title: MR angiography with blood pool contrast agents.
abstract: Contrast-enhanced magnetic resonance angiography (CE-MRA) with standard extracellular contrast material is well established for vascular imaging. Recently, the first blood pool contrast agent (BPA) has become clinically available. This paper reviews characteristics and classification of BPA as well as first clinical experience in various vascular territories. BPAs comprise gadolinium-based compounds, synthetic compounds, and ultrasmall superparamagnetic iron-oxide (USPIO) particles. Such BPAs are retained in blood with a prolonged time-window of enhancement as compared to extracellular gadolinium chelates. Promising results from USPIO at first-pass and steady-state angiography have been published, but no USPIO is approved yet. Gadofosveset is the first clinically approved BPA. After bolus injection, gadofosveset binds noncovalently to serum-albumine, thus enhancing relaxivity. First published results from carotid, coronary, renal, and peripheral angiography are encouraging; particularly helpful is prolonged enhancement during steady state. More BPAs have been clinically evaluated, but no approval has been granted. Bolus-injectable BPAs allow for first-pass CE-MRA similar to standard extracellular contrast media, but with higher relaxivity, allowing lower doses and reduced injection rates. An additional feature of BPA is the steady-state phase with a broad time window enabling high-resolution angiography or double-gated angiography of coronary arteries to compensate for the complex motion pattern.
authors.affiliation: Department of Radiology, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland. jens.bremerich@unibas.ch
authors.forename: Jens
authors.initials: J
authors.lastname: Bremerich
authors.forename: Deniz
authors.initials: D
authors.lastname: Bilecen
authors.forename: Peter
authors.initials: P
authors.lastname: Reimer
mesh_terms: D003287:Contrast Media; D003911:Dextrans; D052203:Ferrosoferric Oxide; D005682:Gadolinium; D006801:Humans; D007501:Iron; D018810:Magnetic Resonance Angiography / Q000379:methods*; D058185:Magnetite Nanoparticles; D009942:Organometallic Compounds; D010087:Oxides; D014652:Vascular Diseases / Q000175:diagnosis*
chemical_list: D003287:Contrast Media; D003911:Dextrans; D058185:Magnetite Nanoparticles; D009942:Organometallic Compounds; D010087:Oxides; C097921:ferumoxtran-10; D005682:Gadolinium; D007501:Iron; D052203:Ferrosoferric Oxide; C109932:gadofosveset trisodium