Hoelter Philip, Lang Stefan, Weibart Marina, Schmidt Manuel, Knott Michael F X, Engelhorn Tobias, Essig Marco, Kloska Stephan, Doerfler Arnd
Department of Neuroradiology, University Hospital Erlangen, Schwabachanlage 6, 91054, Erlangen, Germany.
Department of Radiology, University of Manitoba, GA216-820 Sherbrook Street, Winnipeg, Manitoba, Canada.
Neuroradiology. 2017 Dec;59(12):1233-1239. doi: 10.1007/s00234-017-1922-z. Epub 2017 Sep 14.
Gadobutrol (GB) is reported to provide improved relaxivity and concentration compared to gadoterate (GT). This study was designed to intraindividually compare quantitative and qualitative enhancement characteristics of GB to GT in cervicocranial magnetic resonance angiography (MRA) of patients with cerebrovascular disease (CVD).
Patients (n = 54) with CVD underwent two identical contrast-enhanced magnetic resonance angiography (CE-MRA) examinations of the cervical and intracranial vasculature in randomized order, using GB and GT in equimolar dose. Signal-to-noise ratios (SNR) and contrast-to-noise ratios (CNR) were obtained by two independent neuroradiologists, blinded to the applied contrast agents. Qualitative assessment was performed using a three-point scale with a focus on M1/M2 segments.
One thousand and twenty-six vessel segments were analyzed. GB revealed a significantly higher SNR (p = 0.032) and CNR (p = 0.031) in all vessel segments. GB featured a significantly higher SNR and CNR in thoracic (p = 0.022; p = 0.016) and cervical vessels (p = 0.03; p = 0.038), as well as in the posterior circulation (p = 0.012; p = 0.005). In blinded qualitative assessment, overall preference was given to GB (p = 0.02), showing a significant better delineation of the M1/M2 segments (p = 0.041).
Compared to GT, the use of GB results in a significantly higher SNR and CNR in cervical and cerebral CE-MRA, leading to a better delineation of the intracranial vasculature. Present results underline the potential of GB for improved CE-MRA assessment of vasculature in CVD patients.
据报道，与钆喷酸葡胺（GT）相比，钆布醇（GB）具有更高的弛豫率和浓度。本研究旨在对脑血管疾病（CVD）患者的颈颅磁共振血管造影（MRA）中GB和GT的定量和定性增强特征进行个体内比较。
54例CVD患者以随机顺序接受了两次相同的颈部和颅内血管对比增强磁共振血管造影（CE-MRA）检查，使用等摩尔剂量的GB和GT。两名独立的神经放射科医生在不知道所用造影剂的情况下获得信噪比（SNR）和对比噪声比（CNR）。使用三点量表进行定性评估，重点是M1/M2段。
分析了1026个血管段。GB在所有血管段中显示出显著更高的SNR（p = 0.032）和CNR（p = 0.031）。GB在胸段（p = 0.022；p = 0.016）和颈段血管（p = 0.03；p = 0.038）以及后循环（p = 0.012；p = 0.005）中具有显著更高的SNR和CNR。在盲法定性评估中，总体上更倾向于GB（p = 0.02），显示出对M1/M2段的描绘明显更好（p = 0.041）。
与GT相比，在颈部和脑部CE-MRA中使用GB可导致显著更高的SNR和CNR，从而更好地描绘颅内血管系统。目前的结果强调了GB在改善CVD患者血管系统CE-MRA评估方面的潜力。
