Blood pool contrast agents for venous magnetic resonance imaging

Abstract

Imaging of the venous system plays a vital role in the diagnosis and management of a wide range of clinically significant disorders. There have been great advances in venous imaging techniques, culminating in the use of magnetic resonance venography (MRV). Although MRV has distinct advantages in anatomic and quantitative cross sectional imaging without ionizing radiation, there are well-known challenges in acquisition timing and contrast administration in patients with renal impairment. The latest advancement involves the addition of new contrast media agents, which have emerged as valuable alternatives in these difficult scenarios. In this review, we will focus on a group of specific contrast agents called blood pool agents and discuss their salient features and clinical applications.

Methodological Considerations for Neuroimaging in Deep Brain Stimulation of the Subthalamic Nucleus in Parkinson’s Disease Patients

“…As discussed, accurate DBS implantation requires careful trajectory planning and identification of vasculature to limit the risk of hemorrhagic complications. Visualization of larger venous architecture is most commonly achieved with an anatomical T1w scan with added gadolinium [ 119 , 120 ]. In its most basic form, T1w can be viewed as an anatomical scan that approximates the appearance of macroscopic tissues.…”

Smart MRI Agents for Detecting Extracellular Events In Vivo: Progress and Challenges

“…Blood pool agents are T 1 CAs that display an increased dwell time within the vasculature and have an indication in magnetic resonance angiography (MRA), which is the visualization of the arterial system with contrast [31,32]. Two general methods have been used to develop blood pool agents-either agents are designed with very high molecular weight which prevents extravasation through cell membranes, or agents have an albumin binding moiety which increases dwell time within the vasculature.…”

“…Ablavar contains an albumin-binding ligand (Figure 3) which strongly and reversibly binds to albumin, leading to decreased tumbling time and increased T 1 signal intensity [31,32]. Clinically, Ablavar was developed to increase the ease and accuracy of MRA exams; ECF agents, which do enhance arterial vessels, leave the vasculature within minutes and, therefore, can only be visualized on a first-pass basis with carefully timed boluses and sequences, whereas Ablavar can stay within the circulatory system for over an hour, decreasing the technical difficulty of the exam [31,32]. The clinical utility of these agents, however, has been sparse; Ablavar was pulled from the market in 2017 by Bayer due to poor sales.…”

Acute aortic syndromes and aortic emergencies

“…An ECG tracing can be acquired with the imaging data, which can be reconstructed in the different phases of the cardiac cycle and displayed in cine mode. Non-contrast MRA with balanced steady-state free precession techniques are increasingly applied in patients at risk for renal insufficiency or nephrogenic systemic fibrosis (25,41).…”