High Spatial Resolution and High Contrast Visualization of Brain Arteries and Veins: Impact of Blood Pool Contrast Agent and Water-Selective Excitation Imaging at 3T

Zusammenfassung

Ziel: Untersuchung eines intravasalen Kontrastmittels und einer wasser-selektiven Anregung bei 3 T für die hoch-aufgelöste und Hochkontrast-Darstellung der Hirngefässe einschliesslich der Venen. Methode und Ergebnisse: 48 Patienten (47 ± 18Jahre alt) wurden nach schriftlichem Einverständnis eingeschlossen. Im Rahmen einer klinischen MRT erhielten 24 Patienten eine Einfachdosis des extrazellulären Gadoterate-Meglumines (Dotarem®) und 24 das intravasale Kontrastmittel Gadofosveset (Vasovist®). Im Anschluss wurde alle Patienten mit 2 örtlich hochaufgelösten (Voxelgröße 0,15 mm³) Gradientenechosequenzen in zufälliger Reihenfolge in der Äquilibriumsphase nach Kontrastmittelgabe untersucht: Eine gespoilte Standard-Gradientenechosequenz (HR-SS, TR/TE 5,1 / 2,3 ms, FA 30°) und eine fettunterdrückende Gradientenechosequenz mit wasserselektiver Anregung (HR-FS, 1331 Binominal-Puls, TR/TE 8,8 / 3,8 ms, FA 30°). Die Aufnahmen wurden subjektiv von 2 Radiologen in Bezug auf Bildqualität, Gefäßkontrast, Artefakte und Abgrenzbarkeit der Läsion analysiert sowie das Kontrast-zu-Rauschen-Verhältnis (CNR) mittels Students-t-Test verglichen. Die Bildqualität und das CNR waren für beide Kontrastmittel in der HR-FS signifikant höher als in der HR-SS (p < 0,05). CNR wurde geringfügig weiter gesteigert durch den Einsatz des intravasalen Kontrastmittels, jedoch ohne dass dabei eine subjektive Verbesserung erzielt werden konnte. Schlussfolgerung: Die wasserselektive Anregung verbessert die Bildqualität und das CNR bei einer örtlich hochaufgelösten Darstellung von Hirnarterien und -venen. Der Einsatz eines intravasalen Kontrastmittels ergibt nur eine geringfügig weitere Verbesserung.

Abstract

Purpose: To investigate a blood pool contrast agent and water-selective excitation imaging at 3 T for high spatial and high contrast imaging of brain vessels including the veins. Methods and Results: 48 clinical patients (47 ± 18years old) were included. Based on clinical findings, twenty-four patients received a single dose of standard extracellular Gadoterate-meglumine (Dotarem®) and 24 received the blood pool contrast agent Gadofosveset (Vasovist®). After finishing routine MR protocols, all patients were investigated with two high spatial resolution (0.15 mm³ voxel size) gradient echo sequences in random order in the equilibrium phase (steady-state) as approved by the review board: A standard RF-spoiled gradient-echo sequence (HR-SS, TR/TE 5.1 / 2.3 msec, FA 30°) and a fat-suppressed gradient-echo sequence with water-selective excitation (HR-FS, 1331 binominal-pulse, TR/TE 8.8 / 3.8 msec, FA 30°). The images were subjectively assessed (image quality with vessel contrast, artifacts, depiction of lesions) by two investigators and contrast-to-noise ratios (CNR) were compared using the Student’s t-test. The image quality and CNR in the HR-FS were significantly superior compared to the HR-SS for both contrast agents (p < 0.05). The CNR was also improved when using the blood pool agent but only to a minor extent while the subjective image quality was similar for both contrast agents. Conclusion: The utilized sequence with water-selective excitation improved image quality and CNR properties in high spatial resolution imaging of brain arteries and veins. The used blood pool contrast agent improved the CNR only to a minor extent over the extracellular contrast agent.

MR imaging - brain - veins - arteries - sequence design, water selective excitation - blood pool contrast agent

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