Gadobenate dimeglumine-enhanced MR angiography: Diagnostic performance of four doses for detection and grading of carotid, renal, and aorto-iliac stenoses compared to digital subtraction angiography.
OBJECTIVE
To determine the diagnostic performance of contrast-enhanced MR angiography (CE-MRA) with four doses of gadobenate dimeglumine for detection of significant steno-occlusive disease of the carotid, renal, and pelvic vasculature.


METHODS
Eighty-four patients with suspected disease of the renal (n = 16), pelvic (n = 41), or carotid (n = 27) arteries underwent CE-MRA (3D-spoiled gradient-echo sequences) at 1.5T. CE-MRA was performed with gadobenate dimeglumine at 0.025, 0.05, 0.1, or 0.2 mmol/kg (23, 24, 19, and 18 patients, respectively) administered at 2 mL/sec. Accuracy, sensitivity, specificity, and positive and negative predictive values (PPV and NPV, respectively) for detection of significant disease (>50% stenosis or occlusion for renal/pelvic arteries; >70% stenosis or occlusion for carotid arteries) was determined by three fully blinded, independent radiologists using conventional digital subtraction angiography (DSA) as reference standard. All comparisons were tested statistically (ANOVA, chi-square, and Mantel-Haenszel tests as appropriate) and reader agreement (kappa) was assessed.


RESULTS
Values for accuracy, sensitivity, specificity, PPV, and NPV on CE-MRA were consistently higher for 0.1 mmol/kg gadobenate dimeglumine (accuracy = 95.2-97.3%, sensitivity = 84.2% (all readers), specificity = 96.9-99.2%, PPV = 80.0-94.1%, NPV = 97.6-97.7%). The greater accuracy of the 0.1 mmol/kg dose was significant (P < 0.01, all readers) compared to all other dose groups. Agreement between the three readers was good for all dose groups (kappa >/=0.58), with the highest percent agreement (85.7%) noted for the 0.1 mmol/kg dose.


CONCLUSIONS
Significantly better diagnostic performance on CE-MRA of the renal, pelvic, and carotid arteries is achieved with a gadobenate dimeglumine dose of 0.1 mmol/kg bodyweight.
Schneider
Günther
G
Department of Diagnostic Radiology, University Hospital, Homburg/Saar, Germany.
Ballarati
Claudio
C
Grazioli
Luigi
L
Manfredi
Riccardo
R
Thurnher
Siegfried
S
Kroencke
Thomas J
TJ
Taupitz
Matthias
M
Merlino
Biagio
B
Bonomo
Lorenzo
L
Shen
Ningyan
N
Pirovano
Gianpaolo
G
Kirchin
Miles A
MA
Spinazzi
Alberto
A
D000328:Adult; D000368:Aged; D001024:Aortic Valve Stenosis / Q000175:diagnosis* / Q000473:pathology; D016893:Carotid Stenosis / Q000175:diagnosis* / Q000473:pathology; D003251:Constriction, Pathologic / Q000175:diagnosis* / Q000473:pathology; D003287:Contrast Media / Q000494:pharmacology*; D005260:Female; D006801:Humans; D007083:Iliac Artery / Q000473:pathology*; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008536:Meglumine / Q000031:analogs & derivatives* / Q000494:pharmacology; D008875:Middle Aged; D009942:Organometallic Compounds / Q000494:pharmacology*; D011237:Predictive Value of Tests; D012078:Renal Artery Obstruction / Q000175:diagnosis* / Q000473:pathology; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
D003287:Contrast Media; D009942:Organometallic Compounds; C064572:gadobenic acid; D008536:Meglumine