Combined blood pool and extracellular contrast agents for pediatric and young adult cardiovascular magnetic resonance imaging

Joyce Tawfik Johnson*, Joshua D Robinson, Jie Deng, Cynthia K Rigsby

*Corresponding author for this work

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Background: A comprehensive cardiac magnetic resonance (cardiac MR) study including both late gadolinium enhancement (LGE) and MR angiography may be indicated for patients with a history of acquired or congenital heart disease. Objective: To study the novel use of an extracellular agent for assessment of LGE combined with a blood pool contrast agent for detailed MR angiography evaluation to yield a comprehensive cardiac MR study in these patients. Materials and methods: We reviewed clinical cardiac MR studies utilizing extracellular and blood pool contrast agents and noted demographics, clinical data and adverse events. We rated LGE image quality and MR angiography image quality for each vascular segment and calculated inter-rater variability. We also quantified contrast-to-noise ratio (CNR). Results: Thirty-three patients (mean age 13.9 ± 3 years) received an extracellular contrast agent (10 gadobenate dimeglumine, 23 gadopentetate dimeglumine) and blood pool contrast agent (33 gadofosveset trisodium). No adverse events were reported. MRI indications included Kawasaki disease (8), cardiomyopathy and coronary anatomy (15), repaired congenital heart disease (8), and other (2). Mean LGE quality was 2.6 ± 0.6 with 97% diagnostic imaging. LGE quality did not vary by type of contrast agent given (P = 0.07). Mean MR angiography quality score was 4.7 ± 0.6, with high inter-rater agreement (k = 0.6–0.8, P < 0.002). MR angiography quality did not vary by type of contrast agent used (P = 0.6). Conclusion: Cardiac MR studies utilizing both extracellular and blood pool contrast agents are feasible and safe and provide excellent-quality LGE and MR angiography images. The use of two contrast agents allows for a comprehensive assessment of both myocardial viability and vascular anatomy during the same exam.

Original languageEnglish (US)
Pages (from-to)1822-1830
Number of pages9
JournalPediatric Radiology
Volume46
Issue number13
DOIs
StatePublished - Dec 1 2016

Keywords

  • Blood pool contrast agent
  • Cardiac magnetic resonance
  • Children
  • Heart
  • Late gadolinium enhancement
  • Magnetic resonance angiography

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Radiology Nuclear Medicine and imaging

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