Steady state vascular imaging with extracellular gadobutrol: evaluation of the additional diagnostic benefit in patients who have undergone a peripheral magnetic resonance angiography protocol

Abstract

BackgroundTo evaluate the feasibility and additional diagnostic benefit of a high-resolution steady state 3D-volume interpolated breath-hold exam (VIBE) sequence between a continuous table movement (CTM) MR angiography of the entire runoff vasculature and a time-resolved (TWIST) MRA of the calves.MethodsIn this retrospective IRB approved study 224 patients (72 women, 152 men, mean age 67.29 ± 13.9) were included who had undergone a low-dose MR angiographic protocol at 3T (Siemens TimTrio) after injection of 0.1 mmol/kg gadobutrol including a CTM MRA, a time-resolved MRA of the calf station and a steady state 3D VIBE sequence prior to the time-resolved MRA. One board-certified radiologist rated the image quality of the steady state VIBE sequences on an ordinal three point scale (excellent, good, poor) and analyzed the images for additional diagnostic findings of and beyond the vascular system in comparison to the CTM MRA and the time-resolved MRA. Descriptive statistics and demographic patient data were used for further evaluation.ResultsThe image quality of the steady state imaging of the pelvis, upper and lower leg was excellent in up to 88%, 84% and 47%, respectively, while poor image quality was only detected in the upper (2%) and lower leg (6%). An additional diagnostic benefit was found in 44% of the patients overall. The most common relevant pathologies included inflammatory processes of the soft tissues (26%), thrombi (14%), abscesses (13%) and tumors (11%). In subgroups of patients above the age of 60, 65, 70, 75 and 80 years an additional pathology was found in 50% 33%, 44%, 65% and 58%, respectively. There was no significant difference in terms of additional findings between men and women (46% and 39%, p > 0.05) and inpatients and outpatients (42% and 45%, p > 0.05).ConclusionSteady state imaging is also feasible with extracellular contrast agents with good image quality yielding additional diagnostic findings in up to 44% and above in patients older than 60 years of age irrespective of gender or patient status. Given the short acquisition time of 4 minutes this sequence could be added to all peripheral MRA exams.

Diagnostic value of gadobutrol versus gadopentetate dimeglumine in enhanced MRI of brain metastases

“…Compared with 0.5 M of other gadolinium‐containing contrast agents, the bolus injection of gadobutrol resulted in peak concentration in a shorter time. Previous studies have shown that gadobutrol showed significant advantages in MR angiography and perfusion imaging …”

“…Previous studies have shown that gadobutrol showed significant advantages in MR angiography and perfusion imaging. 18,19 In the present study the standard dose (equimolar dose) of gadobutrol and Gd-DTPA was used in the enhanced MR scan of brain metastases. The enhancement in brain metastases was significantly higher when using gadobutrol compared with Gd-DTPA at 3, 7, and 10 minutes postenhancement.…”

Review of Journal of Cardiovascular Magnetic Resonance 2014

“…Beside its key role in research, CMR is most frequently used clinically for the carotid arteries where it can be used to characterize thrombus, [ 41 ] plaque components, [ 42 ] plaque vulnerability, atheroma burden, natural history of progression, and response to treatment. However, peripheral artery angiography, [ 43 – 45 ] and the role in investigation of pulmonary hypertension, [ 46 ] vasculitis and systemic hypertension, [ 47 ] is also making progress. This is an area of CMR where contrast agents, [ 48 ] and 3 T has had an impact [ 49 , 50 ].…”

Review of Journal of Cardiovascular Magnetic Resonance 2013

“…This paper details the additional diagnostic benefits that can be achieved with imaging during the blood-pool phase following injection of an extracellular contrast agent for peripheral contrast-enhanced angiography [ 13 ]. Although the study is retrospective, the analysis, discussion and references list are comprehensive.…”