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 J Magn Reson Imaging. 2012 Sep;363:704-13. doi: 10.1002/jmri.23696. Epub 2012 May 29.

Time-resolved MR angiography of renal artery stenosis in a swine model at 3 Tesla using gadobutrol withdigital subtraction angiography correlation.

Morelli JN1Ai FRunge VMZhang WLi XSchmitt PMcNeal GMichaely HJSchoenberg SOMiller MGerdes CMSincleair STSpratt HAttenberger UI.

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Abstract

PURPOSE:

To establish the minimum dose required for detection of renal artery stenosis using high temporal resolution, contrast enhanced MRangiography MRA in a porcine model.

MATERIALS AND METHODS:

Surgically created renal artery stenoses were imaged with 3 Tesla MR and digital subtraction angiography DSA in 12 swine in this IACUC approved protocol. Gadobutrol was injected intravenously at doses of 0.5, 1, 2, and 4 mL for time-resolved MRA 1.5 × 1.5 mm2 spatial resolution. Region of interest analysis was performed together with stenosis assessment and qualitative evaluation by two blinded readers.

RESULTS:

Mean signal to noise ratio SNR and contrast to noise ratio CNR values were statistically significantly less with the 0.5-mL protocol P < 0.001. There were no statistically significant differences among the other evaluated doses. Both readers found 10/12 cases with the 0.5-mL protocol to be of inadequate diagnostic quality κ = 1.0. All other scans were found to be adequate for diagnosis. Accuracies in distinguishing between mild/insignificant <50% and higher grade stenoses >50% were comparable among the higher-dose protocols sensitivities 73-93%, specificities 62-100%.

CONCLUSION:

Renal artery stenosis can be assessed with very low doses ~0.025 mmol/kg bodyweight of a high concentration, high relaxivity gadolinium chelate formulation in a swine model, results which are promising with respect to limiting exposure to gadolinium based contrast agents.

Copyright © 2012 Wiley Periodicals, Inc.

PMID: 22645046 DOI: 10.1002/jmri.23696 [PubMed - indexed for MEDLINE]