Dynamic contrast-enhanced three-dimensional MR imaging of liver parenchyma: source images and angiographic reconstructions to define hepatic arterial anatomy

PURPOSE: To assess the accuracy of an interpolated breath-hold T1-weighted three-dimensional (3D) gradient-echo (GRE) magnetic resonance (MR) imaging sequence with near-isotropic pixel size (相似文献   

Enhancement effects of hepatic dynamic MR imaging at 3.0 T and 1.5 T using gadoxetic acid in a phantom study: comparison with gadopentetate dimeglumine

To identify the optimum sequence at gadoxetic acid enhanced hepatic dynamic magnetic resonance imaging in the arterial phase, we studied phantoms that contained gadoxetic acid or gadopentetate dimeglumine diluted in human blood. We obtained magnetic resonance images at 3.0 T and 1.5 T with one vendor (Siemens) using 3D‐gradient echo (GRE)‐, 2D‐fast low angle shot (FLASH)‐, and turbo spin echo sequences. Contrast ratio was highest for 3D‐GRE; at both 3.0 T and 1.5 T it was superior when the contrast agent was gadoxetic acid. With both gadoxetic acid and gadopentetate dimeglumine, contrast ratio peaked at around 5‐and 2 mmol/L on 3D‐GRE‐ and 2D‐FLASH images, respectively. Compared with gadopentetate dimeglumine, at 3.0 T, the peak contrast ratio of gadoxetic acid was 14.1% better on 3D‐GRE images and 14.0% better on 2D‐FLASH images; at 1.5 T it was 16.4% better on 3D‐GRE‐ and 5.7% better on 2D‐FLASH images. With respect to the magnetic field strength, at 3.0 T the peak contrast ratio of gadoxetic acid was 6.0% better than at 1.5 T on 3D‐GRE images and 49.5% better on 2D‐FLASH images; it was 8.5% better on 3D‐GRE‐ and 44.6% better on 2D‐FLASH images than when the contrast agent was gadopentetate dimeglumine. Thus, gadoxetic acid yielded better enhancement on 3D‐GRE images acquired at 3.0 T than at 1.5 T and enhancement was better than that obtained with gadopentetate dimeglumine at the same concentration. Magn Reson Med 66:213–218, 2011. © 2011 Wiley‐Liss, Inc.     

Parotid gland: plain and gadolinium-enhanced MR imaging

The purpose of this study was to show the typical appearance of lesions of the parotid gland with plain MR imaging and MR imaging enhanced with gadopentetate dimeglumine. Seventeen patients with inflammatory changes and 43 with benign and malignant tumors were studied. The examinations were carried out with plain T1-weighted sequences with a repetition time (TR) of 500 msec and an echo time (TE) of 25 msec (TR/TE = 500/25), T2-weighted sequences (1,600/90), and gadolinium-enhanced T1-weighted sequences in axial, coronal, and sagittal orientations. For identifying normal anatomic structures such as the facial nerve and the main duct, the administration of gadopentetate dimeglumine was helpful. In inflammatory changes, gadolinium-enhanced images showed no diagnostic advantages. Gadopentetate dimeglumine proved helpful in delineating tumorous lesions and in differentiating benign and malignant lesions. However, an exact differentiation of the different histologic types was not possible. Post-operative fibrosis could be differentiated from recurrent tumors after administration of gadolinium. If a question regarding infiltration or definition of the boundaries of a lesion cannot be answered with non-enhanced MR imaging, gadopentetate dimeglumine administration is advised. However, for routine imaging of the parotid gland, its use is not recommended.     

Pituitary adenomas and normal pituitary tissue: enhancement patterns on gadopentetate-enhanced MR imaging

A dynamic study of magnetic resonance (MR) imaging was used to obtain successive heavily T1-weighted coronal images (spin-echo [SE] 100/15 [repetition time msec/echo time msec]) of normal pituitary glands and pituitary adenoma immediately after patients were given an intravenous bolus injection of gadopentetate dimeglumine. The images were obtained every minute for 5-8 minutes at 1.5 T. Usual T1-weighted images (SE 600/15) were also obtained before and after the dynamic study was performed. The study group consisted of 18 patients, 10 with normal pituitary glands, and eight with pituitary adenoma. Normal pituitary glands showed maximum enhancement on the first or second image following the administration of gadopentetate dimeglumine, followed by gradual signal reduction through the later images, whereas pituitary adenomas reached a peak of enhancement later and showed slower signal reduction than normal pituitaries. The difference of enhancement patterns between the normal pituitary gland and the pituitary adenoma produced prominent image contrast on the first or second image after administration of gadopentetate dimeglumine, which improved the visualization of one microadenoma and four normal pituitary glands that had been displaced by large adenomas. Dynamic MR imaging is a useful diagnostic procedure not only for detection of microadenomas, but also for visualization of pituitary glands that have been displaced by large pituitary adenomas.     

Lateral ulnar collateral ligament of the elbow: optimization of evaluation with two-dimensional MR imaging

PURPOSE: To compare, in a cadaveric model, magnetic resonance (MR) imaging techniques with differing contrast and spatial resolution properties in the evaluation of disruption of the lateral ulnar collateral ligament (LUCL) at the elbow. MATERIALS AND METHODS: LUCL tears were surgically created in eight of 28 cadaveric elbow specimens. All specimens underwent 1.5-T MR imaging with the following pulse sequences: T1-weighted spin echo (SE), intermediate-weighted fast SE, fat-suppressed T2-weighted fast SE, gradient-recalled echo (GRE) with high spatial resolution, intermediate-weighted fast SE with high spatial resolution, and fat-suppressed T1-weighted SE with intraarticular administration of gadopentetate dimeglumine (MR arthrography). All images were obtained in the oblique coronal plane. Two radiologists independently graded the LUCL with separate and side-by-side assessment. RESULTS: Areas under the receiver operating characteristic curve were as follows for readers A and B, respectively: T1-weighted SE imaging, 0.64 and 0.62; intermediate-weighted fast SE imaging, 0.87 and 0.67; T2-weighted fast SE imaging, 0.68 and 0.69; GRE imaging, 0.56 and 0.68; MR arthrography, 0.84 and 0.85; and intermediate-weighted imaging with high spatial resolution, 0.92 and 0.88. Interobserver reliability was poor with T1-weighted SE imaging (kappa = 0.13) and GRE imaging (kappa = 0.18), fair with T2-weighted fast SE imaging (kappa = 0.36), and moderate with MR arthrography (kappa = 0.46), intermediate-weighted fast SE imaging (kappa = 0.55), and intermediate-weighted imaging with high spatial resolution (kappa = 0.59). CONCLUSION: Intermediate-weighted imaging with high spatial resolution and MR arthrography showed the greatest overall ability to enable the diagnosis of LUCL tears.     

Enhancement effects and relaxivities of gadolinium-DTPA at 1.5 versus 3 Tesla: a phantom study.

PURPOse: To investigate the difference in enhancement effects and relaxivities of the gadolinium chelate at 1.5 and 3 Tesla (T) and to elucidate the contribution of the high magnetic field to contrast enhancement in spin-echo (SE) and gradient-echo (GRE) images. METHODS: Phantoms containing water with or without gadopentetate dimeglumine (Gd-DTPA) at different concentrations were scanned using 1.5T and 3T MRI scanners of the same manufacturer and under the same temperature conditions and scanning parameters. Relaxivities of gadolinium, R1 and R2, were estimated from serial T1 and T2 values of the phantoms using linear regression. Contrast enhancement ratios in SE and GRE T1-weighted images were compared at 1.5 and 3T. RESULTS: The R1 and R2 of Gd-DTPA at 1.5 and 3T were 4.79 and 5.14, and 4.50 and 5.09, respectively. Although the relaxivities at 3T were slightly lower than those at 1.5T, the contrast enhancement ratio improved in both SE and GRE images as a result of T1 prolongation of the water at 3T. CONCLUSION: The decrease in relaxivities of the Gd-DTPA at 3T appears to be so small that T1 prolongation of the water improves contrast enhancement, suggesting a potential clinical advantage in administration of Gd-DTPA at high field strength.     

MR imaging of Sturge-Weber syndrome: role of gadopentetate dimeglumine and gradient-echo techniques

Five patients with Sturge-Weber syndrome were evaluated by conventional noncontrast spin-echo MR imaging, a gradient-recalled echo (GRE) technique, and T1-weighted spin-echo imaging after administration of gadopentetate dimeglumine. In four of five cases the full extent of intracranial disease was appreciated only on the postcontrast images. In one patient precontrast and GRE images were entirely normal, while only the postcontrast study demonstrated extensive involvement of both brain and retina. Nevertheless, some abnormal vessels with higher flows were seen better on precontrast T2-weighted images than on postcontrast T1-weighted images. GRE techniques demonstrated calcifications to best advantage, in one case even better than on CT. Contrast enhancement with gadopentetate dimeglumine is necessary for the complete MR evaluation of patients with suspected Sturge-Weber syndrome. Traditional noncontrast T2-weighted and GRE images may provide additional complementary information.     

Early MR detection of experimentally induced cerebral ischemia using magnetic susceptibility contrast agents: comparison between gadopentetate dimeglumine and iron oxide particles.

PURPOSETo evaluate early patterns of MR changes in a rat model of cerebral ischemia using the first pass of two magnetic susceptibility contrast agents.METHODSOne hours after endovascular middle cerebral artery occlusion, all animals were examined in an experimental MR unit. After bolus application of gadopentetate dimeglumine and, 10 minutes later, of iron oxide particles, the MR changes of the first pass of these contrast agents were followed using a T2*-weighted fast low-angle shot sequence. Time-density curves of both contrast agents were analyzed and compared.RESULTSAfter bolus injection of either (paramagnetic) gadopentetate dimeglumine or superparamagnetic particles, nonischemic brain parenchyma decreased markedly in signal, whereas the ischemic brain area remained relatively hyperintense (and thus became clearly delineated). Only after application of gadopentetate dimeglumine did a mild reduction in signal occur in the ischemic hemisphere, although the main artery was occluded. An explantation for this phenomenon might be residual capillary perfusion (plasma flow), which is detectable only when the smaller (paramagnetic) contrast molecules are being used.CONCLUSIONSCerebral perfusion deficits can be detected 1 hour after vascular occlusion with T2*-weighted fast low-angle shot sequences and bolus injection of paramagnetic or superparamagnetic MR contrast agents. Gadopentetate dimeglumine may be used as a marker of microcirculatory plasma flow.     

Vascular intracranial lesions: applications of gradient-echo MR imaging

To investigate the role of the gradient-echo (GRE) technique in clinical intracranial magnetic resonance (MR) imaging, 63 patients with a variety of vascular intracranial lesions were examined at 1.5 T with the use of spin-echo (SE) and GRE sequences. In all cases, the sequential section acquisition technique called gradient recalled acquisition in the steady state (GRASS) was employed; a repetition time of 150-200 msec, an echo time of 13-16 msec, and a flip angle of 50 degrees-60 degrees were used to optimize the depiction of blood flow as high intensity and the depiction of stationary fluid as low intensity. In 61 of 63 cases, gradient moment nulling was utilized to compensate for first-order flow effects. Although GRE images rapidly demonstrated flow in vascular intracranial lesions as high intensity, the vascular nature of these lesions was also clearly evident on SE images in most cases. In some cases, GRE images can be used to clarify the vascular nature of a lesion or to characterize a neoplasm. Other applications include the detection of vascular thrombosis, occult vascular malformations, and hemorrhagic complications of vascular lesions.     

Subclavian MR arteriography: reduction of susceptibility artifact with short echo time and dilute gadopentetate dimeglumine

At arterial phase gadolinium-enhanced magnetic resonance (MR) angiography, artifactual stenosis of the subclavian artery is sometimes seen adjacent to the subclavian vein on the side of the contrast material injection. Experiments in phantoms and in 19 patients showed increased artifact with longer echo time and higher concentration of injected contrast material. An effective method to substantially decrease this susceptibility artifact was threefold dilution of gadopentetate dimeglumine and use of a short echo time (1 msec).     

Superparamagnetic iron oxide-enhanced MR imaging: pulse sequence optimization for detection of liver cancer

The effects of magnetic resonance (MR) pulse sequences and timing parameters on tumor-liver contrast were studied in an animal model of metastatic liver cancer. Six spin-echo (SE), three inversion-recovery (IR), and four gradient-echo (GRE) sequences were evaluated at 0.6 T before and after injection of super-paramagnetic iron oxide. GRE techniques, irrespective of echo time and flip angle, showed the greatest change in signal intensity (enhancement) of the liver after administration of iron oxide. Single-acquisition GRE sequences (16 seconds) matched the contrast-to-noise ratio (C/N) performance of the most effective 6.4-minute SE sequences. Multiexcitation GRE sequences showed tumor-liver C/Ns per unit time that were significantly (P less than .05) higher than those achieved with SE and IR sequences. GRE sequences, which recruit intravoxel dephasing as an additional source of transverse relaxation enhancement (T2*), show a higher C/N per unit time and in this respect seem superior to SE and IR sequences for MR imaging with superparamagnetic iron oxide.     

Theoretical analysis of gadopentetate dimeglumine enhancement in T1-weighted imaging of the brain: Comparison of two-dimensional spin-echo and three-dimensional gradient-echo sequences

By using a theoretical model, the signal difference-to noise ratios between simulated lesions and normal white matter and gray matter were calculated as a function of lesion concentration of gadopentetate dimeglumine (GD) for two-dimensional (2D) T1-weighted spin-echo (SE), three-dimensional (3D) steady-state spoiled gradient-echo (GRE) (FLASH [fast low-angle shot]), and 3D magnetization-prepared rapid gradient echo (MP-RAGE) pulse sequences. The 3D GRE sequences provided greater contrast enhancement at relatively high [GD], and the 2D SE sequence demonstrated greater enhancement and a higher rate of enhancement at low [GD]. The results predict that at low [GD], certain lesions could probably be detected with the 2D SE sequence but possibly not with one or both of the 3D GRE sequences. At high [GD], certain lesions could probably be detected with one or both of the 3D GRE sequences but possibly not with the 2D SE sequence. This provides a potential explanation for the clinical observation that certain contrast agent enhanced lesions appear less conspicuous on 3D GRE images than on 2D SE images and vice versa. Modified parameter values were derived for the 3D FLASH and 3D MP-RAGE sequences that are predicted to produce contrast enhancement behavior equivalent or superior to that of a conventional 2D SE sequence.     

Patellar articular cartilage lesions: in vitro MR imaging evaluation after placement in gadopentetate dimeglumine solution

PURPOSE: To evaluate T1-weighted magnetic resonance (MR) imaging after diffusion of gadopentetate dimeglumine for visualization of articular cartilage lesions. MATERIALS AND METHODS: MR imaging was performed in eight human cadaveric patella specimens immediately and 4 hours after placement into a vessel filled with gadopentetate dimeglumine solution (2.5 mmol/L). T1-weighted spin-echo and inversion-recovery turbo spin-echo MR sequences with nulled cartilage signal (inversion time of 300 msec) were used. In a total of 128 articular cartilage areas, MR imaging findings were compared with macroscopic and histopathologic findings. Pathologic evaluation was performed by one musculoskeletal pathologist. With knowledge of pathologic observations, MR images were analyzed by one musculoskeletal radiologist with regard to intrinsic signal intensity characteristics and surface abnormalities of articular cartilage. RESULTS: Histopathologic findings demonstrated 67 areas of normal articular cartilage and 66 cartilage lesions (grade 1, n = 19; grade 2, n = 15; grade 3, n = 26; grade 4, n = 6). All grade 3 and 4 lesions could be identified on MR images obtained immediately after submersion and after 4 hours. Ninety-four percent of grade 1 and 2 lesions were identified as areas of predominantly decreased contrast enhancement on delayed MR images obtained with both sequences. MR images obtained immediately after submersion demonstrated abnormal signal intensity in only 9% and 12% of grade 1 and 2 lesions, respectively. CONCLUSION: T1-weighted MR images obtained in vitro after gadopentetate dimeglumine diffusion allow demonstration of articular cartilage surface lesions and early stages of cartilage degradation.     

The diagnosis of herniated intervertebral disks with MR imaging: a comparison of gradient-refocused-echo and spin-echo pulse sequences

Axial MR images of 65 lumbar disks with herniated nucleus pulposus imaged by gradient-refocused-echo (GRE) and spin-echo (SE) MR pulse sequences of 200-400/15 with a flip angle of 15-30 degrees was selected as optimal because of its high signal-to-noise ratio and good contrast between CSF, nucleus pulposus, and bone. The GRE technique was confirmed to be more sensitive in detecting prolapsed disks than the SE technique, but was less sensitive in demonstrating extruded disks. The combination of axial GRE and SE resulted in high detectability of herniated nucleus pulposus on axial MR images. Our results suggest that the GRE technique is an important adjunct to SE imaging in studying herniated nucleus pulposus.     

Detection of small, functional islet cell tumors in the pancreas: selection of MR imaging sequences for optimal sensitivity

PURPOSE: To determine the sensitivity and specificity of magnetic resonance (MR) imaging for depicting pancreatic small, functional islet cell tumors and the minimum number of sequences for expedient diagnosis. MATERIALS AND METHODS: Twenty-eight patients clinically suspected to have functional islet cell tumors underwent T1- and T2-weighted spin-echo (SE) MR imaging with and without fat suppression, T2-weighted fast SE imaging, and spoiled gradient-echo (GRE) imaging before and after injection of gadopentetate dimeglumine. Sensitivity, specificity, and the best and minimum number of sequences for definitive diagnosis were determined. RESULTS: MR images depicted proved islet cell tumors in 17 of 20 patients (sensitivity, 85%). Images were true-negative in eight patients with negative follow-up examination results for more than 1 year. Specificity was 100%; positive predictive value, 100%; and negative predictive value, 73%. Among 20 patients with tumor, T1-weighted SE images with fat suppression and nonenhanced spoiled GRE images each showed lesions in 15 (75%); T2-weighted conventional SE with fat suppression, in 13 (65%); gadolinium-enhanced spoiled GRE, in 12 (60%); and T2-weighted fast SE, in seven of 10 patients (70%). CONCLUSION: MR imaging accurately depicts small islet cell tumors. T2-weighted fast SE and spoiled GRE sequences usually suffice. Gadolinium-enhanced sequences are needed only if MR imaging results are equivocal or negative.     

Intracranial lesion enhancement with gadolinium: T1-weighted spin-echo versus three-dimensional Fourier transform gradient-echo MR imaging.

The conspicuity of lesion enhancement with gadopentetate dimeglumine was evaluated subjectively and quantitatively through calculation of contrast-to-noise ratios (C/Ns) on T1-weighted three-dimensional (3D) Fourier transform (FT) gradient-echo (GRE) and two-dimensional (2D) FT spin-echo (SE) images of the brain in 406 consecutive patients. One hundred one enhancing intracranial lesions were present in 61 patients, including intra-(n = 76) and extraaxial (n = 25) processes of neoplastic (n = 68), infectious or inflammatory (n = 13), ischemic (n = 11), or vascular (n = 9) origin. Enhancement was apparent in all lesions on 2DFT SE and 3DFT GRE images, with similar subjective conspicuity in 86.8% (87 of 101) of lesions. Quantitative C/N measurements for 2DFT SE (mean, 17.6) and 3DFT GRE (mean, 17.2) imaging were not significantly different (P = .72). These findings, along with the other advantages of 3DFT GRE imaging, indicate that 3DFT GRE examinations are likely to play a major role in the performance of contrast-enhanced MR imaging of the brain.     

Combined gadolinium-enhanced and fat-saturation MR imaging of renal masses

Combined gadopentetate dimeglumine enhancement and fat-saturation (FS) spin-echo (SE) magnetic resonance (MR) imaging for the detection and characterization of renal masses was evaluated in 43 patients with a total of 71 lesions (28 solid masses and 43 cysts). SE MR sequences compared were the following: short repetition time (TR)/echo time (TE), conventional SE, short TR/TE FS SE, long TR/TE conventional SE, gadolinium-enhanced short TR/TE conventional SE, and gadolinium-enhanced short TR/TE FS SE techniques. MR findings were compared with findings of contrast-enhanced computed tomography (CT) and with pathologic findings in all patients. The sensitivities for detection of renal masses with gadolinium-enhanced FS (71 of 71 lesions) and with gadolinium-enhanced short TR/TE conventional (65 of 71 lesions) SE sequences were significantly (P less than .01) greater than with any unenhanced (short TR/TE conventional [40 of 71 lesions], or long TR/TE [39 of 71 lesions]) SE sequence. Lesion characterization was also best with the gadolinium-enhanced FS SE sequence (65 of 71 lesions correctly classified). When combined pre- and postcontrast short TR/TE FS SE images were analyzed with both qualitative (visual) and quantitative (region-of-interest measurements) assessment, lesion characterization improved even further (70 of 71 lesions were correctly characterized). All lesions detected with CT were visualized with the gadolinium-enhanced FS SE MR sequence, which in addition depicted seven cysts and two small renal cell carcinomas. In summary, the use of gadopentetate dimeglumine, especially when combined with the FS technique, was superior to unenhanced MR imaging for detection and characterization of renal lesions.     

Gadolinium-enhanced magnetization transfer contrast imaging of intracranial tumors.

The magnetization transfer contrast (MTC) technique was used in low-field-strength (0.1 T) magnetic resonance (MR) imaging of 28 patients with intracranial tumors. MTC images were generated with an off-resonance, low-power radio-frequency pulse applied during the interpulse delay period of a gradient-echo partial-saturation sequence (TR msec/TE msec = 200/20). Images in the presence and absence of the MTC pulse were concurrently acquired before and after injection of gadopentetate dimeglumine at a dose of 0.1 mmol/kg. The contrast agent enhanced 27 of 28 tumors. Application of the MTC pulse improved the contrast-to-noise ratio (C/N) between tumor and normal white matter in 26 of 28 cases on the preinjection images and in 25 of 28 cases on the postinjection images. On the gadolinium-enhanced images, the mean C/N was 2.6 +/- 1.7 without the MTC pulse and 3.2 +/- 1.9 with the MTC pulse. The greatest contrast improvement with the MTC technique was obtained in tumors showing the strongest paramagnetic enhancement. The results indicate that MTC can improve contrast between normal brain and some intracranial neoplasms. The use of gadopentetate dimeglumine generally intensified this effect.     

Dynamic gadolinium-enhanced rapid acquisition spin-echo MR imaging of the liver

Rapid acquisition spin-echo (RASE) magnetic resonance (MR) imaging allows for coverage of the entire liver with highly T1-weighted SE images during a single 23-second breath-holding period. The RASE sequence was implemented in conjunction with rapid intravenous injection of gadopentetate dimeglumine to enable performance of dynamic contrast material-enhanced MR imaging of the liver. Prospective evaluation of 24 patients with 62 liver lesions 1 cm or greater in diameter was performed. Images obtained with RASE were devoid of respiratory-related ghost artifacts or edge blurring. The dynamic contrast-enhanced RASE technique resulted in contrast-to-noise and contrast-to-artifact values and time efficiency measures significantly greater (P less than .05) than those obtained with use of conventional T1- and T2-weighted pulse sequences, indicating a higher likelihood for lesion detectability. Lesion conspicuity was maximal during or immediately following bolus administration of gadopentetate dimeglumine, with lesions often becoming obscured at delayed postcontrast imaging.     

Lesion enhancement in radio-frequency spoiled gradient-echo imaging: theory,experimental evaluation,and clinical implications.

PURPOSETo investigate the lesser lesion conspicuity after gadolinium contrast infusion with radio-frequency spoiled gradient-echo (SPGR) sequences relative to conventional T1-weighted spin-echo techniques.METHODSThe influences of repetition time, echo time, and flip angle on spin-echo and SPGR signal were studied with mathematical modeling of the image signal amplitude for concentrations of gadopentetate dimeglumine solute from 0 to 10 mM. Predictions of signal strength were verified in vitro by imaging of a doped water phantom. The effects of standard (0.1 mmol/kg) and high-dose (0.3 mmol/kg) gadoteridol on spin-echo and SPGR images were also investigated in three patients.RESULTSThe measured amplitude of undoped water and the rate of increase of doped water signal with increasing gadopentetate concentration (slope) for spin-echo 600/11/1/90 degrees (repetition time/echo time/excitations/flip angle) and SPGR (600/11/190 degrees) were similar and exceeded those of SPGR (35/5/145 degrees). Greater increases in SPGR doped water signal and its slope were produced by increasing TR than by varying echo-time or flip angle. The subjective lesion conspicuity and measured lesion contrast at 0.3 mmol/kg were greater with spin-echo (600/11/1/90 degrees) than with SPGR (35/5/145 degrees) in all three patients; the measured lesion enhancement was similar for both techniques in two patients and decreased for SPGR in the third patient.CONCLUSIONSThe phantom studies suggest that the short repetition time of 35 msec, typically used in clinical SPGR imaging, is largely responsible for a reduced signal amplitude and a diminished rate of increase of signal with increasing gadopentetate concentration, relative to spin-echo. Phantom and clinical studies suggest that the dose of paramagnetic agent required to achieve SPGR lesion conspicuity with short repetition time comparable with spin-echo would have to be higher than the dose in current clinical use.