Effects of Height and Blood Volume on Venous Enhancement After Gadolinium-Based Contrast Administration in MR Venography: A Paradigm Challenge and Implications for Clinical Imaging.
OBJECTIVE
The purpose of this study was to analyze quantitative and qualitative effects of estimated blood volume on venous enhancement in patients undergoing cerebral MR venography (MRV) with standard weight-based dosing of a gadolinium-based contrast agent.


METHODS
Fifty-two patients with normal 1.5-T cerebral MRV findings and contemporaneous height and weight measurements were included. Estimated blood volume was calculated with the Nadler formula for blood volume. Standard weight-based cerebral MRV was performed after administration of gadobenate dimeglumine (0.1 mmol/kg up to 20 mL). Venous enhancement within the superior sagittal sinus, right jugular bulb, and left jugular bulb was measured. Patients were dichotomized on the basis of administration of less than versus a maximum weight-based gadolinium-based contrast dose of 20 mL. Venographic quality was assigned by two neuroradiologists. Correlational and multiple linear regression analyses were performed.


RESULTS
Among patients receiving less than the maximum 20 mL of gadolinium, no significant correlations were observed between weight and vascular enhancement (p > 0.05). Significant correlations between height and enhancement were observed in the superior sagittal sinus and left jugular bulb. This finding suggests that differences in estimated blood volume driven by height remain unaccounted for (p < 0.05). With the 20-mL maximal dose, a significant inverse relation was noted between estimated blood volume and contrast enhancement of all vascular segments (p < 0.05). Within all vascular segments, significant correlations were observed between enhancement and user-defined quality scores (p < 0.05). This finding suggests that optimized dosing may affect reader confidence.


CONCLUSIONS
Standard weight-based dosing for cerebral MRV insufficiently accounts for differences in circulating blood volume. An expanded biometric dosing paradigm leveraging readily attainable subject data may mitigate unintended variations in enhancement affecting venography and other clinical imaging modalities.
1 Department of Radiology and Imaging Sciences, Emory University Hospital, 1364 Clifton Rd NE, B-115, Atlanta, GA 30322.|2 Department of Neurology, Emory University Hospital, Atlanta, GA.
Seena
S
Dehkharghani
1 Department of Radiology and Imaging Sciences, Emory University Hospital, 1364 Clifton Rd NE, B-115, Atlanta, GA 30322.
T Richard
TR
Williams
1 Department of Radiology and Imaging Sciences, Emory University Hospital, 1364 Clifton Rd NE, B-115, Atlanta, GA 30322.
Deqiang
D
Qiu
1 Department of Radiology and Imaging Sciences, Emory University Hospital, 1364 Clifton Rd NE, B-115, Atlanta, GA 30322.
Amit M
AM
Saindane
D000293:Adolescent; D000328:Adult; D000368:Aged; D001810:Blood Volume; D002550:Cerebral Veins; D003287:Contrast Media / Q000008:administration & dosage*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008536:Meglumine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D008875:Middle Aged; D009942:Organometallic Compounds / Q000008:administration & dosage*; D012189:Retrospective Studies
D003287:Contrast Media; D009942:Organometallic Compounds; C064572:gadobenic acid; D008536:Meglumine
contrast-enhanced MR venography; gadolinium dosing; gadolinium safety; venography