Tsutomu Tamada MD, PhD, Presenter: Nothing to Disclose

Akihiko Kanki MD, Abstract Co-Author: Nothing to Disclose

Tomohiro Sato MD, Abstract Co-Author: Nothing to Disclose

Fuyuki Tanaka MD, Abstract Co-Author: Nothing to Disclose

Hiroki Higashi MD, Abstract Co-Author: Nothing to Disclose

Katsuyoshi Ito MD, Abstract Co-Author: Nothing to Disclose

To compare three different injection methods for optimizing hepatic arterial phase of contrast-enhanced dynamic MR imaging obtained with Gd-EOB-DTPA.

Hepatic arterial phase images were obtained after an intravenous bolus injection of contrast agent at a rate of 3 mL/sec with diluted Gd-EOB-DTPA (dilution method) in 27 patients, 3 mL/sec with undiluted Gd-EOB-DTPA (3 mL method) in 26 patients and 1 mL/sec with undiluted Gd-EOB-DTPA (1 mL method) in 28 patients using a fluoroscopic triggering injection method. The bolus was flushed with 30 mL saline at the same rate of Gd-EOB-DTPA injection. In the quantitative evaluation, signal-to-phantom ratios (SPR) of the liver parenchyma, pancreas, renal cortex, portal vein and aorta were evaluated. In the qualitative evaluation, the seven items for image quality of hepatic arterial phase were assessed, and the total score of all items in each subject was calculated.

The SPR of the liver parenchyma in 3 mL method was significantly higher than that in 1 mL method (average value: 1 mL< dilution<3 mL), indicating substantial inflow from portal venous return during the arterial phase. The score of good enhancement of abdominal aorta (average score: 1 mL>dilution> 3 mL) and total score of seven items (average score: 1 mL>dilution> 3 mL) were significantly higher in 1 mL method than those in 3 mL method. The SPRs of the pancreas, renal cortex, portal vein and aorta, and the scores of remaining six items (respiratory or ringing artifact, enhancement of portal vein, spleen, and pancreas, minimal enhancement of the liver, and renal corticomedullary differentiation) showed no significant difference between three groups.

In the arterial phase of Gd-EOB-DTPA enhanced MR imaging, injection rate of 1 mL/sec with undiluted contrast agent was optimal, compared with injection rate of 3 mL/sec with undiluted contrast agent, and was comparable to 3 mL/sec with diluted contrast agent.

Slow injection rate of 1 mL/sec with undiluted Gd-EOB-DTPA will be convenient and preferable for optimal arterial-phase liver MR imaging, compared with faster injection rate and a dilution method.

Tamada, T, Kanki, A, Sato, T, Tanaka, F, Higashi, H, Ito, K, Comparison of Three Different Injection Methods for Arterial Phase of Gd-EOB-DTPA-enhanced MR Imaging of the Liver.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9002592.html