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 C. B., Codari M., Cozzi A., Ali M., Saggiante L., Sardanelli F., Secchi F.
• Other Authors: C.B. Monti, M. Codari, A. Cozzi, M. Ali, L. Saggiante, F. Sardanelli, F. Secchi
• Format: Article in Journal/Newspaper
• Language: English
• Published: Springer 2020
• Subjects: Contrast media; Gadobutrol; Gadolinium; Magnetic resonance imaging; Myocardial infarction; Settore MED/36 - Diagnostica per Immagini e Radioterapia; SCAR
• Online Access: http://hdl.handle.net/2434/733620; 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 (SNRscar) and contrast-to-noise ratio between scar and either remote myocardium (CNRscar-rem) or blood (CNRscar-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). SNRscar 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), CNRscar-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.