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Radiology. 2017 May;283(2):429-437. doi: 10.1148/radiol.2016160241. Epub 2016 Dec 15.

Reducing Artifacts during Arterial Phase of Gadoxetate Disodium-enhanced MR Imaging: Dilution Method versus Reduced Injection Rate.

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1
From the Department of Radiological Sciences, University of California, 10833 Le Conte Ave, Los Angeles, CA 90095-1721 (Y.K.K., W.C.L., K.S., S.S.R., D.M., D.L.); and Biostatistics and Clinical Epidemiology Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Korea (Y.L., S.G.).

Abstract

Purpose To compare two contrast material-administration protocols (dilution vs slow injection) in terms of their effectiveness in arterial phase artifact reduction at gadoxetic acid-enhanced magnetic resonance (MR) imaging. Materials and Methods This HIPAA-compliant retrospective case-controlled cohort study was approved by the institutional review board, with a waiver of informed patient consent. A total of 318 consecutive patients undergoing gadoxetic acid-enhanced MR imaging were placed into one of two subcohorts of 159 consecutive patients each: the dilution subcohort (gadoxetic acid was diluted 1:1 with saline and injected at a rate of 2.0 mL/sec) and the slow injection subcohort (gadoxetic acid was not diluted and was injected at a rate of 1.0 mL/sec). Eighty-nine patients in the dilution subcohort also underwent follow-up MR imaging with the slow injection method, and 34 patients in the slow injection subcohort underwent follow-up MR imaging with the dilution method. Both patient- and image-based analyses, as well as intraindividual analysis, were used to compare two parameters-mean artifact score rated by two observers using a five-point scale and frequency of severe artifact-between the dilution and slow injection subcohorts with the Wilcoxon Mann-Whitney test, χ2 test, and generalized estimating equation. Results In both patient- and image-based analyses, the mean artifact score and frequency of severe artifact were lower in the dilution subcohort (mean, 1.46% and 3.8% [six of 159]) than in the slow injection subcohort (mean, 1.95% and 15.1% [24 of 159]) (P ≤ .001 and P < .001, respectively). In intraindividual analysis, both variables were also decreased in the dilution subcohort (P = .007 and P = .001, respectively). We found the two variables to be significantly increased in the slow injection subcohort when compared with that in the dilution subcohort for three different MR platforms (P < .05). Conclusion In comparison with slow injection of undiluted contrast material at a rate of 1.0 mL/sec, gadoxetic acid diluted to 50% and injected at a rate of 2 mL/sec had a significantly less severe ghosting artifact in the arterial phase of gadoxetic acid-enhanced MR imaging. © RSNA, 2016 Online supplemental material is available for this article.

PMID:
27977329
DOI:
10.1148/radiol.2016160241
[Indexed for MEDLINE]

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