Department of Radiology, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, 409-3898, Japan.
Department of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany.
Eur Radiol. 2020 Jan;30(1):281-290. doi: 10.1007/s00330-019-06358-7. Epub 2019 Jul 23.
To acknowledge the facts of gadoxetate disodium-related events in Japan and to achieve better MR practice by analyzing large cohort data with various MR parameters.
This prospective multi-institutional study included 1993 patients (1201 men, mean age 66.4 ± 12.8 years), who received dynamic MRI with gadoxetate disodium (gadoxetate group, n = 1646) or extracellular gadolinium-based contrast agents (other-GBCAs group, n = 347) between January and November 2016. Recorded data covered adverse reactions including dyspnea, breath-hold failure during acquisition, respiratory artifacts rated with a four-point scale, and MR parameters. We compared data between the two groups in whole cohort and age-, gender-, and institution-matched subcohort using χ test (n = 640). Logistic regression model was used to reveal independent associates of substantial artifacts in arterial phase imaging.
Transient dyspnea rarely occurred in gadoxetate or other-GBCAs group (both < 1%). Gadoxetate group (vs other-GBCAs group) showed higher rates of breath-hold failure (whole cohort, 18.2% vs 7.7%, p < 0.001; subcohort, 17.6% vs 6.3%, p < 0.001) and substantial artifacts in arterial phase (7.2% vs 2.2%, p = 0.001; 7.4% vs 1.7%, p = 0.001). With single arterial phase protocol, substantial artifacts under gadoxetate were independently associated with age (odds ratio [OR] = 1.04, p < 0.001), hearing difficulty (OR = 2.92, p = 0.008), breath-hold practice required (OR = 1.61, p = 0.039), and short acquisition time (OR = 0.43, p = 0.005). Multiple arterial phase acquisition did not reduce the incident rate of substantial artifacts.
Gadoxetate disodium was associated with breath-hold failure and substantial artifacts in arterial phase imaging, but not with dyspnea in Japan. Shorter acquisition time should be used to sustain image quality in gadoxetate disodium-enhanced arterial phase imaging.
• Gadoxetate disodium administration leads to breath-hold failure and substantial imaging artifacts in arterial phase MRI in Japan. • Contrast agent-induced dyspnea in arterial phase and adverse reactions are rare in Japan, without showing differences between gadoxetate disodium or other extracellular gadolinium-based contrast agents. • Shorter acquisition time significantly reduces gadoxetate-induced imaging artifacts in the arterial phase.
通过分析具有各种 MR 参数的大队列数据，承认钆塞酸二钠相关事件在日本的事实，并实现更好的磁共振实践。
本前瞻性多机构研究纳入了 1993 名患者（1201 名男性，平均年龄 66.4±12.8 岁），他们在 2016 年 1 月至 11 月期间接受了钆塞酸二钠（钆塞酸组，n=1646）或细胞外钆基对比剂（其他-GBCA 组，n=347）的动态 MRI。记录的数据包括不良反应，包括呼吸困难、采集期间的屏气失败、呼吸伪影的 4 分制评分，以及 MR 参数。我们使用 χ 检验（n=640）比较了两组在全队列和年龄、性别和机构匹配亚队列中的数据。逻辑回归模型用于揭示动脉期成像中大量伪影的独立相关因素。
在钆塞酸或其他-GBCA 组中，短暂性呼吸困难很少发生（均<1%）。钆塞酸组（与其他-GBCA 组相比）显示出更高的屏气失败率（全队列，18.2%对 7.7%，p<0.001；亚队列，17.6%对 6.3%，p<0.001）和动脉期大量伪影（7.2%对 2.2%，p=0.001；7.4%对 1.7%，p=0.001）。在使用单动脉期方案时，动脉期下的大量伪影与年龄（优势比[OR] =1.04，p<0.001）、听力困难（OR=2.92，p=0.008）、屏气实践要求（OR=1.61，p=0.039）和较短的采集时间（OR=0.43，p=0.005）独立相关。多次动脉期采集并不能降低大量伪影的发生率。
在日本，钆塞酸二钠与屏气失败和动脉期成像中的大量伪影有关，但与呼吸困难无关。在钆塞酸二钠增强的动脉期成像中，应使用较短的采集时间来维持图像质量。
钆塞酸二钠给药会导致日本磁共振成像动脉期的屏气失败和大量伪影。
在日本，动脉期造影剂诱导的呼吸困难和不良反应罕见，且钆塞酸二钠与其他细胞外钆基造影剂之间无差异。
较短的采集时间可显著减少钆塞酸引起的动脉期成像伪影。
