Cheong Benjamin Y C, Duran Cihan, Preventza Ourania A, Muthupillai Raja
1 Department of Diagnostic and Interventional Radiology, CHI St. Luke's Medical Center and the Texas Heart Institute, 6720 Bertner Ave, MC 2-270, Houston, TX 77030.
2 Department of Cardiology, The Texas Heart Institute and CHI St. Luke's Medical Center, Houston, TX.
AJR Am J Roentgenol. 2015 Sep;205(3):533-9. doi: 10.2214/AJR.14.13749.
The gadolinium-based MRI contrast agent gadobenate dimeglumine has nearly twice the MR relaxivity of gadopentetate dimeglumine at 1.5 T. The purpose of this study was to determine whether a lower dose (0.1 mmol/kg) of gadobenate dimeglumine can be used to obtain delayed-enhancement MR images comparable to those obtained with a standard dose (0.2 mmol/kg) of gadopentetate dimeglumine.
In this blinded randomized crossover study, 20 patients with known myocardial infarction underwent two separate delayed-enhancement MRI examinations after receiving 0.1 mmol/kg gadobenate dimeglumine and 0.2 mmol/kg gadopentetate dimeglumine (random administration). The conspicuity of lesion enhancement 5, 10, and 20 minutes after contrast administration was quantified as relative enhancement ratio (RER).
With either gadolinium-based contrast agent, damaged myocardium had higher signal intensity than normal remote myocardium (RER > 4) on delayed-enhancement MR images, and the blood RER declined over time after contrast administration. The blood RER was not significantly higher for gadobenate dimeglumine than for gadopentetate dimeglumine at 5 and 10 minutes. Nevertheless, there was a larger reduction in blood RER for gadobenate dimeglumine than for gadopentetate dimeglumine between 5 and 10 minutes and between 10 and 20 minutes. The volumes of enhancement were similar for gadobenate dimeglumine (13.6 ± 8.8 cm(3)) and gadopentetate dimeglumine (13.5 ± 8.9 cm(3)) (p = 0.98). The mean difference in Bland-Altman analysis for delayed-enhancement volume between the agents was 0.1 cm(3).
Qualitatively and quantitatively, delayed-enhancement MR images of ischemic myocardium obtained with 0.1 mmol/kg gadobenate dimeglumine are comparable to those obtained with 0.2 mmol/kg gadopentetate dimeglumine 5, 10, and 20 minutes after contrast administration.
钆基磁共振成像(MRI)造影剂钆贝葡胺在1.5T时的磁共振弛豫率几乎是钆喷酸葡胺的两倍。本研究的目的是确定较低剂量(0.1 mmol/kg)的钆贝葡胺是否可用于获得与标准剂量(0.2 mmol/kg)钆喷酸葡胺所获得的延迟增强MRI图像相当的图像。
在这项双盲随机交叉研究中,20例已知心肌梗死的患者在接受0.1 mmol/kg钆贝葡胺和0.2 mmol/kg钆喷酸葡胺(随机给药)后,分别接受了两次延迟增强MRI检查。在注射造影剂后5、10和20分钟时,将病变强化的明显程度量化为相对强化率(RER)。
使用任何一种钆基造影剂时,在延迟增强MRI图像上,受损心肌的信号强度均高于正常远隔心肌(RER>4),且注射造影剂后血RER随时间下降。在5分钟和10分钟时,钆贝葡胺的血RER并不显著高于钆喷酸葡胺。然而,在5至10分钟之间以及10至20分钟之间,钆贝葡胺的血RER下降幅度大于钆喷酸葡胺。钆贝葡胺(13.6±8.8 cm³)和钆喷酸葡胺(13.5±8.9 cm³)的强化体积相似(p = 0.98)。两种造影剂在延迟增强体积的Bland-Altman分析中的平均差异为0.1 cm³。
在定性和定量方面,0.1 mmol/kg钆贝葡胺获得的缺血心肌延迟增强MRI图像与注射造影剂后5、10和20分钟时0.2 mmol/kg钆喷酸葡胺所获得的图像相当。