1 M Gd-chelate (gadobutrol) for multislice first-pass magnetic resonance myocardial perfusion imaging

doi:10.1259/bjr/34610669

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1 M Gd-chelate (gadobutrol) for multislice first-pass magnetic resonance myocardial perfusion imaging

M Fenchel, MD ¹ A Franow, MD ¹ P Martirosian, PhD ¹ M Engels, BS ¹ U Kramer, MD ¹ N I Stauder, MD ¹ U Helber, MD ² H Vogler, MD ³ C D Claussen, MD ¹ and S Miller, MD ¹

Departments of ¹ Diagnostic Radiology and² Internal Medicine, Eberhard-Karls-University, Tuebingen and³ Schering AG, Berlin, Germany

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Figure 1. (a) T₁ relaxation- and (b) T₂ relaxation-rate curve for gadopentetate (Gd-DTPA; solid line) and gadobutrol (dashed line). (c) Ratio of signal intensity from phantom measurements using a SR-TrueFISP (repetition time (TR) 2.4 ms, echo time (TE) 1.2 ms, matrix 72x128, field-of-view (FOV) 225x300 mm, slice thickness 8 mm, flip angle 45°, bandwidth (BW) 1300 Hz pixel^–1) perfusion sequence (SI_gadobutrol/SI_Gd-DTPA).

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Figure 2. 59-year-old male patient without evidence of coronary artery disease (CAD). Three early images from a perfusion series of 40 images in short-axis angulations are shown using a SR-TrueFISP sequence (repetition time (TR) 2.4 ms, echo time (TE) 1.2 ms, matrix 72x128, field-of-view (FOV) 225x300 mm, slice thickness 8 mm, flip angle 45°, bandwidth (BW) 1300 Hz pixel^–1) after injection of 0.05 mmol kg^–1 gadobutrol. Note the circular appearance of the subendocardial susceptibility artefact. Artefacts are significantly shorter and are limited to the endocardium–blood interface compared with perfusion deficits.

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Figure 3. 77-year-old male patient with one-vessel coronary artery disease (CAD) (LAD 90%). Rest/stress perfusion series (8 of 40 images) in short-axis angulations are shown using a SR-TrueFISP sequence (see Figure 2

for parameters) after injection of 0.05 mmol kg^–1 gadobutrol. (a) Besides homogeneous enhancement of the left ventricular myocardium, a circumscribed septal perfusion deficit can be observed in rest examinations (arrowheads). (b) An increased stress-induced perfusion deficit (white arrows) is diagnosed in the anterior septal part of the left ventricle. (c) Corresponding coronary angiography depicting the high-grade LAD stenosis.

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Figure 4. 67-year-old male patient with three-vessel coronary artery disease (CAD) (LAD 50%, RCX 70%, RCA 100%). Rest/stress perfusion series (8 of 40 images) in short-axis angulations are shown using a SR-TrueFISP sequence (see Figure 2

for parameters) after injection of 0.05 mmol kg^–1 gadobutrol. (a) Homogeneous enhancement of the left ventricular myocardium is evident in rest examinations. (b) A stress-induced perfusion deficit (white arrows) is visible in the inferior lateral part of the left ventricle. (c) Corresponding coronary angiography demonstrating the RCA occlusion and high-grade RCX stenosis.