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The accuracy and reproducibility of cardiac ejection fraction (EF) measurements based on cine magnetic resonance (MR) imaging, radionuclide multigated acquisition (MUGA) blood pool imaging, and angiographic ventriculography were evaluated by comparing them with a volumetrically determined standard. A biventricular, compliant, fluid-filled heart phantom was developed to mimic normal cardiac anatomy and physiology. Ventricular EFs were measured with cine MR imaging by summation of nine contiguous 10-mm-thick sections in short and long axis, with single-plane ventriculography, and with MUGA. Three measurements were performed with each modality for each of three EFs. Ventriculography was least accurate, with average relative errors ranging from 7.9% for the largest EF to 60.1% for the smallest. Cine MR was most accurate, with average relative errors ranging from 4.4% to 8.5%. MUGA EF measurements showed good correlation, with average relative errors ranging from 7.1% to 22.4%. Comparison of the error variances for the three modalities with the F test revealed that MR and MUGA EF measurements were significantly more accurate than those based on ventriculography (P less than .01). No significant difference was demonstrated between the accuracy of short- and long-axis cine MR acquisitions.

Technical failures and enhancement variability are common in CT arterial portography. Factors leading to technical failure include catheter choice and position, portal hypertension, and operator error.

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A phase III open-label clinical trial was conducted at 11 institutions to determine the safety and efficacy of gadoteridol in children suspected of having neurologic disease. One hundred three children were included in the safety analysis; 92 were evaluated for efficacy (76 intracranial and 16 spinal examinations). Three adverse events were reported in two children. All adverse events were considered minor and resolved spontaneously without treatment or sequelae. In a comparison of enhanced T1-weighted magnetic resonance images with unenhanced T1- and T2-weighted images, enhancement of disease was noted in 70% of the intracranial and 38% of the spinal examinations. Additional diagnostic information was reported in 82% of the postcontrast intracranial examinations and 62% of the spinal examinations. Use of this additional information contributed to a potential modification of patient diagnosis in 48% of intracranial and 20% of spinal cases with additional information. These results indicate excellent safety and efficacy for use of gadoteridol in children with suspected intracranial or spinal disease.

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