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DOI: 10.1055/s-2003-39931
© Georg Thieme Verlag Stuttgart · New York
MR-Angiographie der Koronararterien: Vergleich des Blutpoolkontrastmittels Gadomer mit Gd-DTPA am Schwein
MR Angiography of the Coronary Arteries: Comparison of the Blood Pool Contrast Medium Gadomer and Gd-DTPA in Pigs Herrn Prof. Dr. Dr. h.c. Karl-Jürgen Wolf zum 60. Geburtstag gewidmetPublication History
Publication Date:
17 June 2003 (online)
Zusammenfassung
Ziel: Die signalverstärkenden Eigenschaften des makromolekularen Kontrastmittels Gadomer in der MR-Angiographie der Koronararterien im Vergleich zu Gd-DTPA zu prüfen. Material und Methoden: Insgesamt wurden 15 MRT-Untersuchungen an Herzen von Schweinen bei 1,5 T mit einer Puls-getriggerten, segmentierten 3D-FLASH-Sequenz jeweils während Atemanhaltens vor und bis zu 30 min nach Injektion des Kontrastmittels durchgeführt. Gadomer wurde in zwei (0,05 und 0,1 mmol Gd/kg), Gd-DTPA in einer Dosierung (0,3 mmol Gd/kg) geprüft (je n = 5 Untersuchungen). Quantitativ wurden für Blut und Myokard die Signal-zu-Rausch (S/R)- und Kontrast-zu-Rausch(K/R)-Werte bestimmt. Qualitativ wurden Bildqualität und Darstellbarkeit der Koronararterien bewertet. Ergebnisse: Gadomer führt im Vergleich zu Gd-DTPA zu einem länger anhaltenden, gegenüber der Nativuntersuchung signifikant erhöhten K/R-Anstieg zwischen Blut und Myokard (Gd-DTPA: nur unmittelbar nach Injektion, Gadomer, 0,05 mmol Gd/kg: bis 5 min; 0,1 mmol Gd/kg: bis 10 min nach Injektion). Die qualitative Auswertung zeigt, dass die Darstellung der Koronararterien und der Seitenäste mit Gadomer ohne Unterschied zwischen den beiden Dosierungen signifikant besser ist als mit Gd-DTPA. Schlussfolgerung: Gadomer ist ein geeignetes Kontrastmittel für die MR-Angiographie der Koronararterien, wobei die Dosis von 0,1 mmol Gd/kg gegenüber 0,05 mmol Gd/kg Vorteile durch ein verlängertes Bildgebungsfenster aufweist.
Abstract
Aim: To investigate the signal-enhancing effects of the macromolecular contrast medium Gadomer in MR angiography of the coronary arteries compared to Gd-DTPA. Material and Methods: A total of 15 MRI examinations of the heart were performed in pigs at 1.5 T using a pulse-triggered, segmented 3D FLASH sequence with data acquisition during breathhold before and up to 30 min after contrast medium injection. Gadomer was investigated at two doses (0.05 and 0.1 mmol Gd/kg), Gd-DTPA at one (0.3 mmol Gd/kg) (n = 5 examinations per dose). Standard sequences without magnetization preparation were supplemented by sequences with magnetization saturation applied before data acquisition before and immediately after contrast medium injection. Analysis comprised quantitative determination of blood and myocardium signal to noise (S/N) and contrast to noise (C/N) and qualitative assessment of several parameters of image quality and coronary artery visualization. Results: Gadomer leads to a significant C/N increase between blood and myocardium compared to the unenhanced examination and the increase is longer-lasting than that produced by Gd-DTPA (Gd-DTPA: only directly after injection; Gadomer: up to 5 min post injection at 0.05 mmol Gd/kg, up to 10 min at 0.1 mmol Gd/kg). The qualitative evaluation shows that visualization of the coronary arteries and branch vessels is significantly better with Gadomer at both doses than with Gd-DTPA. Magnetization saturation increases the C/N in combination with Gd-DTPA and at the higher dose of Gadomer with the latter producing a higher increase in C/N values. Conclusion: Gadomer is a suitable contrast medium for MR angiography of the coronary arteries with the dose of 0.1 mmol Gd/kg being superior to 0.05 mmol Gd/kg due to a longer imaging window.
Key words
MR angiography - coronary arteries - contrast medium - gadolinium - experimental studies
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Dr. med. vet. Jörg Schnorr
Institut für Radiologie, Charité, Medizinische Fakultät der Humboldt-Universität zu Berlin
Schumannstraße 20/21
10098 Berlin
Phone: + 49-30-450539044
Fax: + 49-30-450539901
Email: joerg.schnorr@charite.de