MRA of the Supraaortic Vasculature: Comparison of Gadobutrol and Gadoterate Meglumine at 1.5 T

John W. Cerne*, Ashitha Pathrose, Alyssa M. Singer, Jackson E. Moore, Ali Serhal, Pascale Aouad, Muhammad Umair, Ann Ragin, Bradley D. Allen, Ryan Avery, Michael Markl, James C. Carr

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Background: Gadobutrol (GB) and gadoterate meglumine (GM) are contrast agents used for contrast-enhanced magnetic resonance angiography (CEMRA). Supraaortic vasculature (SAV) CEMRAs are used to evaluate stroke risk and neurologic symptoms. There is a need to compare the SAV CEMRA image quality obtained with GB and GM. Purpose: To intra-individually compare MRA images obtained with equimolar GB and GM at 1.5 T in the SAV. Study Type: Prospective, crossover. Population: Twenty-eight subjects (54 ± 13 years; 17 female). Field Strength/Sequence: 1.5 T; three-dimensional (3D) gradient recalled echo. Assessment: Quantitative image quality was measured by normalized signal intensity (SIn) [SIn = SI blood/SD blood] and contrast ratio (CR) [CR = SI blood/SI muscle], determined by an observer (JWC) with 1 year of vascular imaging experience. Three radiologists (AS, PA, and MU) with (5, 5, and 6 years of) vascular imaging experience evaluated image quality by Likert-scale ratings (of image impression, wall conspicuity, and artifact absence). Statistical Tests: SIn and CR were compared with paired t-tests or Wilcoxon signed-rank tests and Bland–Altman plots. Qualitative ratings were compared with Wilcoxon signed-rank test. Results: No significant difference in SIn was found between GB and GM. CRs with GB were significantly higher than GM at the right common carotid (6.9 ± 2.5 vs. 4.8 ± 1), left internal carotid (7.3 ± 2 vs. 4.4 ± 1.2), right internal carotid (7.7 ± 2.2 vs. 5 ± 1.1), and left vertebral (6.6 ± 2.2 vs. 4.5 ± 1.1) arteries. Bland–Altman plots showed relatively greater differences between GB and GM at higher CRs and SIns. GM showed significantly higher artifact than GB (3.56 ± 0.52 vs. 3.36 ± 0.46) and significantly lower overall image quality (10.73 ± 1.45 vs. 11.26 ± 1.58) at the left vertebral artery. Data Conclusion: At 1.5 T and equimolar demonstration, GB (0.1 mL/kg, i.e., 0.1 mmol/kg) showed higher CRs in the SAV compared to GM (0.2 mL/kg, i.e., 0.1 mmol/kg) at most vessels. Subjective image quality was not significantly different between the two agents for most vessels. Level of Evidence: 2. Technical Efficacy: Stage 2.

Original languageEnglish (US)
Pages (from-to)440-449
Number of pages10
JournalJournal of Magnetic Resonance Imaging
Issue number2
StatePublished - Aug 2022


  • gadobutrol
  • gadoterate meglumine
  • supraaortic vasculature

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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