Enhancement characteristics and impact on image quality of two gadolinium chelates at equimolar doses for time-resolved 3-Tesla MR-angiography of the calf station.

Abstract

To compare enhancement characteristics and image quality of two macrocyclic gadolinium chelates, gadoterate meglumine and gadobutrol, in low-dose, time-resolved MRA of the calf station. 100 consecutive patients with peripheral arterial disease (stages II-IV) were retrospectively analysed. Fifty patients were included in each group - 32 men and 18 women for gadobutrol (mean age 67 years) and 34 men, 16 women for gadoterate meglumine (mean age 64 years). 0.03 mmol/kg bw of either gadobutrol or gadoterate meglumine was injected. Gadobutrol was diluted 1 ∶ 1 with normal saline (0.9% NaCl) to provide similar injection volume and bolus geometry compared to the undiluted 0.5 M dose of gadoterate meglumine. Signal-to-noise-ratio (SNR), contrast-to-noise-ratio (CNR) and image quality were analysed and compared between the two groups. Mean SNR ranged from 83.0 ± 46.7 (peroneal artery) to 96.4 ± 64.5 (anterior tibial artery) for gadobutrol, and from 37.6 ± 13.8 (peroneal artery) to 45.3 ± 16.4 (anterior tibial artery) for the gadoterate meglumine group (p<0.0001). CNR values ranged from 30.1 ± 20.1 (peroneal artery) to 37.6 ± 26.0 (anterior tibial artery) for gadobutrol and from 14.9 ± 8.0 (peroneal artery) to 18.6 ± 16.4 (anterior tibial artery) for gadoterate meglumine (p<0.0001). No significant difference in image quality was found except for the peroneal arteries (p = 0.006 and p = 0.04). Interreader agreement was excellent (kappa 0.87-0.93). The significantly better enhancement as assessed by SNR and CNR provided by gadobutrol compared to gadoterate meglumine does not translate into substantial differences in image quality in an equimolar, low-dose, time-resolved MRA protocol of the calves.