Enhanced MR-Angiography (CE-MRA) of the Supraaortic Arteries: Dose Reduction with a Contrast Agent of High Relaxivity (Gd-BOPTA)

Purpose: Reducing the amount of contrast medium in contrast-enhanced MR-angiography (CE-MRA) of the cervical vessels could lead to considerable cost reduction. This study investigates whether the amount of contrast medium possessing high relaxivity can be reduced without loss of diagnostic information. Materials and Methods: In a prospective study the supraaortic vessels of 40 patients were examined on a 1.5 T MR-system using 10 or 20 ml Gd-BOPTA (MultiHance®). The examinations were evaluated by measurement of the signal increase in the common carotid arteries in 38 patients. Furthermore, CE-MRA was rated by two independent observers, who were blinded to the amount of contrast medium and degree of stenosis. Rating criteria were quality of arterial contrast and image impression. Results: Signal increase in the carotid artery was identical for 10 and 20 ml Gd-BOPTA in 12 patients with optimal bolus timing (10 ml: 454 ± 58; 20 ml: 458 ± 63). Signal intensities were significantly lower for 10 ml when bolus timing was suboptimal (281 ± 80 vs 353 ± 65; p < 0.02). The quality of the CE-MRA using 10 and 20 ml Gd-BOPTA was rated as identical by the observers, and the amount of contrast medium used could not be deduced from the images. Conclusion: Image quality and signal values of the carotid arteries did not differ in CE-MRA performed with either 10 ml or 20 ml Gd-BOPTA (MultiHance®) as long as the examination is adequate. Thus, cost reduction can be achieved with a reduced standard dose of 10 ml Gd-BOPTA without loss of diagnostic information