In just over a decade, magnetic resonance (MR) has become the imaging modality of choice for the study of central nervous system disease, with additional broad applications in the abdomen, pelvis and musculoskeletal system. Concurrent development of contrast media, now in widespread use, has aided the rapid expansion of this field and improved clinical efficacy. Magnetic resonance imaging offers high spatial resolution and soft tissue contrast, with sensitivity to contrast media greater than that of x-ray computed tomography (CT). First pass brain studies now make possible the assessment of regional cerebral blood volume, with high spatial and temporal resolution. New...

MR has evolved as the modality of choice in evaluating patients with actual or suspected brain tumors. It is noninvasive, has multiplanar capability, displays increased sensitivity to disease relative to other modalities, and employs no ionizing radiation. Cost, availability (in some locations and at some times), and decreased sensitivity to tumoral calcification and subtle bone erosion are limitations of MR relative to CT. However, these concerns are far outweighed by the ability of MR to provide rapid, accurate diagnoses of intracranial mass lesions.

MR contrast agents are used in about thirty percent of all central nervous system MR studies. However,...

Intravenous contrast use in magnetic resonance (MR) was first clinically evaluated in neoplastic disease of the brain. Subsequent trials included non-neoplastic disease, with widespread applications quickly noted. Today, contrast use in MR is as important in non-neoplastic disease of the brain as in neoplastic disease. This chapter describes the utility of contrast administration and the patterns of abnormal enhancement in infection, vascular disorders (arteriovenous malformations and infarction), diseases of white matter, and trauma. Contrast enhancement assumes a prominent position in the routine clinical evaluation by MR of non-neoplastic disease, with advances in instrumentation driving additional new applications including the assessment...

Magnetic resonance (MR) has permitted for the first time noninvasive, accurate delineation of the spinal cord and spinal nerve roots. The subsequent development of paramagnetic gadolinium chelates has made it possible to accurately and sensitively pinpoint disruptions or absences in the blood-central nervous system (CNS) barrier frequently associated with spinal disease.¹ This chapter outlines the use of MR contrast agents in the evaluation of disease involving the spinal column, spinal neural tissue, and spinal leptomeninges.²

Gadolinium containing contrast agents must come into close proximity with water protons in order to exert their effect and thereby enhance proton relaxation. In the...

The use of magnetic resonance (MR) contrast media in the head and spine dominates today’s clinical applications, with experience and indications lagging in the body. Broad indications for intravenous gadolinium chelate use have been established in the central nervous system (CNS). However, the role of contrast media is less certain in body imaging. This situation can be attributed to two factors. First, the development of clinical MR initially focused on head imaging, and then subsequently expanded to include the spine. Today, body applications, regardless of the application of contrast media, still constitute a small proportion of all clinical scans. Only...

In just over a decade, magnetic resonance (MR) has become the imaging modality of choice for the study of central nervous system disease. Concurrent development of contrast media, now in widespread use, has aided the rapid expansion of this field and increased clinical efficacy. Magnetic resonance imaging offers high spatial resolution and soft tissue contrast, with a sensitivity to contrast media greater than that of x-ray computed tomography (CT). First pass brain studies now make possible the assessment of regional cerebral blood volume, with high spatial and temporal resolution. New hardware developments, together with advances in contrast media design, continue...