title: Gadolinium-enhanced three-dimensional MR angiography of the aorta and peripheral arteries: evaluation of a multistation examination using two gadopentetate dimeglumine infusions.
abstract: OBJECTIVE
  Three-dimensional gadolinium-enhanced MR angiography is a rapid and accurate method that can at times image only a limited amount of anatomy during an examination. We evaluated a technique that doubled the anatomy imaged by obtaining two separate gadolinium-enhanced MR angiograms during a single examination.
  
  
  METHODS
  Twenty-three patients referred for MR evaluation of aortic or peripheral vascular disease underwent two successive gadolinium-enhanced three-dimensional MR angiographic examinations during a single MR examination. An injection of 15 ml of gadopentetate dimeglumine was used for the first MR angiogram, and 25 ml was used for the second MR angiogram. The angiograms were quantitatively and qualitatively evaluated to determine the effect of residual gadolinium from the initial MR angiogram on the second angiogram.
  
  
  RESULTS
  The two studies depicted either the entire aorta to the femoral arteries (n = 10) or the distal aorta to the popliteal arteries (n = 13). The total mean gadolinium dose was 0.245 mmol/kg per patient. An average of 15 min elapsed between injections. The value of arterial signal-to-noise ratio (mean, 48.8 versus 56.4) and artery-to-vein contrast-to-noise ratio (mean, 45.5 versus 49.0) increased between the first and second angiograms, respectively. Residual gadolinium elevated the values for venous signal-to-noise ratio (mean, 2.3 versus 7.2) and background-to-muscle signal-to-noise ratio (mean, 5.5 versus 10.1) on the second MR angiogram. Qualitative evaluation by three observers showed no significant differences in diagnostic usefulness or overall image quality between the first and second MR angiograms.
  
  
  CONCLUSIONS
  The use of two low-dose gadolinium-enhanced three-dimensional MR angiograms during a single examination is a feasible approach to increase anatomic coverage when performing gadolinium-enhanced three-dimensional MR angiography of the aorta and peripheral vessels. Although background enhancement is slightly elevated on the second angiogram, such enhancement does not significantly change diagnostic usefulness or overall image quality.
authors.affiliation: Department of Radiology, Harborview Medical Center, University of Washington School of Medicine, Seattle 98104, USA.
authors.forename: J P
authors.initials: JP
authors.lastname: Earls
authors.forename: N H
authors.initials: NH
authors.lastname: Patel
authors.forename: P A
authors.initials: PA
authors.lastname: Smith
authors.forename: S
authors.initials: S
authors.lastname: DeSena
authors.forename: M H
authors.initials: MH
authors.lastname: Meissner
mesh_terms: D000368:Aged; D001018:Aortic Diseases / Q000175:diagnosis*; D003287:Contrast Media / Q000008:administration & dosage; D005240:Feasibility Studies; D005260:Female; D019786:Gadolinium DTPA / Q000008:administration & dosage; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007275:Injections, Intravenous; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D016491:Peripheral Vascular Diseases / Q000175:diagnosis*; D013997:Time Factors
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA