High Spatial Resolution and High Contrast Visualization of Brain Arteries and Veins: Impact of Blood-Pool Contrast Agent and Water-Selective Excitation Imaging

E. Spuentrup; J. E. Jacobs; J. Kleimann; W. Möller-Hartmann; G. Brinker; M. Loehr; R. I. Ernestus; K. J. Lackner

doi:10.1055/s-0028-1124038

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High Spatial Resolution and High Contrast Visualization of Brain Arteries and Veins: Impact of Blood-Pool Contrast Agent and Water-Selective Excitation Imaging

E Spuentrup ¹, JE Jacobs ¹, J Kleimann ¹, W Möller-Hartmann ¹, G Brinker ², M Loehr ², RI Ernestus ², KJ Lackner ¹

¹Department of Radiology, University of Cologne, Cologne, Germany
²Department of Neurosurgery, University of Cologne, Cologne, Germany

Abstract

Purpose: To assess the impact of a blood-pool contrast agent (Gadofosveset) and water-selective excitation for high spatial resolution and high contrast visualization of brain arteries and veins.

Materials and Methods: 48 patients (46±17 years old) scheduled for brain MRI including the assessment of the brain vessels (arteries and veins, i.e. prior to brain surgery etc) were included. 24 patients received standard extracellular Gd-DOTA (Dotarem®, 0.1mmol/kgBW) and 24 received the blood-pool contrast agent Gadofosveset (Vasovist®). All patients were investigated with two high spatial resolution gradient echo sequences: A standard RF spoiled gradient echo sequence (HR-FFE, TR/TE 5.1/2.3ms, FA30°) and a fat-suppressed gradient echo sequence with water selective excitation (FS-FFE, 1331 binominal prepulse resulting in a fat suppression and subsequent water selective excitation, TR/TE 8.8/3.9ms, FA 30°). Identical geometry data for both sequences were used (280 0.6mm thick slices (including zero filling) covering the entire brain, 0.6×0.6mm² in plane resolution). Data were acquired in random order 10 minutes after contrast agent administration to allow for imaging in the equilibrium phase. To obtain similar scanning durations, for the FS-FFE parallel imaging with SENSE 2 was utilized resulting in a 4:43min scanning time, while for the HR-FFE SNESE without acceleration (SENSE 1, 5:27min scanning time) was applied. All studies were carried out on a clinical 3T whole body MR scanner (3T Achieva, Philips Healthcare, Best, The NL) using the 8 channel head coil.

CNR between the vessels (arteries and veins) and the surrounding tissue (white and gray matter was assesses and compared using Students t-test. Visualization of the lesion (tumors n=31, thrombi n=3) in the HR-FFE vs. the FS-FFE sequence was subjectively compared.

Results: CNR in the FS-FFE was significantly superior compared to the HR-FFE for both the contrast agents used (Gd-DOTA and Gadofosveset): CNRarteries vs. gray matter 66±15 and 76±15 vs. 36±11 and 49±10, CNRveins vs. gray matter 51±14 and 66±13 vs. 40±12 and 54±10, CNRarteries vs. white matter 60±14 and 70±14 vs. 33±12 and 46±11, CNRveins vs. white matter 45±14 and 60±12 vs. 37±12 and 51±11, p<0.05 for all comparisons. Lesions were superiorly visualized on the FS-FFE sequence. Furthermore, all CNR values were superior using Gadofosveset compared with Gd-DOTA (p<0.05).

Conclusion: The use of the blood-pool contrast agent Gadofosveset in conjunction with water selective excitation imaging allows for improved high spatial resolution and high contrast visualization of all the brain vessels including the veins.