Gadofosveset trisodium-enhanced magnetic resonance angiography of the left atrium--a feasibility study.
OBJECTIVE
Imaging of the left atrium is regularly performed prior to pulmonary vein isolation. The aim of the study was to evaluate the feasibility of contrast-enhanced high-resolution magnetic resonance angiography (MRA) of the left atrium using the blood-pool contrast agent gadofosveset trisodium in comparison to noncontrast MRA.


METHODS
Twenty consecutive patients were examined by free-breathing electrocardiogram-gated whole-heart MRA (reconstructed spatial resolution, 0.7mm x 0.6mm x 0.8mm) with a noncontrast T2-prepared steady state free precession sequence (T2-prep SSFP) and a gadofosveset trisodium-enhanced inversion-recovery SSFP sequence (CE IR-SSFP). Contrast-to-noise ratio (CNR) of blood in the left atrium was determined. Depiction of the left atrium was rated by two radiologists in consensus. A cardiologist segmented the MR data sets and rated depiction of the left atrium.


RESULTS
Five of 20 patients had irregular breathing patterns with navigator efficiency less than 35% and were excluded from evaluation. CNR was significantly higher for CE IR-SSFP compared with T2-prep SSFP (18.4+/-5.3 vs. 11.7+/-3.5, p<0.01). Depiction of the left atrium by T2-prep SSFP was rated as good in four patients, moderate in ten patients, and poor in one patient, whereas depiction of the left atrium by CE IR-SSFP was rated as excellent in nine patients, good in four patients, and moderate in two patients. CE IR-SSFP allowed for semiautomated segmentation of the left atrium in 15 patients, whereas T2-prep SSFP allowed for segmentation only in ten patients.


CONCLUSIONS
Gadofosveset trisodium-enhanced MRA of the left atrium is feasible with significantly improved image quality compared to noncontrast MRA.
Wagner
Moritz
M
Department of Radiology, Charité - University Hospital, Berlin, Germany. moritz.wagner@charite.de
Rief
Matthias
M
Asbach
Patrick
P
Vogtmann
Thomas
T
Huppertz
Alexander
A
Beling
Mark
M
Butler
Craig
C
Laule
Michael
M
Warmuth
Carsten
C
Taupitz
Matthias
M
Hamm
Bernd
B
Lembcke
Alexander
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D055424:Cardiac-Gated Imaging Techniques; D003287:Contrast Media; D003327:Coronary Disease / Q000473:pathology; D005240:Feasibility Studies; D005260:Female; D005682:Gadolinium; D006325:Heart Atria / Q000473:pathology*; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds; D011667:Pulmonary Veins / Q000473:pathology*
D003287:Contrast Media; D009942:Organometallic Compounds; D005682:Gadolinium; C109932:gadofosveset trisodium