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Aplication of MRI Contrast Agent

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109 views26 pages

Aplication of MRI Contrast Agent

Uploaded by

DKpaljrix
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© © All Rights Reserved
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Aplication of MRI Contrast Agent

Fatimah
2018
Gd-based MR Contrast Agents
MR Contrast Agents
• Gadobenate Dimeglumine (marketed as MultiHance)
• Gadodiamide (marketed as Omniscan)
• Gadopentetate Dimeglumine (marketed as Magnevist)
• Gadoteridol (marketed as ProHance)
• Gadoversetamide (marketed as OptiMARK)
Gd-based MR Contrast Agents
• MultiHance by Bracco Diagnostics
 Gd-BOPTA: gadobenate dimeglumine
 dose: 0.05 mmol/kg for Liver MRI; 0.1 mmol/kg
for CNS
Gd-based MR Contrast Agents
• Omniscan by Nycomed (Winthrop)
 Gd-DTPA-BMA: gadodiamide
 Approved for double dose in adults
 Dose: 0.1 mmol/kg (0.2 ml/kg)
 followed by 0.2 mmol/kg (0.4 ml/kg) if necessary
 Since non-ionic, can bolus inject
 Approved for pediatrics (0.1 mmol/kg )
Gd-based MR Contrast Agents
• Magnevist by Berlex
 Gd-DTPA: gadopentate dimeglumine
 dose: 0.1 mmol/kg (0.2 ml/kg)
 approved for pediatrics 0.1 mmol/kg
 ionic, high osmolality
Gd-based MR Contrast Agents
• ProHance by Bracco (Squibb)
 Gd-HP-DO3A: gadoteridol
 Approved for double dose in adults
 Dose: 0.1 mmol/kg (0.2 ml/kg)
 followed by 0.2 mmol/kg (0.4 ml/kg) if necessary
 Less toxic (vomiting at MCG)
 Since non-ionic, can bolus inject
 More stable (less Gd release)
 Approved for pediatrics (0.1 mmol/kg )
Gd-based MR Contrast Agents
• OptiMARK by Mallinckrodt Inc.
 Gd-DTPA-BMEA: gadoversetamide
 dose: 0.1 mmol/kg / 0.2 mL/kg
When to Use MRI Contrast
• Diferensiasi tumor dari edema
• Peradangan dan jaringan lunak dari jaringan
parut
• Evaluasi jenis lesi
• Evaluasi awal iskemia
• Infeksi otak parenkim
• lesi meningeal
• Demielinasi lesi di MS
Indications and Usage
• Central Nervous System
• Extracranial/Extraspinal Tissue
• Body
MRI Guidelines
• MRI Brain
Secara umum selalu dengan dan tanpa (HA,
Trauma, perubahan MS, Dizzy, CVA,
Kelemahan, Memory Loss)
• MRI Sinus - dengan dan tanpa (tumor)
MRI Orbit / Sella / Telinga - dengan dan tanpa
Guidelines
• MRI Abdomen (Including MRCP)
– With and Without
– Exception – Fetal MRI
• MRI Pelvis
– Bony exams – without
– Soft tissue exams – with and without
• MRI Cardiac – with and without
• MRA Chest – with only
Guidelines
• MRI C, T, L Spine
– Generally done without
– Tumor, Infection/Abscess, Metastases, CA
• With and Without
• MRI Extremity
– Generally done without
– Tumor, Infection/Abscess, CA – with/without
– To follow arthrogram - with
Relative Concentration for Indications
• The concentration of MRI contrast is intermediate to x-
ray and nuclear medicine contrast.
 10-3 to 10-2 mmol/kg X-ray (iodine)
 10-5 to 10-3 mmol/kg MRI
 < 10-7 mmol/kg Nuclear Medicine
Mn-based MR Contrast Agents

• Manganese dipyridoxyl-diphosphate (MnDPDP;


Teslascan)
Fe-Based MR Contrast
Conslusions
• Tumor selalu membutuhkan kontras
• MRI umumnya perlu kontras kecuali hanya
mengevaluasi struktur tulang
• CT - tumor dan infeksi selalu membutuhkan
kontras
Terima Kasih

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