[Whole-body MR angiography: comparison of two protocols for contrast media injection].
OBJECTIVE
To compare two injection strategies for contrast media injection in whole-body MR angiography quantitatively and qualitatively with regard to contrast and image quality.


METHODS
40 patients were examined at 1.5 Tesla using either a single injection protocol or a double injection protocol with two separate bolus injections. Vessel regions I (supraaortic/thoracic), II (abdominal/pelvic), III (upper legs) and IV (lower legs) were examined in the following order: single injection: I, II, III, IV, double injection: I and IV after the first injection, II and III after the second bolus injection. Quantitative evaluation: SI measurements were carried out in 2 arteries per region. Contrast values were calculated. Qualitative evaluation: Evaluation of regions I-IV regarding vessel contrast, venous overlay and image quality on a five-point scale by two reviewers in consensus. The Mann-Whitney-U test was used to test the differences for significance.


RESULTS
Quantitative evaluation: Using the double injection protocol, significantly higher contrast values in regions I and II and significantly lower contrast values in the subregions IIIa (upper part of III) and IVb (lower part of IV) were obtained (p < 0.05). The mean contrast values in subregions IIIb (lower part of III) and IVa (upper part of IV) were lower using the double injection protocol, but not significantly. Qualitative evaluation: Using the double injection protocol, region II was rated significantly higher (mean ratings: 3.55, 3.45 and 3.5 versus 2.7, 2.5 and 2.55; p < 0.05) and region III significantly lower (mean ratings: 3.1, 2, 2.5 versus 3.9, 3.1 and 3.55; p < 0.05) for all three examined criteria. When using the double injection protocol, ratings were significantly lower in region IV regarding vessel contrast and image quality (mean ratings: 2.4 and 2.15 versus 3.45 and 3.15; p < 0.05). The ratings regarding venous overlay in region IV showed no significant differences (mean ratings: 2.15 versus 2.75; p > 0.05).


CONCLUSIONS
Due to the better results in the supraaortic/thoracic and abdominal/pelvic regions, the double injection protocol is preferred. However, both protocols require further improvement.
Institut für Radiologie, Charité Campus Mitte, Charité-Universitätsmedizin Berlin. christian.klessen@charite.de
C
C
Klessen
P
P
Asbach
P A
PA
Hein
A
A
Lembcke
H C
HC
Bauknecht
A
A
Huppertz
T
T
Nentwig
B
B
Hamm
M
M
Taupitz
D000328:Adult; D000368:Aged; D001161:Arteriosclerosis / Q000175:diagnosis*; D002985:Clinical Protocols; D003287:Contrast Media / Q000008:administration & dosage*; D003627:Data Interpretation, Statistical; D005260:Female; D019786:Gadolinium DTPA / Q000008:administration & dosage*; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged
D003287:Contrast Media; D019786:Gadolinium DTPA