- Poster presentation
- Open Access
Comparison of blood pool and extracellular gadolinium contrast for functional MR evaluation of vascular thoracic outlet syndrome
© Lim et al; licensee BioMed Central Ltd. 2013
- Published: 30 January 2013
- Subclavian Artery
- Gadopentetate Dimeglumine
- Thoracic Outlet Syndrome
- Blood Pool Agent
- Arterial Contrast
MR angiography (MRA) is useful for vascular thoracic outlet syndrome (TOS) assessment. With standard extracellular contrast (ECA), two injections are administered in arm abduction and then adduction, with relatively high total dose. Our purpose was to compare TOS MRA image quality, vessel contrast, and detection of vascular pathology between single-injection low-dose blood pool agent (BPA) using gadofosveset trisodium, and dual-injection ECA using gadopentetate dimeglumine.
31 patients (21 F, mean 36.5 years) with suspected vascular TOS underwent BPA (n=18) or ECA MRA (n=13) at 1.5T. T1 weighted 3D spoiled gradient echo imaging over 4 time points (abduction-early, abduction-late, adduction-early, adduction-late) was performed with injection via the less symptomatic arm. For BPA, a 0.03 mmol/kg dose was given in abduction only. For ECA, 0.075 mmol/kg was injected in abduction then adduction (total 0.15 mmol/kg). Two radiologists (R1, R2) independently evaluated images for image quality (1=non-diagnostic, 3=diagnostic, 5=excellent) and vessel contrast (1=same as muscle, 4=much brighter than muscle), with arterial contrast assessed for 1st and 3rd, and venous contrast for 2nd and 4th time points. Scores were compared with independent samples t-tests. Vascular pathology assessment was compared to reference evaluation by an unblinded experienced vascular radiologist.
Comparison of Image Quality and Vessel Contrast Scores for each time point between BPA MRA (gadofosveset trisodium) and ECA MRA (gadopentetate dimeglumine) for the symptomatic arm
For ECA, there were 3 arterial stenoses. All were correctly identified by R1, and 2/3 by R2. 13 venous stenoses were present at the reference standard. R1 identified 12/13 stenoses and R2 11/13, with 4 false positive stenoses.
Single-injection low-dose BPA for functional MRA of vascular TOS allows similar image quality, vessel contrast, and identification of both arterial and venous pathology as standard dual-injection ECA.
No funding to disclose.
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.