Vergleich des 1 molaren Gadobutrol (Gadovist®) und des 0,5 molaren Gadobenat-Dimeglumin (MultiHance®) bei der kontrastmittelverstärkten Magnetresonanzangiographie der unteren Extremität

In der vorliegenden Studie sollte das 0,5 molare MR-Kontrastmittel Gadobenat-Dimeglumin in halber Dosierung mit dem 1 molaren Gadobutrol in Standarddosierung bei der kontrastmittelverstärkten Magnetresonanzangiographie (CE-MRA) der unteren Extremität verglichen werden. Hierzu wurden jeweils 37 CE-...

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Bibliographic Details
Main Author: Achenbach, Marina
Contributors: Heverhagen, Johannes (Prof. Dr. Dr.) (Thesis advisor)
Format: Dissertation
Language:German
Published: Philipps-Universität Marburg 2011
Klinik für Strahlentherapie
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Table of Contents: The purpose of this study was to compare the 0.5 molar MR-contrast agent Gadobenate Dimeglumine in half dose (0.05 mmol/kg bodyweight (BW)) to the 1 molar Gadobutrol in standard dose (0.1 mmol/kg BW) in run-off contrast-enhanced Magnetic Resonance Angiography (CE-MRA) of the lower extremities. 37 CE-MRAs at 1.5 Tesla from the infrarenal aorta to the calf arteries were retrospectively analysed with 0.1 mmol/kg BW Gadobutrol and 0.05 mmol/kg BW Gadobenate-Dimeglumine, respectively. Two independent blinded investigators analysed the occurrence of significant (> 70%) and non-significant (≤ 70%) stenosis as well as subjective image quality and venous overlay of CE-MRAs. A third investigator measured signal intensity, signal-to-noise-ratio (SNR) and contrast-to-noise-ratio (CNR) within all vessel segments from the infrarenal aorta to the popliteal artery. Interobserver agreement in detection of significant and non-significant stenosis was considerable with Gadobutrol (kappa = 0.547) as well as with Gadobenate Dimeglumine (kappa = 0.524). With regard to subjective image quality, no significant difference was shown for investigator 1 (p = 0.209). Investigator 2 noted a significantly better image quality with Gadobenate Dimeglumine (p < 0.05). Venous overlay occurred with similar frequency in both contrast agent groups (p = 0.132 and p= 0.06). As noted by both investigators, a high grade venous overlay in the area of the lower leg more often caused non-diagnostic image quality with Gadobutrol (in 1.4 und 2.6% of vessel segments) than with Gadobenate Dimeglumine (in 0.4 und 0.3 % of vessel sements). No significant difference between the contrast agents was noted with regard to signal intensity (p = 0. 28), SNR (p = 0.18) and CNR (p = 0.18). Using Gadobenate Dimeglumine, the gadolinium dose during CE-MRA of the lower extremities can be halfed without loss of image quality or signal intensity, SNR and CNR. Moreover, Gadobenate Dimeglumine should be favored over Gadobutrol due to the lower rate of non-diagnostic image quality.