Histologic basis for increased extraocular muscle enhancement in gadolinium-enhanced MR imaging

Minimal to mild enhancement of skeletal muscles is normally seen on gadolinium-enhanced magnetic resonance images. The enhancement of the extraocular muscles is much more intense than that of other skeletal muscles. The authors investigated the structural features of extraocular muscles that contribute to this increased enhancement. After comparing samples of extraocular muscle and quadriceps muscle, the authors concluded that the rich vascularity and the prominence of extravascular space most probably cause extraocular muscles to demonstrate intense enhancement on gadolinium-enhanced images.