magnetic resonance (MR) image is negative except for poor definition of the conus and proximal nerve roots. In retrospect, very vague nodules may be present in the subarachnoid space. Upper Center and Right: These noncontrast long-TR sagittal MR images are also equivocal. There may be a suggestion of high intensity near the conus. Lower Left: Postcontrast short-TR/TE sagittal MR image showing an enhancing subarachnoid tumor encasing the nonenhancing distal spinal cord, causing the total block seen on the myelogram (lower right). In addition, multiple other drop metastases are clearly seen. Lower Right: Myelogram confirming the presence of multiple nodules and total block at the level of the conus. (Reprinted from Sze G, Abramson A, Krol G, et al. AJNR 9:153–163, 1988, with permission.)

  • View in gallery

    Magnetic resonance imaging of a surgically proven spinal neurofibroma. Upper: Consecutive noncontrast short-TR/TE sagittal images depicting an apparent widening of the distal cord and conus. Center: Postcontrast short-TR/TE sagittal images demonstrating a well-defined enhancing mass, consistent with a neurofibroma. Lower: Postcontrast short-TR/TE axial image confirming the intradural extramedullary location of this lesion.

  • View in gallery

    Magnetic resonance imaging of breast carcinoma metastasis to the spinal cord. Left and Center: These noncontrast short-TR/TE (left) and long-TR/TE (right) sagittal images of the cervical cord cannot depict the exact location of the lesion. Right: Postcontrast short-TR/TE sagittal image demonstrating a focal enhancing lesion consistent with an intramedullary metastasis. The finding of the focal lesion enabled radiation therapy to be directed at the metastasis itself, sparing the remainder of the cord.

  • View in gallery

    Magnetic resonance imaging of a low-grade cervical astrocytoma. Left: Precontrast short-TR/TE sagittal image disclosing extensive enlargement of the cervical cord. Right: The postcontrast short-TR/TE sagittal image, however, shows enhancement of the nidus of the tumor. While tumor undoubtedly extends beyond the area of enhancement, Gd-DTPA depicts the region of the most active tumor. Low-grade gliomas of the spinal cord enhance much more frequently than low-grade gliomas of the brain.

References

1.

Berry IBrant-Zawadzki MOsaki Let al: Gd-DTPA in clinical MR of the brain. 2. Extraaxial lesions and normal structures. AJNR 7:7897931986Berry I Brant-Zawadzki M Osaki L et al: Gd-DTPA in clinical MR of the brain. 2. Extraaxial lesions and normal structures. AJNR 7:789–793 1986

2.

Bird CRDrayer BPMedina Met al: Gd-DTPA-enhanced MR imaging in pediatric patients after brain tumor resection. Radiology 169:1231261988Bird CR Drayer BP Medina M et al: Gd-DTPA-enhanced MR imaging in pediatric patients after brain tumor resection. Radiology 169:123–126 1988

3.

Bousquet JGSaini SStark DDet al: Gd-DOTA: characterization of a new paramagnetic complex. Radiology 166:6936981988Bousquet JG Saini S Stark DD et al: Gd-DOTA: characterization of a new paramagnetic complex. Radiology 166:693–698 1988

4.

Brant-Zawadzki MBerry IOsaki Let al: Gd-DTPA in clinical MR of the brain. 1. Intraaxial lesions. AJNR 7:7817881986Brant-Zawadzki M Berry I Osaki L et al: Gd-DTPA in clinical MR of the brain. 1. Intraaxial lesions. AJNR 7:781–788 1986

5.

Brasch RCBennett HF: Considerations in the choice of contrast media for MR imaging. Radiology 166:8978991988 (Editorial)Brasch RC Bennett HF: Considerations in the choice of contrast media for MR imaging. Radiology 166:897–899 1988 (Editorial)

6.

Breger RKPapke RAPojunas KWet al: Benign extraaxial tumors: contrast enhancement with Gd-DTPA. Radiology 163:4274291987Breger RK Papke RA Pojunas KW et al: Benign extraaxial tumors: contrast enhancement with Gd-DTPA. Radiology 163:427–429 1987

7.

Breger RKWilliams ALDaniels DLet al: Contrast enhancement in spinal MR imaging. AJNR 10:6336371989 and AJR 153:387–391 1989Breger RK Williams AL Daniels DL et al: Contrast enhancement in spinal MR imaging. AJNR 10:633–637 1989 and AJR 153:387–391 1989

8.

Bydder GBrown JNiendorf HPet al: Enhancement of cervical intraspinal tumors in MR imaging with intravenous gadolinium-DTPA. J Comput Assist Tomogr 9:8478511985Bydder G Brown J Niendorf HP et al: Enhancement of cervical intraspinal tumors in MR imaging with intravenous gadolinium-DTPA. J Comput Assist Tomogr 9:847–851 1985

9.

Cohen MDKlatte ECBaehner Ret al: Magnetic resonance imaging of bone marrow disease in children. Radiology 151:7157181984Cohen MD Klatte EC Baehner R et al: Magnetic resonance imaging of bone marrow disease in children. Radiology 151:715–718 1984

10.

Curati WLGraif MKingsley DPEet al: Acoustic neuromas: Gd-DTPA enhancement in MR imaging. Radiology 158:4474511986Curati WL Graif M Kingsley DPE et al: Acoustic neuromas: Gd-DTPA enhancement in MR imaging. Radiology 158:447–451 1986

11.

Daffner RHLupetin ARCash Net al: MRI in the detection of malignant infiltration of bone marrow. AJR 146:3533581986Daffner RH Lupetin AR Cash N et al: MRI in the detection of malignant infiltration of bone marrow. AJR 146:353–358 1986

12.

Daniels DLCzervionke LFMillen SJet al: MR imaging of facial nerve enhancement in Bell's palsy or after temporal bone surgery. Radiology 171:8078091989Daniels DL Czervionke LF Millen SJ et al: MR imaging of facial nerve enhancement in Bell's palsy or after temporal bone surgery. Radiology 171:807–809 1989

13.

Daniels DLCzervionke LFPojunas KWet al: Facial nerve enhancement in MR imaging. AJNR 8:6056071987Daniels DL Czervionke LF Pojunas KW et al: Facial nerve enhancement in MR imaging. AJNR 8:605–607 1987

14.

Davis PCHoffman HC JrMalko JAet al: Gadolinium-DTPA and MR imaging of pituitary adenoma: a preliminary report. AJNR 8:8178231987Davis PC Hoffman HC Jr Malko JA et al: Gadolinium-DTPA and MR imaging of pituitary adenoma: a preliminary report. AJNR 8:817–823 1987

15.

Dillon WPNorman DNewton THet al: Intradural spinal cord lesions: Gd-DTPA-enhanced MR imaging. Radiology 170:2292371989Dillon WP Norman D Newton TH et al: Intradural spinal cord lesions: Gd-DTPA-enhanced MR imaging. Radiology 170:229–237 1989

16.

Doppman JLFrank KADwyer AJet al: Gadolinium DTPA enhanced MR imaging of ACTH secreting adenomas of the pituitary gland. J Comput Assist Tomogr 12:7287351988Doppman JL Frank KA Dwyer AJ et al: Gadolinium DTPA enhanced MR imaging of ACTH secreting adenomas of the pituitary gland. J Comput Assist Tomogr 12:728–735 1988

17.

Dwyer AJFrank JADoppman JLet al: Pituitary adenomas in patients with Cushing's disease. Initial experience with Gd-DTPA enhanced MR imaging. Radiology 163:4214261987Dwyer AJ Frank JA Doppman JL et al: Pituitary adenomas in patients with Cushing's disease. Initial experience with Gd-DTPA enhanced MR imaging. Radiology 163:421–426 1987

18.

Elster ADDiPersio DA: Cranial postoperative site: assessment with contrast-enhanced MR imaging. Radiology 174:93981990Elster AD DiPersio DA: Cranial postoperative site: assessment with contrast-enhanced MR imaging. Radiology 174:93–98 1990

19.

Elster ADRieser GD: Gd-DTPA-enhanced cranial MR imaging in children: initial clinical experience and recommendations for its use. AJNR 10:102710301989Elster AD Rieser GD: Gd-DTPA-enhanced cranial MR imaging in children: initial clinical experience and recommendations for its use. AJNR 10:1027–1030 1989

20.

Engelstad BLWolf GL: Contrast agents in Stark DDBradley WG Jr (eds): Magnetic Resonance Imaging. St Louis: CV Mosby1988 pp 161179Engelstad BL Wolf GL: Contrast agents in Stark DD Bradley WG Jr (eds): Magnetic Resonance Imaging. St Louis: CV Mosby 1988 pp 161–179

21.

Felix RSchörner WLaniado Met al: Brain tumors: MR imaging with gadolinium-DTPA. Radiology 156:6816881985Felix R Schörner W Laniado M et al: Brain tumors: MR imaging with gadolinium-DTPA. Radiology 156:681–688 1985

22.

Frank JAGirton MDwyer AJet al: Meningeal carcinomatosis in the VX2 rabbit tumor model: detection with Gd-DTPA enhanced MR imaging. Radiology 167:8258291988Frank JA Girton M Dwyer AJ et al: Meningeal carcinomatosis in the VX2 rabbit tumor model: detection with Gd-DTPA enhanced MR imaging. Radiology 167:825–829 1988

23.

Gaensler EHLDillon WPTsuruda Jet al: Vascular malformations of the spinal cord: MR spectrum and pitfalls. AJNR 10:8801989 (Abstract)Gaensler EHL Dillon WP Tsuruda J et al: Vascular malformations of the spinal cord: MR spectrum and pitfalls. AJNR 10:880 1989 (Abstract)

24.

Gibby WA: MR contrast agents. Overview. Radiol Clin North Am 26:104710581988Gibby WA: MR contrast agents. Overview. Radiol Clin North Am 26:1047–1058 1988

25.

Grossman RIBraffman BHBrorson JRet al: Multiple sclerosis: serial study of gadolinium-enhanced MR imaging. Radiology 169:1171221988Grossman RI Braffman BH Brorson JR et al: Multiple sclerosis: serial study of gadolinium-enhanced MR imaging. Radiology 169:117–122 1988

26.

Grossman RIGonzalez-Scarano FAtlas SWet al: Multiple sclerosis. Gadolinium enhancement in MR imaging. Radiology 161:7217251986Grossman RI Gonzalez-Scarano F Atlas SW et al: Multiple sclerosis. Gadolinium enhancement in MR imaging. Radiology 161:721–725 1986

27.

Haughton VMRimm AACzervionke LFet al: Sensitivity of Gd-DTPA enhanced imaging of benign extraaxial tumors. Radiology 166:8298331988Haughton VM Rimm AA Czervionke LF et al: Sensitivity of Gd-DTPA enhanced imaging of benign extraaxial tumors. Radiology 166:829–833 1988

28.

Healy MEHesselink JRPress GAet al: Increased detection of intracranial metastasis with intravenous Gd-DTPA. Radiology 165:6196241987Healy ME Hesselink JR Press GA et al: Increased detection of intracranial metastasis with intravenous Gd-DTPA. Radiology 165:619–624 1987

29.

Hesselink JRHealy MEPress GAet al: Benefits of Gd-DTPA for imaging of intracranial abnormalities. J Comput Assist Tomogr 12:2662741988Hesselink JR Healy ME Press GA et al: Benefits of Gd-DTPA for imaging of intracranial abnormalities. J Comput Assist Tomogr 12:266–274 1988

30.

Hesselink JRPress GA: MR contrast enhancement of intracranial lesions with Gd-DTPA. Radiol Clin North Am 26:8378871988Hesselink JR Press GA: MR contrast enhancement of intracranial lesions with Gd-DTPA. Radiol Clin North Am 26:837–887 1988

31.

Hueftle MGModic MTRoss JSet al: Lumbar spine: postoperative MR imaging with Gd-DTPA. Radiology 167:8178241988Hueftle MG Modic MT Ross JS et al: Lumbar spine: postoperative MR imaging with Gd-DTPA. Radiology 167:817–824 1988

32.

Imakita SNishimura TYamada Net al: Magnetic resonance imaging of cerebral infarction: time course of Gd-DTPA enhancement and CT comparison. Neuroradiology 30:3723781988Imakita S Nishimura T Yamada N et al: Magnetic resonance imaging of cerebral infarction: time course of Gd-DTPA enhancement and CT comparison. Neuroradiology 30:372–378 1988

33.

Kilgore DPBreger RKDaniels DLet al: Cranial tissues: normal MR appearance after intravenous injection of Gd-DTPA. Radiology 160:7577611986Kilgore DP Breger RK Daniels DL et al: Cranial tissues: normal MR appearance after intravenous injection of Gd-DTPA. Radiology 160:757–761 1986

34.

Kornguth SETurski PAPerman WHet al: Magnetic resonance imaging of gadolinium-labeled monoclonal antibody polymers directed at human T lymphocytes implanted in canine brain. J Neurosurg 66:8989061987Kornguth SE Turski PA Perman WH et al: Magnetic resonance imaging of gadolinium-labeled monoclonal antibody polymers directed at human T lymphocytes implanted in canine brain. J Neurosurg 66:898–906 1987

35.

Kuharik MAEdwards MKFarlow MRet al: Gd-enhanced MR imaging of acute and chronic experimental demyelinating lesions. AJNR 9:6436481988Kuharik MA Edwards MK Farlow MR et al: Gd-enhanced MR imaging of acute and chronic experimental demyelinating lesions. AJNR 9:643–648 1988

36.

Larson EMHoltas SNilsson O: Gd-DTPA-enhanced MR of suspected spinal multiple sclerosis. AJNR 10:107110761989Larson EM Holtas S Nilsson O: Gd-DTPA-enhanced MR of suspected spinal multiple sclerosis. AJNR 10:1071–1076 1989

37.

Majumbar SZoghbi SSGore JC: Regional differences in rat brain displayed by fast MRI with superparamagnetic contrast agents. Magn Reson Imaging 6:6116151988Majumbar S Zoghbi SS Gore JC: Regional differences in rat brain displayed by fast MRI with superparamagnetic contrast agents. Magn Reson Imaging 6:611–615 1988

38.

Mathews VPKuharik MAEdwards MKet al: Gd-DTPA-enhanced MR imaging experimental bacterial meningitis: evaluation and comparison with CT. AJNR 9:104510501988 and AJR 152:131–136 1989Mathews VP Kuharik MA Edwards MK et al: Gd-DTPA-enhanced MR imaging experimental bacterial meningitis: evaluation and comparison with CT. AJNR 9:1045–1050 1988 and AJR 152:131–136 1989

39.

McNamara MTBrant-Zawadzki MBerry Iet al: Acute experimental cerebral ischemia: MR enhancement using Gd-DTPA. Radiology 158:7017051986McNamara MT Brant-Zawadzki M Berry I et al: Acute experimental cerebral ischemia: MR enhancement using Gd-DTPA. Radiology 158:701–705 1986

40.

Modic MTSteinberg PMRoss JSet al: Degenerative disk disease: assessment of changes in vertebral body marrow with MR imaging. Radiology 166:1931991988Modic MT Steinberg PM Ross JS et al: Degenerative disk disease: assessment of changes in vertebral body marrow with MR imaging. Radiology 166:193–199 1988

41.

Moseley MEWhite DLLang SCet al: Vascular mapping using albumin-(Gd-DTPA), intravascular MR contrast agent, and projection MR imaging. J Comput Assist Tomogr 13:2152211989Moseley ME White DL Lang SC et al: Vascular mapping using albumin-(Gd-DTPA) intravascular MR contrast agent and projection MR imaging. J Comput Assist Tomogr 13:215–221 1989

42.

Nelson JACegnar JSpence AMet al: Lipophilic manganese porphyrin crosses blood-brain barrier. Radiology 165 (Suppl):3031987 (Abstract)Nelson JA Cegnar J Spence AM et al: Lipophilic manganese porphyrin crosses blood-brain barrier. Radiology 165 (Suppl):303 1987 (Abstract)

43.

Newton DRDillon WPNormal Det al: Gd-DTPA-enhanced MR imaging of pituitary adenomas. AJNR 10:9499541989Newton DR Dillon WP Normal D et al: Gd-DTPA-enhanced MR imaging of pituitary adenomas. AJNR 10:949–954 1989

44.

Niendorf HPLaniado MSemmler Wet al: Dose administration of gadolinium-DTPA in MR imaging of intracranial tumors. AJNR 8:8038151987Niendorf HP Laniado M Semmler W et al: Dose administration of gadolinium-DTPA in MR imaging of intracranial tumors. AJNR 8:803–815 1987

45.

Okada YAoki SBarkovich AJet al: Cranial bone marrow in children: assessment of normal development with MR imaging. Radiology 171:1611641989Okada Y Aoki S Barkovich AJ et al: Cranial bone marrow in children: assessment of normal development with MR imaging. Radiology 171:161–164 1989

46.

Parizel PMBaleriaux DRodesch Get al: Gadolinium-DTPA-enhanced MR imaging of spinal tumors. AJNR 10:2492581989Parizel PM Baleriaux D Rodesch G et al: Gadolinium-DTPA-enhanced MR imaging of spinal tumors. AJNR 10:249–258 1989

47.

Parizel PMDegrise HRGheuens Jet al: Gadolinium DOTA enhanced MR imaging of intracranial lesions. J Comput Assist Tomogr 13:3783851989Parizel PM Degrise HR Gheuens J et al: Gadolinium DOTA enhanced MR imaging of intracranial lesions. J Comput Assist Tomogr 13:378–385 1989

48.

Post MJDSze GQuencer RMet al: Gadolinium-enhanced MR vertebral osteomyelitis and in spinal infection. J Comput Assist Tomogr (In press1990)Post MJD Sze G Quencer RM et al: Gadolinium-enhanced MR vertebral osteomyelitis and in spinal infection. J Comput Assist Tomogr (In press 1990)

49.

Powers TAPartian CLKessler RMet al: Central nervous system lesions in pediatric patients: Gd-DTPA enhancing MR imaging. Radiology 169:7237261988Powers TA Partian CL Kessler RM et al: Central nervous system lesions in pediatric patients: Gd-DTPA enhancing MR imaging. Radiology 169:723–726 1988

50.

Robinson JDCrawford SCTeresi LMet al: Extracranial lesions of head and neck. Preliminary experience with Gd-DTPA-enhanced MR imaging. Radiology 172:1651701989Robinson JD Crawford SC Teresi LM et al: Extracranial lesions of head and neck. Preliminary experience with Gd-DTPA-enhanced MR imaging. Radiology 172:165–170 1989

51.

Rosen GMGriffeth LKBrown MAet al: Intrathecal administration of nitroxides as potential contrast agents for MR imaging. Radiology 163:2392431987Rosen GM Griffeth LK Brown MA et al: Intrathecal administration of nitroxides as potential contrast agents for MR imaging. Radiology 163:239–243 1987

52.

Runge VMClanton JAHerzer WAet al: Intravascular contrast agents suitable for magnetic resonance imaging. Radiology 153:1711761984Runge VM Clanton JA Herzer WA et al: Intravascular contrast agents suitable for magnetic resonance imaging. Radiology 153:171–176 1984

53.

Runge VMClanton JALukehart CMet al: Paramagnetic agents for contrast-enhanced NMR imaging: a review. AJR 141:120912151983Runge VM Clanton JA Lukehart CM et al: Paramagnetic agents for contrast-enhanced NMR imaging: a review. AJR 141:1209–1215 1983

54.

Runge VMClanton JAPrice ACet al: Evaluation of contrast-enhanced MR imaging in a brain-abscess model. AJNR 6:1391471985Runge VM Clanton JA Price AC et al: Evaluation of contrast-enhanced MR imaging in a brain-abscess model. AJNR 6:139–147 1985

55.

Runge VMJacobson SWood MLet al: MR imaging of rat brain glioma: Gd-DTPA versus Gd-DOTA. Radiology 166:8358381988Runge VM Jacobson S Wood ML et al: MR imaging of rat brain glioma: Gd-DTPA versus Gd-DOTA. Radiology 166:835–838 1988

56.

Runge VMSchaible TFGoldstein HAet al: Gd-DTPA clinical efficacy. Radiographics 8:1471591988Runge VM Schaible TF Goldstein HA et al: Gd-DTPA clinical efficacy. Radiographics 8:147–159 1988

57.

Runge VMWood MLKaufman Det al: Gd-DTPA. Future applications with advanced imaging techniques. Radiographics 8:1611791988Runge VM Wood ML Kaufman D et al: Gd-DTPA. Future applications with advanced imaging techniques. Radiographics 8:161–179 1988

58.

Russell EJGeremia GKJohnson CEet al: Multiple cerebral metastases: detectability with Gd-DTPA-enhanced MR imaging. Radiology 165:6096171987Russell EJ Geremia GK Johnson CE et al: Multiple cerebral metastases: detectability with Gd-DTPA-enhanced MR imaging. Radiology 165:609–617 1987

59.

Russell EJSchaible TFDillon Wet al: Multicenter double-blind placebo-controlled study of gadopentetate dimeglumine as an MR contrast agent: evaluation in patients with cerebral lesions. AJR 152:8138231989Russell EJ Schaible TF Dillon W et al: Multicenter double-blind placebo-controlled study of gadopentetate dimeglumine as an MR contrast agent: evaluation in patients with cerebral lesions. AJR 152:813–823 1989

60.

Saini SFrankel RBStark DDet al: Magnetism: a primer and review. AJR 150:7357431988Saini S Frankel RB Stark DD et al: Magnetism: a primer and review. AJR 150:735–743 1988

61.

Schmidl UOgan MPaajanen Het al: Albumin labeled with Gd-DTPA as an intravascular, blood pool enhancing agent for MR imaging. Biodistribution and imaging studies. Radiology 162:2052101987Schmidl U Ogan M Paajanen H et al: Albumin labeled with Gd-DTPA as an intravascular blood pool enhancing agent for MR imaging. Biodistribution and imaging studies. Radiology 162:205–210 1987

62.

Seltzer SE: The role of liposomes in diagnostic imaging. Radiology 171:19211989Seltzer SE: The role of liposomes in diagnostic imaging. Radiology 171:19–21 1989

63.

Simon JHSzumowski J: Chemical shift imaging with paramagnetic contrast material enhancement for improved lesion depiction. Radiology 171:5395431989Simon JH Szumowski J: Chemical shift imaging with paramagnetic contrast material enhancement for improved lesion depiction. Radiology 171:539–543 1989

64.

Stack JPAntoun NMJenkins JPRet al: Gadolinium-DTPA as a contrast agent in magnetic resonance imaging of the brain. Neuroradiology 30:1451541988Stack JP Antoun NM Jenkins JPR et al: Gadolinium-DTPA as a contrast agent in magnetic resonance imaging of the brain. Neuroradiology 30:145–154 1988

65.

Stack JPRamsden RTAntoun NMet al: Magnetic resonance imaging of acoustic neuromas: the role of gadolinium-DTPA. Br J Radiol 61:8008051988Stack JP Ramsden RT Antoun NM et al: Magnetic resonance imaging of acoustic neuromas: the role of gadolinium-DTPA. Br J Radiol 61:800–805 1988

66.

Stimac GKPorter BAOlson DOet al: Gadolinium-DTPA enhanced MR imaging of spinal neoplasms: preliminary investigation and comparison with unenhanced spin-echo and STIR sequences. AJNR 9:8398461988 and AJR 151:1185–1192 1988Stimac GK Porter BA Olson DO et al: Gadolinium-DTPA enhanced MR imaging of spinal neoplasms: preliminary investigation and comparison with unenhanced spin-echo and STIR sequences. AJNR 9:839–846 1988 and AJR 151:1185–1192 1988

67.

Sze G: Gadolinium-DTPA in spinal disease. Radiol Clin North Am 26:100910241988Sze G: Gadolinium-DTPA in spinal disease. Radiol Clin North Am 26:1009–1024 1988

68.

Sze GAbramson AKrol Get al: Gadolinium-DTPA/dimeglumine in the MR evaluation of intradural extramedullary spinal disease. AJNR 9:1531631988 and AJR 150:911–921 1988Sze G Abramson A Krol G et al: Gadolinium-DTPA/dimeglumine in the MR evaluation of intradural extramedullary spinal disease. AJNR 9:153–163 1988 and AJR 150:911–921 1988

69.

Sze GBravo SCrow G: Post-operative enhancement: gadolinium-DTPA in a clinical series and an animal model. Radiology 169 (Suppl):701988 (Abstract)Sze G Bravo S Crow G: Post-operative enhancement: gadolinium-DTPA in a clinical series and an animal model. Radiology 169 (Suppl):70 1988 (Abstract)

70.

Sze GJohnson C: Benign lumbar arachnoiditis: contrast-enhanced MR imaging. AJNR 11:7637701990Sze G Johnson C: Benign lumbar arachnoiditis: contrast-enhanced MR imaging. AJNR 11:763–770 1990

71.

Sze GKrol GZimmerman RDet al: Gadolinium-DPTA: malignant extradural spinal tumors. Radiology 167:2172331988Sze G Krol G Zimmerman RD et al: Gadolinium-DPTA: malignant extradural spinal tumors. Radiology 167:217–233 1988

72.

Sze GKrol GZimmerman RDet al: Intramedullary disease of the spine: diagnosis using gadolinium-DTPA enhanced MR imaging. AJNR 9:8478581988 and AJR 151:1193–1204 1988Sze G Krol G Zimmerman RD et al: Intramedullary disease of the spine: diagnosis using gadolinium-DTPA enhanced MR imaging. AJNR 9:847–858 1988 and AJR 151:1193–1204 1988

73.

Sze GMilano EJohnson Cet al: Detection of brain metastases: comparison of contrast-enhanced MR with unenhanced MR and enhanced CT. AJNR 11:7857911990Sze G Milano E Johnson C et al: Detection of brain metastases: comparison of contrast-enhanced MR with unenhanced MR and enhanced CT. AJNR 11:785–791 1990

74.

Sze GSoletsky SBronen Ret al: MR imaging of the cranial meninges, with emphasis on contrast enhancement and meningeal carcinomatosis. AJNR 10:9659751989Sze G Soletsky S Bronen R et al: MR imaging of the cranial meninges with emphasis on contrast enhancement and meningeal carcinomatosis. AJNR 10:965–975 1989

75.

Unger ECTotty WGNeufeld DMet al: Magnetic resonance imaging using gadolinium labeled monoclonal antibody. Invest Radiol 20:6937001985Unger EC Totty WG Neufeld DM et al: Magnetic resonance imaging using gadolinium labeled monoclonal antibody. Invest Radiol 20:693–700 1985

76.

Valk J: Gadolinium-DTPA in MR of spinal lesions. AJNR 9:3453501988Valk J: Gadolinium-DTPA in MR of spinal lesions. AJNR 9:345–350 1988

77.

Virapongse CMancuso AQuisling R: Human brain infarcts Gd-DTPA enhanced MR imaging. Radiology 161:7857941986Virapongse C Mancuso A Quisling R: Human brain infarcts Gd-DTPA enhanced MR imaging. Radiology 161:785–794 1986

78.

Vogl TBruning RSchedel Het al: Paragangliomas of the jugular bulb and carotid body: MR imaging and short sequences Gd-DTPA enhancement. AJNR 10:8238271989Vogl T Bruning R Schedel H et al: Paragangliomas of the jugular bulb and carotid body: MR imaging and short sequences Gd-DTPA enhancement. AJNR 10:823–827 1989

79.

Weinmann HJBrasch RCPress WRet al: Characteristics of gadolinium-DTPA complex: a potential NMR contrast agent. AJR 142:6196421984Weinmann HJ Brasch RC Press WR et al: Characteristics of gadolinium-DTPA complex: a potential NMR contrast agent. AJR 142:619–642 1984

80.

Weissleder RStark DDEngelstad BLet al: Superparamagnetic iron oxide: pharmacokinetics and toxicity. AJR 152:1671731989Weissleder R Stark DD Engelstad BL et al: Superparamagnetic iron oxide: pharmacokinetics and toxicity. AJR 152:167–173 1989

81.

West MRussell EJBreit Ret al: Calvarial and skull base metastases: comparison of non-enhanced and Gd-DTPA-enhanced MR images. Radiology 174:85911990West M Russell EJ Breit R et al: Calvarial and skull base metastases: comparison of non-enhanced and Gd-DTPA-enhanced MR images. Radiology 174:85–91 1990

82.

Williams ALCzervionke LFHaughton VMet al: Quantitative assessment of spinal tissue enhancement with intravenous gadolinium in MR imaging. Radiology 165 (Suppl):781987 (Abstract)Williams AL Czervionke LF Haughton VM et al: Quantitative assessment of spinal tissue enhancement with intravenous gadolinium in MR imaging. Radiology 165 (Suppl):78 1987 (Abstract)

TrendMD

Metrics

Metrics

All Time Past Year Past 30 Days
Abstract Views 24 24 16
Full Text Views 129 129 49
PDF Downloads 91 91 24
EPUB Downloads 0 0 0

PubMed

Google Scholar