Signal quality of single dose gadobenate dimeglumine pulmonary MRA examinations exceeds quality of MRA performed with double dose gadopentetate dimeglumine.
Signal quality of single dose gadobenate dimeglumine pulmonary MRA examinations exceeds quality of MRA performed with double dose gadopentetate dimeglumine.
复制标题
单剂量钆喷酸二葡胺肺部 MRA 检查的信号质量超过双剂量钆喷酸二葡胺进行的 MRA 检查的信号质量。
DOI：
10.1007/s10554-011-9821-6
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发表时间：
2012
期刊：
影响因子：
--
通讯作者：
Weg,JohnG
中科院分区：
文献类型：
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作者：
Woodard,PamelaK;Chenevert,ThomasL;Sostman,HDirk;Jablonski,KathleenA;Stein,PaulD;Goodman,LawrenceR;Londy,FrankJ;Narra,Vamsidhar;Hales,CharlesA;Hull,RussellD;Tapson,VictorF;Weg,JohnG
在最近一项评估Gd增强磁共振血管成像(MRA)诊断急性肺栓塞(PE)的多中心试验中，美国食品和药物管理局(FDA)宣布，接受静脉注射Gd基磁共振造影剂的肾功能不全患者存在肾源性硬化性纤维化的风险。尽管在这项试验中没有患者出现肾功能不全，但作为对这一声明的谨慎回应，试验方案从静脉注射传统的基于Gd的磁共振造影剂0.2 mg/kg改为0.1 mg/kg的加多贝酯地葡胺。本文描述的研究比较了双剂量常规剂和单剂量加多贝酸地葡胺进行的肺部MRA的信号质量。这项研究是对一项前瞻性多中心研究的数据进行的回顾分析，研究对象为18岁的有记录的存在或不存在PE的男性和女性≥。这项研究得到了机构审查委员会在所有参与中心的批准，所有患者都提供了知情同意的书面指示。我们对肺动脉图像质量进行了客观和主观分析。比较单剂量和双剂量方案下主动脉的信噪比(SNR)和对比噪声比(CNR)。主肺动脉的SNR和CNR与主/叶、段和亚段肺动脉的主观质量评价相关。尽管存在个体异常值，但在所有四分位数中，使用加多贝酯地葡胺的信噪比(P=0.01)和正常信噪比(P=0.008)均高于使用加多喷妥钠的患者。血管信号强度的主观质量在每一级血管中明显好于加多贝酯地葡胺(P<；0.0001)，并且与每一级的信噪比和噪声比有很好的相关性(P<；0.001)。由于药剂的高弛豫度，单剂加多贝酸地葡胺可提供比双剂量传统Gd基磁共振造影剂更好的肺部MRA信号质量。
During a recent multi-center trial assessing gadolinium (Gd)-enhanced magnetic resonance angiography (MRA) for diagnosis of acute pulmonary embolism (PE), the Food and Drug Administration announced a risk of nephrogenic sclerosing fibrosis in patients with renal insufficiency who had received intravenous Gd-based MR contrast agents. Although no patients in this trial had renal insufficiency, in cautious response to this announcement, the trial protocol was changed from an intravenous administration of 0.2 mmol/Kg of a conventional Gd-based MR contrast agent to 0.1 mmol/Kg of gadobenate dimeglumine. The study described herein compares the signal quality of pulmonary MRA performed with double dose conventional agent to single dose gadobenate dimeglumine. This study is a retrospective analysis of data from a prospective, multicenter study in men and women ≥18 years with documented presence or absence of PE. The study was approved by the Institutional Review Board at all participating centers, and all patients provided written indication of informed consent. We performed both objective and subjective analysis of pulmonary artery image quality. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) in the main pulmonary artery were assessed in single and double dose protocols and compared. SNR and CNR of the main PA were correlated with subjective quality assessment of main/lobar, segmental and subsegmental pulmonary arteries. Although there were individual outliers, both SNR (P= 0.01) and CNR (P= 0.008) were higher in all quartiles for examinations using gadobenate dimeglumine than with gadopentetate dimeglumine. Subjective quality of vascular signal intensity at each vessel order was significantly better for gadobenate dimeglumine (P< 0.0001), and correlated well with SNR and CNR at each order (<0.001). Because of agent high relaxivity, a single dose of gadobenate dimeglumine provides better pulmonary MRA signal quality than double dose of a conventional Gd-based MR contrast agent.