Image quality of late gadolinium enhancement in cardiac magnetic resonance with different doses of contrast material in patients with chronic myocardial infarction

• Published in: European Radiology Experimental
• Main Authors: Monti, Caterina Beatrice, Codari, Marina, Cozzi, Andrea, Alì, Marco, Saggiante, Lorenzo, Sardanelli, Francesco, Secchi, Francesco
• Format: Text
• Language: English
• Published: Springer International Publishing 2020
• Subjects: Original Article; SCAR
• Online Access: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7118177/; http://www.ncbi.nlm.nih.gov/pubmed/32242266; https://doi.org/10.1186/s41747-020-00149-2

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.