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Contrast media for cardiothoracic MR imaging
C B Higgins1, M Saeed, M Wendland
1Department of Radiology, University of California Medical Center, San Francisco 94143.
Insights
Magnetic resonance (MR) contrast media enhance imaging of the heart and thoracic masses. New agents like gadodiamide injection show promise for improving thoracic mass detection and evaluating myocardial ischemia.
Area of Science:
- Cardiovascular Imaging
- Thoracic Radiology
- Medical Physics
Background:
- Magnetic resonance (MR) contrast media are established tools for assessing myocardial infarction, ischemia, and jeopardized myocardium.
- Current contrast agents typically show ischemic areas as decreased signal intensity compared to normal tissue.
- Limited data exist on MR contrast media for evaluating mediastinal and lung masses.
Purpose of the Study:
- To review the current applications of MR contrast media in thoracic imaging.
- To explore the potential of new contrast agents for enhancing thoracic masses.
- To discuss the role of MR contrast media in myocardial ischemia and thoracic mass evaluation.
Main Methods:
- Review of existing literature on MR contrast media in thoracic imaging.
- Analysis of studies utilizing contrast agents for myocardial ischemia and thoracic masses.
- Evaluation of a new nonionic contrast medium, gadodiamide injection.
Main Results:
- MR contrast media improve the delineation of acute myocardial infarction and ischemic areas.
- Magnetic susceptibility agents identify ischemic areas as increased signal intensity.
- Gadodiamide injection significantly increases signal-to-noise (S/N) and contrast-to-noise (C/N) ratios for thoracic masses.
Conclusions:
- MR contrast media play a crucial role in evaluating myocardial ischemia.
- Newer agents like gadodiamide injection enhance the conspicuity of thoracic masses.
- Further research is needed to fully define the clinical utility of MR contrast media for thoracic conditions.
Abstract:
Contrast media have been used for the study of disease of the thorax. Most experience has consisted of the use of MR contrast media for improving the delineation of acute myocardial infarction, for demarcating the area of acute myocardial ischemia, and for demonstrating the area of potentially jeopardized myocardium after acute coronary occlusion. Contrast agents demonstrate the ischemic or jeopardized area as a zone of decreased signal intensity to normal myocardium. On the other hand, the magnetic susceptibility agents demonstrate the ischemic or jeopardized area as a zone of increased signal intensity to normal myocardium. Little experience exists concerning the use of MR contrast media for enhancing mediastinal and lung masses. The few reports to date demonstrate that contrast media can improve the conspicuity of thoracic masses. A new nonionic contrast medium, gadodiamide injection, has been shown to considerably increase S/N and C/N of thoracic masses. Further studies are necessary to define the role of MR contrast media in the evaluation of myocardial ischemia and thoracic masses in clinical practice.