By Steven Dymarkowski MD, PhD, Hilde Bosmans PhD (auth.), Jan Bogaert MD, PhD, Steven Dymarkowski MD, PhD, Andrew M. Taylor MD, MRCP, FRCR (eds.)
MRI has develop into the popular noninvasive imaging modality for the guts and nice vessels. The monstrous technological growth accomplished in recent times has supplied the consumer with state-of-the-art MRI structures, yet their optimum use will be restricted by way of limited wisdom of the aptitude sufferer profit and the need for instructing. This commonly illustrated quantity, has been particularly compiled to fulfill those wishes. crucial theoretical history details is supplied, and imaging acquisition and capability pitfalls are thought of intimately. most significantly, based guidance are supplied at the interpretation of scientific facts within the wide variety of cardiac pathology that may be encountered. all through, the emphasis is at the implementation of cardiac MRI in scientific practice.
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2 Blood-Pool Contrast Agents This unique type refers to a variety of contrast agents that are confined by purpose to the intravascular space and dedicated exclusively to cardiovascular applications. Such blood-pool property can be realized by controlling the distribution and elimination of the contrast agents, which in turn is determined by their size relative to the permeability of the capillary endothelium in different organs. Although BPCAs are partially or completely limited in passing through the endothelial membrane elsewhere, they can still be excreted by the kidneys (Fig.
As a result, the amount of contrast agent in the tissue is not proportional to the blood flow into the tissue. A second restriction results from the MR acquisition technique itself. Signal intensities are not necessarily proportional to the local concentrations of the contrast agent (Prakash et al. 2004). Trials with intravascular contrast agents are currently underway to investigate the potential of these agents for determination of absolute myocardial blood flow. T2- or T2*-weighted, single-shot techniques are rarely used for cardiac perfusion measurements.
Extracellular fluid (ECF) space versus blood-pool (BP) contrast agents (CAs) sess longer plasma half-life and render a higher intravascular signal, and therefore facilitate MRA with improved flexibility, accuracy, and versatility. With the use of BPCAs, the time interval between contrast injection and imaging acquisition becomes less crucial due to the resultant optimal imaging window in tens of minutes instead of seconds with the use of ECF contrast agents. An adequate and uniform particulate size, a high ratio of T1 over T2 relaxivity, an initial intravascular space distribution, a sufficient eventual body clearance, and a lack of toxicity and/or immunogenecity are the basic requirements for an ideal BPCA.