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Biomedical subjects

Christian Fink

Publications and source records attributed to Christian Fink.

At least 37 records · Page 2Linked to original sources

Value of high spatial and high temporal resolution magnetic resonance angiography for differentiation between idiopathic and thromboembolic pulmonary hypertension: initial results.

Differentiation between different forms of pulmonary hypertension (PH) is essential for correct disease management. The goal of this study was to elucidate the clinical impact of high spatial resolution MR angiography (SR-MRA) and time-resolved MRA (TR-MRA) to differentiate between patients with chronic thromboembolic PH (CTEPH) and idiopathic pulmonary arterial hypertension (IPAH). Ten PH patients and five volunteers were examined. Twenty TR-MRA data sets (TA 1.5 s) and SR-MRA (TA 23 s) were acquired. TR-MRA data sets were subtracted as angiography and perfusion images. Evaluation comprised analysis of vascular pathologies on a segmental basis, detection of perfusion defects, and bronchial arteries by two readers in consensus. Technical evaluation comprised evaluation of image quality, signal-to-noise ratio (SNR) measurements, and contrast-media passage time. Visualization of the pulmonary arteries was possible down to a subsegmental (SR-MRA) and to a segmental (TR-MRA) level. SR-MRA outperformed TR-MRA in direct visualization of intravascular changes. Patients with IPAH predominantly showed tortuous pulmonary arteries while in CTEPH wall irregularities and abnormal proximal-to-distal tapering was found. Perfusion images showed a diffuse pattern in IPAH and focal defects in CTEPH. TR-MRA and SR-MRA resulted in the same final diagnosis. Both MRA techniques allowed for differentiation between IPAH and CTEPH. Therefore, TR-MRA can be used in the clinical setting, especially in dyspneic patients.

Diagnosis, Differential↗

Influence of different breathing maneuvers on internal and external organ motion: use of fiducial markers in dynamic MRI.

PURPOSE: To investigate, with dynamic magnetic resonance imaging (dMRI) and a fiducial marker, the influence of different breathing maneuvers on internal organ and external chest wall motion. METHODS AND MATERIALS: Lung and chest wall motion of 16 healthy subjects (13 male, 3 female) were examined with real-time trueFISP (true fast imaging with steady-state precession) dMRI and a small inductively coupled marker coil on either the abdomen or thorax. Three different breathing maneuvers were performed (predominantly "abdominal breathing," "thoracic breathing," and unspecific "normal breathing"). The craniocaudal (CC), anteroposterior (AP), and mediolateral (ML) lung distances were correlated (linear regression coefficient) with marker coil position during forced and quiet breathing. RESULTS: Differences of the CC distance between maximum forced inspiration and expiration were significant between abdominal and thoracic breathing (p < 0.05). The correlation between CC distance and coil position was best for forced abdominal breathing and a marker coil in the abdominal position (r = 0.89 +/- 0.04); for AP and ML distance, forced thoracic breathing and a coil in the thoracic position was best (r = 0.84 +/- 0.03 and 0.82 +/- 0.03, respectively). In quiet breathing, a lower correlation was found. CONCLUSION: A fiducial marker coil external to the thorax in combination with dMRI is a new technique to yield quantitative information on the correlation of internal organ and external chest wall motion. Correlations are highly dependent on the breathing maneuver.

Abdomen↗

Assessment of hemodynamic changes in the systemic and pulmonary arterial circulation in patients with cystic fibrosis using phase-contrast MRI.

Cystic fibrosis (CF) leads to disabling lung disease and pulmonary hypertension (PH). The goal of this study was to assess the hemodynamics in the systemic and pulmonary arterial circulation of patients with CF using MRI. Ten patients with CF and 15 healthy volunteers were examined (1.5-T MRI). Phase-contrast flow measurements were assessed in the ascending aorta, pulmonary trunc, and the left and right pulmonary arteries (PA), resulting in the following parameters: peak velocity (PV) (centimeters per second) velocity rise gradient (VRG), time to PV (milliseconds), and the average area (centimeters squared). The blood flow ratio between the right and left lungs and the bronchosystemic shunt were calculated. For the ascending aorta and pulmonary trunc no parameter was significantly different between both populations. In the right PA a significantly lower PV (p=0.001) and VRG (p=0.02) was found. In the left PA there was a significantly (p=0.007) lower PV but no significant (p=0.07) difference between the VRG. The areas of the right (p=0.08) and left (p=0.5) PA were not significantly enlarged. For the volunteers a linear increase of PV in both PA was found with age, while it decreased in patients with CF. The blood flow distribution (right/left lung) showed no significant (p=0.7) difference between the groups. There was a significantly (p<0.001) higher bronchosystemic shunt volume in patients with CF (1.3 l/min) than in volunteers (0.1 l/min). Magnetic resonance based flow measurements in the right and left PA showed first indications for early development of PH. The significant increase in bronchosystemic shunt volume might be indicative fo the extent of parenchymal changes.

Adult↗

Postoperative evaluation of femoral tunnel position in ACL reconstruction: plain radiography versus computed tomography.

Inaccurate femoral tunnel placement has been identified as one of the most frequent errors in failed anterior cruciate ligament reconstructions. Most surgeons evaluate the femoral tunnel position on plain radiographs but in a lot of cases it is difficult to detect the femoral tunnel. The goal of this study was to compare plain digital radiographs and multiplanar computed tomography (CT) scans for the evaluation of femoral tunnel position. We examined 50 patients 24-60 months postoperatively, following an arthroscopically-assisted anterior cruciate ligament reconstruction with central third bone-patellar tendon-bone graft. Endobutton fixation was used on the femoral side and titanium interference screws on the tibial side. Standard antero-posterior and lateral X-rays and a CT scan were obtained from each patient. Sagittal and frontal reconstructions of the CT scan were used for the evaluation. We measured the height of the center of the tunnel in the notch in the frontal plane, and the position of the tunnel along Blumensaat's line (BL) in the lateral plane. Measurements are reported as percentages of total notch height and of the length of BL. On plain X-rays the tunnel was invisible in 46 cases in the anterior-posterior plane and in eight cases on the lateral plane. The average position in the frontal plane was 89.8%, and in the lateral plane 38.6%. In the CT scans, measurements were able to be done in 48 patients. The frontal-plane position averaged 90.5% and the lateral-plane position 34.1%. Pearson's correlation coefficient for the values in the lateral plane for CT and X-rays was low at 0.22, with p>0.05. In our group of 50 patients we were able to detect the femoral tunnel on both plains of standard X-rays in only four patients, whereas it was possible to take accurate measurements in 48 patients on reconstructed CT scans. We advocate the use of CT technology for the evaluation of femoral position whenever precise measurements are needed.

Adult↗

Comparison of relative forced expiratory volume of one second with dynamic magnetic resonance imaging parameters in healthy subjects and patients with lung cancer.

PURPOSE: To assess relative forced expiratory volume in one second (FEV1/vital capacity (VC)) in healthy subjects and patients with a lung tumor using dynamic magnetic resonance imaging (dMRI) parameters. MATERIALS AND METHODS: In 15 healthy volunteers and 31 patients with a non-small-cell lung carcinoma stage I (NSCLC I), diaphragmatic length change (LE1) and craniocaudal (CC) intrathoracic distance change within one second from maximal inspiration (DE1) were divided by total length change (LE(total), DE(total)) as a surrogate of spirometric FEV1/VC using a true fast imaging with steady-state precession (trueFISP) sequence (TE/TR = 1.7/37.3 msec, temporal resolution = 3 images/second). Influence of tumor localization was examined. RESULTS: In healthy volunteers FEV1/VC showed a highly significant correlation with LE1/LE(total) and DE1/DE(total) (r > 0.9, P < 0.01). In stage IB tumor patients, comparing tumor-bearing with the non-tumor-bearing hemithorax, there was a significant difference in tumors of the middle (LE1/LE(total) = 0.63 +/- 0.05 vs. 0.73 +/- 0.04, DE1/DE(total) = 0.66 +/- 0.05 vs. 0.72 +/- 0.04; P < 0.05) and lower (P < 0.05) lung region. Stage IA tumor patients showed no significant differences with regard to healthy subjects. CONCLUSION: dMRI is a simple noninvasive method to locally determine LE1/LE(total) and DE1/DE(total) as a surrogate of FEV1/VC in volunteers and patients. Tumors of the middle and lower lung regions have a significant influence on these MRI parameters.

Adult↗

Intraindividual comparison of 1.0 M gadobutrol and 0.5 M gadopentetate dimeglumine for time-resolved contrast-enhanced three-dimensional magnetic resonance angiography of the upper torso.

PURPOSE: To compare the signal characteristics and bolus dynamics of 1.0 M gadobutrol and 0.5 M Gd-DTPA for time-resolved, three-dimensional, contrast-enhanced (CE) MRA of the upper torso. MATERIALS AND METHODS: Ten healthy volunteers were examined with time-resolved three-dimensional CE-MRA (scan time per three-dimensional data set: 0.86 second; voxel size: 3.6 x 2 x 6.3 mm(3)). Each volunteer underwent eight individual examinations after intravenous injection of 0.05 and 0.1 mmol/kg body weight (b.w.) of 1.0 M gadobutrol and 0.5 M Gd-DTPA using two injection rates (2.5 and 5 mL/second). The data analysis included quantitative measurements of the peak signal-to-noise ratio (SNR) and bolus dispersion (full width at half maximum (FWHM)) in the pulmonary artery, left atrium, and thoracic and abdominal aortas. RESULTS: No significant differences in the peak SNR and bolus dispersion were observed between gadobutrol and Gd-DTPA for all dose levels and injection rates in any of the vascular segments. For both contrast agents a dose of 0.1 mmol/kg b.w. injected with 5 mL/second achieved the highest SNR in all vascular segments. CONCLUSION: For the imaging parameters used in this study, higher-concentrated gadolinium chelates offer no relevant advantages for time-resolved three-dimensional CE-MRA of the upper torso.

Body Mass Index↗

Evaluation of lung volumetry using dynamic three-dimensional magnetic resonance imaging.

RATIONALE AND OBJECTIVES: We sought to investigate lung volume and surface measurements during the breathing cycle using dynamic three-dimensional magnetic resonance imaging (3D MRI). MATERIALS AND METHODS: Breathing cycles of 20 healthy volunteers were examined using a 2D trueFISP sequence (3 images/second) in combination with a model and segmented 3D FLASH sequence (1 image/second) MR images using view sharing. Segmentation was performed semiautomatically using an interactive region growing technique. Vital capacity (VC) was calculated from MRI using the model (2D) and counting the voxels (3D) and was compared with spirometry. RESULTS: VC from spirometry was 4.9+/-0.9 L, 4.4+/-1.2 L from 2D MRI measurement, and 4.7+/-0.9 L for 3D MRI. Using the 3D technique, correlation to spirometry was higher than using the 2D technique (r>0.95 vs. r>0.83). Using the 3D technique, split lung volumes and lung surface could be calculated. There was a significant difference between the left and right lung volume in expiration (P<0.05). CONCLUSIONS: Dynamic 3D MRI is a noninvasive tool to evaluate split lung volumes and lung surfaces during the breathing cycle with a high correlation to spirometry.

Adult↗

The effect of intermittent pneumatic compression on fracture healing.

OBJECTIVES: Continuously increased venous pressure has been shown to enhance bone growth, stimulate fracture healing, and prevent bone loss, but also causes soft-tissue breakdown as a result of chronic edema. This study was designed to test the hypothesis that intermittently increased venous pressure improves fracture healing without injuring soft tissue. DESIGN: An ostectomy was created in the right radius of 30 skeletally mature male beagles. On postoperative day 7, a pneumatic cuff was placed around the forelimb of each dog. In experimental animals (n = 13), the cuff compressed for 5 minutes followed by no compression for 2.5 minutes. This cycle was repeated 100 times per day for 8 weeks. Control animals (n = 15) wore a nonfunctional cuff. Fracture healing was assessed with dual-energy x-ray absorptiometry, histologic analysis, and biomechanical testing. RESULTS: No soft-tissue complications were noted. Bone mineral content at the ostectomy increased significantly more in the experimental group than in the control group (P < 0.05). Histology revealed that the bone defects in the experimental group were significantly more healed than those in the control group (P < 0.005). No differences were noted between groups in the biomechanical properties of the healing bones. CONCLUSIONS: Intermittently increased venous pressure proximal to a bone defect seems to enhance the formation of new bone without soft-tissue complications. These findings can potentially be applied to the clinical treatment of "difficult to heal" fractures. Further work is necessary to determine the most effective ratio of the presence and absence of pneumatic compression.

Absorptiometry, Photon↗

Effect of inspiratory and expiratory breathhold on pulmonary perfusion: assessment by pulmonary perfusion magnetic resonance imaging.

RATIONALE AND OBJECTIVES: The effect of breathholding on pulmonary perfusion remains largely unknown. The aim of this study was to assess the effect of inspiratory and expiratory breathhold on pulmonary perfusion using quantitative pulmonary perfusion magnetic resonance imaging (MRI). METHODS AND RESULTS: Nine healthy volunteers (median age, 28 years; range, 20-45 years) were examined with contrast-enhanced time-resolved 3-dimensional pulmonary perfusion MRI (FLASH 3D, TR/TE: 1.9/0.8 ms; flip angle: 40 degrees; GRAPPA) during end-inspiratory and expiratory breathholds. The perfusion parameters pulmonary blood flow (PBF), pulmonary blood volume (PBV), and mean transit time (MTT) were calculated using the indicator dilution theory. As a reference method, end-inspiratory and expiratory phase-contrast (PC) MRI of the pulmonary arterial blood flow (PABF) was performed. RESULTS: There was a statistically significant increase of the PBF (delta = 182 mL/100 mL/min), PBV (delta = 12 mL/100 mL), and PABF (delta = 0.5 L/min) between inspiratory and expiratory breathhold measurements (P < 0.0001). Also, the MTT was significantly shorter (delta = -0.5 sec) at expiratory breathhold (P = 0.03). Inspiratory PBF and PBV showed a moderate correlation (r = 0.72 and 0.61, P < or = 0.008) with inspiratory PABF. CONCLUSION: Pulmonary perfusion during breathhold depends on the inspiratory level. Higher perfusion is observed at expiratory breathhold.

Adult↗

Time-resolved contrast-enhanced three-dimensional magnetic resonance angiography of the chest: combination of parallel imaging with view sharing (TREAT).

RATIONALE AND OBJECTIVES: In view sharing, some parts of k-space are updated more often than others, leading to an effective shortening of the total acquisition time. Undersampling of high-frequency k-space data, however, can result in artifacts at the edges of blood vessels, especially during the rapid signal intensity changes. The objective of this study was to evaluate a new time-resolved echo-shared angiographic technique (TREAT) combining parallel imaging with view sharing. First, the presence of artifacts arising from different temporal interpolation schemes was evaluated in simulations of the point spread function. Second, the image quality and presence of artifacts of time-resolved parallel three-dimensional magnetic resonance angiography (3D MRA) of the chest, acquired with and without view sharing, was assessed in a clinical study of patients with cardiovascular or pulmonary disease. MATERIALS AND METHODS: Using parameters from a time-resolved parallel 3D MRA sequence without view sharing (parallel MRA), giving a 33% increase in spatial resolution, our simulations have revealed that k-space segmentation in 3 regions provides acceptable artifacts. Thirty-six consecutive patients (mean age, 50 +/- 16 years; 15 females, 22 males) were examined in a clinical study with TREAT. The image data were compared with that of a group of 31 consecutive patients (mean age, 46 +/- 19 years; 12 females, 19 males) examined with a conventional time-resolved parallel MRA sequence without view sharing (parallel MRA). The image quality and presence of artifacts was assessed in a blind comparison by 2 radiologists in consensus using MPR and MIP reconstructions. Furthermore, the peak SNR of the pulmonary artery and aorta was compared between both MRA sequences. RESULTS: The image quality of TREAT was rated significantly higher than that of the parallel MRA sequence without view sharing: depending on the orientation of MPR and MIP reconstructions, an excellent image quality was found in 69-89% with TREAT and in 45-71% with the parallel MRA protocol without view sharing, respectively. The presence of artifacts was equal with both sequences. CONCLUSION: View sharing can be successfully combined with other acceleration techniques, such as parallel imaging. TREAT allows the assessment of the thoracic vasculature with a high temporal and spatial resolution.

Cardiovascular Diseases↗

Volumetric computed tomography (VCT): a new technology for noninvasive, high-resolution monitoring of tumor angiogenesis.

Volumetric computed tomography (VCT) is a technology in which area detectors are used for imaging large volumes of a subject with isotropic imaging resolution. We are experimenting with a prototype VCT scanner that uses flat-panel X-ray detectors and is designed for high-resolution three-dimensional (3D) imaging. Using this technique, we have demonstrated microangiography of xeno-transplanted skin squamous cell carcinomas in nude mice. VCT shows the vessel architecture of tumors and animals with greater detail and plasticity than has previously been achieved, and is superior to contrast-enhanced magnetic resonance (MR) angiography. VCT and MR images correlate well for larger tumor vessels, which are tracked from their origin on 3D reconstructions of VCT images. When compared with histology, small tumor vessels with a diameter as small as 50 microm were clearly visualized. Furthermore, imaging small vessel networks inside the tumor tissue improved discrimination of vital and necrotic regions. Thus, VCT substantially improves imaging of vascularization in tumors and offers a promising tool for preclinical studies of tumor angiogenesis and antiangiogenic therapies.

Animals↗

Analysis of intrathoracic tumor mobility during whole breathing cycle by dynamic MRI.

PURPOSE: To assess diaphragm, lung region, and tumor mobility during the whole breathing cycle using dynamic MRI. A generalized safety margin concept for radiotherapy planning was calculated and compared with an individualized concept. METHODS AND MATERIALS: The breathing cycles of 20 patients with solitary lung tumors (15 Stage I non-small-cell lung carcinoma, 5 small solitary metastases) were examined with dynamic MRI (true Fast imaging with steady precision, three images per second). The deep inspiratory and expiratory positions of the diaphragm, upper, middle, and lower lung regions, and the tumor were measured in three dimensions. The mobility of tumor-bearing and corresponding tumor-free regions was compared. Tumor mobility in quiet respiration served as an MRI-based safety margin concept. RESULTS: The motion of the lung regions was significantly greater in the lower regions than in the upper regions (5 +/- 2 cm vs. 0.9 +/- 0.4 cm, p < 0.05). Tumor-bearing lung regions showed a significantly lower mobility than the corresponding noninvolved regions (p < 0.05). In quiet respiration, tumor mobility showed a high variability; a safety margin of 3.4 mm in the upper, 4.5 mm in the middle, and 7.2 mm in the lower region was calculated. CONCLUSION: Dynamic MRI is a simple, noninvasive method to evaluate intrathoracic tumor mobility for therapy planning. Because of the high variability of tumor mobility, an individual safety margin is recommended.

Adult↗

Measurement of diaphragmatic length during the breathing cycle by dynamic MRI: comparison between healthy adults and patients with an intrathoracic tumor.

The purpose of this study was to assess diaphragmatic length and shortening during the breathing cycle in healthy volunteers and patients with a lung tumor using dynamic MRI (dMRI). In 15 healthy volunteers and 28 patients with a solitary lung tumor, diaphragmatic motion and length were measured during the breathing cycle using a trueFISP sequence (three images per second in the coronal and sagittal plane). Time-distance curves and maximal length reduction (= shortening) of the diaphragm were calculated. The influence of tumor localization on diaphragmatic shortening was examined. In healthy volunteers maximal diaphragmatic shortening was 30% in the coronal and 34% in the sagittal orientation, with no difference between both hemithoraces. Tumors of the upper and middle lung region did not affect diaphragmatic shortening. In contrast, tumors of the lower lung region changed shortening significantly ( P<0.05). In hemithoraces with a tumor in the lower region, shortening was 18% in the coronal and 19% in the sagittal plane. The ratio of diaphragmatic length change from inspiration to expiration changed significantly from healthy subjects (inspiration length >> expiratory length, P<0.05) to patients with a tumor in the lower lung region (inspiratory length = expiratory length). dMRI is a simple, non-invasive method to evaluate diaphragmatic motion and shortening in volunteers and patients during the breathing cycle. Tumors of the lower lung region have a significant influence on shortening of the diaphragm.

Adult↗

3D pulmonary perfusion MRI and MR angiography of pulmonary embolism in pigs after a single injection of a blood pool MR contrast agent.

The purpose of this study was to assess the feasibility of contrast-enhanced 3D perfusion MRI and MR angiography (MRA) of pulmonary embolism (PE) in pigs using a single injection of the blood pool contrast Gadomer. PE was induced in five domestic pigs by injection of autologous blood thrombi. Contrast-enhanced first-pass 3D perfusion MRI (TE/TR/FA: 1.0 ms/2.2 ms/40 degrees; voxel size: 1.3 x 2.5 x 4.0 mm3; TA: 1.8 s per data set) and high-resolution 3D MRA (TE/TR/FA: 1.4 ms/3.4 ms/40 degrees; voxel size: 0.8 x 1.0 x 1.6 mm3) was performed during and after a single injection of 0.1 mmol/kg body weight of Gadomer. Image data were compared to pre-embolism Gd-DTPA-enhanced MRI and post-embolism thin-section multislice CT (n = 2). SNR measurements were performed in the pulmonary arteries and lung. One animal died after induction of PE. In all other animals, perfusion MRI and MRA could be acquired after a single injection of Gadomer. At perfusion MRI, PE could be detected by typical wedge-shaped perfusion defects. While the visualization of central PE at MRA correlated well with the CT, peripheral PE were only visualized by CT. Gadomer achieved a higher peak SNR of the lungs compared to Gd-DTPA (21 +/- 8 vs. 13 +/- 3). Contrast-enhanced 3D perfusion MRI and MRA of PE can be combined using a single injection of the blood pool contrast agent Gadomer.

Animals↗

Assessment of pulmonary hypertension by CT and MR imaging.

In the recent World Health Organization (WHO) classification the group of pulmonary arterial hypertension (PH) comprises the classic primary pulmonary hypertension and several conditions with definite or very high risk factors to develop pulmonary arterial hypertension. Therapeutic advances drive the need for a comprehensive pre-therapeutic evaluation for optimal treatment. Furthermore, follow-up examinations need to be performed to monitor changes in disease status and response to therapy. Up to now, the diagnostic imaging work-up of PH comprises mainly echocardiography, invasive right heart catheterization and ventilation/perfusion scintigraphy. Due to technical advances helical computed tomography (CT) and magnetic resonance imaging (MRI) became more important in the evaluation and for differential diagnosis of pulmonary arterial hypertension. Both modalities are reviewed and recommendations for clinical use are given.

Heart Diseases↗

Ascorbic acid increases the severity of spontaneous knee osteoarthritis in a guinea pig model.

OBJECTIVE: To determine whether ascorbic acid might be of benefit for the treatment of spontaneous osteoarthritis (OA) when administered over a long period of time. METHODS: We investigated the effects of 8 months' exposure to low, medium, and high doses of ascorbic acid on the in vivo development of histologic knee OA in the male Hartley guinea pig. The low dose represented the minimum amount needed to prevent scurvy. The medium dose was the amount present in standard laboratory guinea pig chow and resulted in plasma levels comparable with those achieved in a person consuming 200 mg/day (5 fruits and vegetables daily). The high dose was the amount shown in a previous study of the guinea pig to slow the progression of surgically induced OA. RESULTS: We found an association between ascorbic acid supplementation and increased cartilage collagen content but, in contrast to findings in a previous study of surgically induced OA in the guinea pig, ascorbic acid worsened the severity of spontaneous OA. Active transforming growth factor beta (TGF beta) was expressed in marginal osteophytes, whose size and number were significantly increased with increasing intake of ascorbic acid. Synovial fluid levels of cartilage oligomeric matrix protein, a biomarker of cartilage turnover, corroborated the histologic findings. CONCLUSION: Ascorbic acid has been shown to activate latent TGF beta. Prolonged intraarticular exposure to TGF beta has been shown to cause OA-like changes. We found expression of active TGF beta in osteophytes, a prominent feature of the joint histology seen in association with ascorbic acid treatment. Thus, the deleterious effects of prolonged ascorbic acid exposure may be mediated in part by TGF beta. This worsening of OA with ascorbic acid supplementation suggests that ascorbic acid intake should not be supplemented above the currently recommended dietary allowance (90 mg/day for men and 75 mg/day for women).

Animals↗

Time-resolved contrast-enhanced three-dimensional pulmonary MR-angiography: 1.0 M gadobutrol vs. 0.5 M gadopentetate dimeglumine.

PURPOSE: To compare contrast characteristics and image quality of 1.0 M gadobutrol with 0.5 M Gd-DTPA for time-resolved three-dimensional pulmonary magnetic resonance angiography (MRA). MATERIALS AND METHODS: Thirty-one patients and five healthy volunteers were examined with a contrast-enhanced time-resolved pulmonary MRA protocol (fast low-angle shot [FLASH] three-dimensional, TR/TE = 2.2/1.0 msec, flip angle: 25 degrees, scan time per three-dimensional data set = 5.6 seconds). Patients were randomized to receive either 0.1 mmol/kg body weight (bw) or 0.2 mmol/kg bw gadobutrol, or 0.2 mmol/kg bw Gd-DTPA. Volunteers were examined three times, twice with 0.2 mmol/kg bw gadobutrol using two different flip angles and once with 0.2 mmol/kg bw Gd-DTPA. All contrast injections were performed at a rate of 5 mL/second. Image analysis included signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) measurements in lung arteries and veins, as well as a subjective analysis of image quality. RESULTS: In patients, significantly higher SNR and CNR were observed with Gd-DTPA compared to both doses of gadobutrol (SNR: 35-42 vs.17-25; CNR 33-39 vs. 16-23; P < or = 0.05). No relevant differences were observed between 0.1 mmol/kg bw and 0.2 mmol/kg bw gadobutrol. In volunteers, gadobutrol and Gd-DTPA achieved similar SNR and CNR. A significantly higher SNR and CNR was observed for gadobutrol-enhanced MRA with an increased flip angle of 40 degrees. Image quality was rated equal for both contrast agents. CONCLUSION: No relevant advantages of 1.0 M gadobutrol over 0.5 M Gd-DTPA were observed for time-resolved pulmonary MRA in this study. Potential explanations are T2/T2*-effects caused by the high intravascular concentration when using high injection rates.

Adult↗