The use of MR contrast in nonneoplastic disease of the brain

The clinical utility of intravenous contrast administration in nonneoplastic disease of the brain is well established. Although primarily providing improved diagnostic specificity, contrast use can also improve lesion detection. Applications are discussed in infection, vascular disorders, diseases of white matter, and trauma. On the basis of prospective studies, contrast use is advocated in all patient examinations in which there is a high clinical suspicion for intracranial disease. The role of high-dose contrast administration, with agents such as gadoteridol (Gd HP-DO3A), is just now being explored in nonneoplastic disease. Basic research suggests efficacy for high dose in disease states with partial or early blood-brain barrier disruption. Gadolinium chelates play as important a role in the evaluation of nonneoplastic disease of the brain as do iodinated agents in computed tomography. Contrast administration facilitates time-efficient and cost-effective diagnosis.