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Background  Contrast-enhanced cardiac magnetic resonance (CMR) is pivotal for evaluating chronic myocardial infarction (CMI). Concerns about safety of gadolinium-based contrast agents favour dose reduction. We assessed image quality of scar tissue in CMRs performed with different doses of gadobutrol in CMI patients.    Methods  Informed consent was waived for this Ethics Committee-approved single-centre retrospective study. Consecutive contrast-enhanced CMRs from CMI patients were retrospectively analysed according to the administered gadobutrol dose (group A, 0.10 mmol/kg; group B, 0.15 mmol/kg; group C, 0.20 mmol/kg). We calculated the signal-to-noise ratio for scar tissue (SNR scar ) and contrast-to-noise ratio between scar and either remote myocardium (CNR scar-rem ) or blood (CNR scar-blood ).    Results  Of 79 CMRs from 79 patients, 22 belonged to group A, 26 to group B, and 31 to group C. The groups were homogeneous for age, sex, left ventricular morpho-functional parameters, and percentage of scar tissue over whole myocardium ( p  ≥ 0.300). SNR scar  was lower in group A (46.4; 40.3–65.1) than in group B (70.1; 52.2–111.5) ( p  = 0.013) and group C (72.1; 59.4–100.0) ( p  = 0.002), CNR scar-rem  was lower in group A (62.9; 52.2–87.4) than in group B (96.5; 73.1–152.8) ( p  = 0.008) and in group C (103.9; 83.9–132.0) ( p  = 0.001). No other significant differences were found ( p  ≥ 0.335).    Conclusions  Gadobutrol at 0.10 mmol/kg provides inferior scar image quality of CMI than 0.15 and 0.20 mmol/kg; the last two dosages seem to provide similar LGE. Thus, for CMR of CMI, 0.15 mmol/kg of gadobutrol can be suggested instead of 0.20 mmol/kg, with no hindrance to scar visualisation. Dose reduction would not impact on diagnostic utility of CMR examinations.

european radiology experimental

Image quality of late gadolinium enhancement in cardiac magnetic resonance with different doses of contrast material in patients with chronic myocardial infarction