Abstract
To compare image quality and diagnostic performance of Gadoteridol-enhanced MR angiography (MRA) with Gadobutrol-enhanced MRA in the evaluation of carotid artery stenosis. MRA was performed in 30 patients with carotid stenosis diagnosed at DUS. Patients were randomly assigned to group A (Gadobutrol-enhanced MRA) or group B (Gadoteridol-enhanced MRA). All examinations were performed with a 3T MR system. Image quality was assessed qualitatively by a 3-grade scale and quantitatively with SNR measurements. Diagnostic performance in the assessment of stenosis, plaque length and morphology was evaluated in the two MRA groups by accuracy calculation and RoC curves analysis using CTA as reference standard. Statistically significant differences in SNR and quality scale were evaluated by the Independent-Samples T Test and Mann–Whitney test, while the Z-statistics was used to compare diagnostic accuracy in the two groups. Image quality was graded adequate to excellent for both GBCAs, without significant differences (p = 0.165). SNR values were not significantly different in group B (Gadoteridol-enhanced MRA) as compared to group A (Gadobutrol-enhanced MRA) (89.32 ± 70.4 vs 81.09 ± 28.38; p = 0.635). Diagnostic accuracy was 94 % for the evaluation of stenosis degree and 94 % for the identification of ulcerated plaques in group A, while it was 93 % for the evaluation of stenosis degree and 76 % for the identification of ulcerated plaques in group B, without statistically significant differences (p = 0.936). No significant difference in terms of image quality and diagnostic accuracy was observed between Gadoteridol-enhanced MRA and Gadobutrol-enhanced MRA in patients undergoing evaluation of carotid stenosis.
Highlights
To compare image quality and diagnostic performance of Gadoteridol-enhanced MR angiography (MRA) with Gadobutrol-enhanced MRA in the evaluation of carotid artery stenosis
Imaging technique Patients were randomly assigned to group A or B, undergoing MRA after the administration of 0.1 mmol/kg Gadobutrol (0.1 mL/kg) and 0.1 mmol/kg Gadoteridol (0.2 ml/kg), respectively; randomization was performed according to a 2:1 ratio with 2/3 of patients undergoing Gadoteridol enhanced MRA
MRA and CTA examinations were successfully performed in all patients, without any adverse reaction related to gadolinium- or iodine-based contrast agent administration. 18 carotid arteries were evaluated in the 9 patients in group A (Gadobutrol-enhanced MRA) and 42 carotid arteries were evaluated in the 21 patients in group B
Summary
To compare image quality and diagnostic performance of Gadoteridol-enhanced MR angiography (MRA) with Gadobutrol-enhanced MRA in the evaluation of carotid artery stenosis. Ischemic stroke is estimated to be responsible for 10 % of all deaths worldwide. It is the second cause of mortality in western countries and the leading cause of mortality in China and Japan [1]. CT-angiography (CTA) and MRangiography (MRA) have attained a cardinal role in the imaging of carotid arteries thanks to their increasing. The purpose of this study was to prospectively compare the image quality and diagnostic performance of Gadoteridol enhanced MRA with that of Gadobutrol (Gadovist®, Bayer) enhanced MRA in the evaluation of carotid artery stenosis, using CTA as reference standard
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