MR imaging advances in practice

Efficacy and safety of gadolinium contrast agents in MR imaging of the brain and spine are examined first in the context of clinical experience at the Barrow Neurological Institute. The role played by the absence and the presence of contrast enhancement in confirming or ruling out diagnostic suspicions is emphasized. Findings from multicenter phase I-III efficacy and safety studies of gadopentetate dimeglumine, gadodiamide, and gadoteridol in head and back imaging are reviewed. All three agents add diagnostic information, increase diagnostic confidence, and are extremely safe, readily tolerated compounds exhibiting generally mild side-effect profiles. Gadolinium-enhanced MR scanning is placed in the longer perspective of diagnostic imaging strategies, to consider the assignment of priorities to various modalities according to the suspected disease at hand.