Background

Contrast-enhanced cardiac magnetic resonance (CMR) is pivotal for evaluating chronic myocardial infarction (CMI). Concerns about safety of gadolinium-based contrast agents favour dose reduction. We assessed image quality of scar tissue in CMRs performed with different doses of gadobutrol in CMI patients.

Methods

Informed consent was waived for this Ethics Committee-approved single-centre retrospective study. Consecutive contrast-enhanced CMRs from CMI patients were retrospectively analysed according to the administered gadobutrol dose (group A, 0.10 mmol/kg; group B, 0.15 mmol/kg; group C, 0.20 mmol/kg). We calculated the signal-to-noise ratio for scar tissue (SNR_scar) and contrast-to-noise ratio between scar and either remote myocardium (CNR_scar-rem) or blood (CNR_scar-blood).

Results

Of 79 CMRs from 79 patients, 22 belonged to group A, 26 to group B, and 31 to group C. The groups were homogeneous for age, sex, left ventricular morpho-functional parameters, and percentage of scar tissue over whole myocardium (p ≥ 0.300). SNR_scar was lower in group A (46.4; 40.3–65.1) than in group B (70.1; 52.2–111.5) (p = 0.013) and group C (72.1; 59.4–100.0) (p = 0.002), CNR_scar-rem was lower in group A (62.9; 52.2–87.4) than in group B (96.5; 73.1–152.8) (p = 0.008) and in group C (103.9; 83.9–132.0) (p = 0.001). No other significant differences were found (p ≥ 0.335).

Conclusions

Gadobutrol at 0.10 mmol/kg provides inferior scar image quality of CMI than 0.15 and 0.20 mmol/kg; the last two dosages seem to provide similar LGE. Thus, for CMR of CMI, 0.15 mmol/kg of gadobutrol can be suggested instead of 0.20 mmol/kg, with no hindrance to scar visualisation. Dose reduction would not impact on diagnostic utility of CMR examinations.

中文翻译：

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慢性心肌梗死患者使用不同剂量的对比材料在心脏磁共振中晚期late增强的图像质量。

背景

对比增强的心脏磁共振（CMR）对于评估慢性心肌梗塞（CMI）至关重要。对基于lin的造影剂安全性的担忧有利于降低剂量。我们评估了在CMI患者中使用不同剂量的gadobutrol进行的CMR中疤痕组织的图像质量。

方法

本伦理委员会批准的单中心回顾性研究放弃了知情同意。根据gadobutrol的给药剂量（A组，0.10 mmol / kg； B组，0.15 mmol / kg； C组，0.20 mmol / kg），对CMI患者的连续对比增强CMR进行回顾性分析。我们计算了疤痕组织的信噪比（SNR _scar）以及疤痕与远端心肌（CNR _scar-rem）或血液（CNR _Scar-blood）之间的对比噪声比。

结果

在79例患者的79例CMR中，A组22例，B组26例，C组31例。各组在年龄，性别，左心室形态功能参数以及瘢痕组织在整个心肌上的百分比均相同（p ≥0.300）。A组（46.4; 40.3–65.1）的SNR_疤痕低于B组（70.1; 52.2–111.5）（p = 0.013）和C组（72.1; 59.4–100.0）（p = 0.002），CNR_疤痕A组（62.9; 52.2–87.4）低于B组（96.5; 73.1–152.8）（p = 0.008）和C组（103.9; 83.9–132.0）（p = 0.001）。没有其他显著差异被发现（p ≥0.335）。

结论

0.10 mmol / kg的Gadobutrol提供的CMI疤痕图像质量低于0.15和0.20 mmol / kg；最后两种剂量似乎提供相似的LGE。因此，对于CMI的CMR，建议使用0.15 mmol / kg的gadobutrol，而不是0.20 mmol / kg，而不会影响疤痕的可视化。减少剂量不会影响CMR检查的诊断效用。