Enhancement Characteristics and Impact on Image Quality of Two Gadolinium Chelates at Equimolar Doses for Time-Resolved 3-Tesla MR-Angiography of the Calf Station

Purpose To compare enhancement characteristics and image quality of two macrocyclic gadolinium chelates, gadoterate meglumine and gadobutrol, in low-dose, time-resolved MRA of the calf station. Materials and Methods 100 consecutive patients with peripheral arterial disease (stages II-IV) were retrospectively analysed. Fifty patients were included in each group - 32 men and 18 women for gadobutrol (mean age 67 years) and 34 men, 16 women for gadoterate meglumine (mean age 64 years). 0.03 mmol/kg bw of either gadobutrol or gadoterate meglumine was injected. Gadobutrol was diluted 1∶1 with normal saline (0.9% NaCl) to provide similar injection volume and bolus geometry compared to the undiluted 0.5 M dose of gadoterate meglumine. Signal-to-noise-ratio (SNR), contrast-to-noise-ratio (CNR) and image quality were analysed and compared between the two groups. Results Mean SNR ranged from 83.0±46.7 (peroneal artery) to 96.4±64.5 (anterior tibial artery) for gadobutrol, and from 37.6±13.8 (peroneal artery) to 45.3±16.4 (anterior tibial artery) for the gadoterate meglumine group (p<0.0001). CNR values ranged from 30.1±20.1 (peroneal artery) to 37.6±26.0 (anterior tibial artery) for gadobutrol and from 14.9±8.0 (peroneal artery) to 18.6±16.4 (anterior tibial artery) for gadoterate meglumine (p<0.0001). No significant difference in image quality was found except for the peroneal arteries (p = 0.006 and p = 0.04). Interreader agreement was excellent (kappa 0.87–0.93) Conclusion The significantly better enhancement as assessed by SNR and CNR provided by gadobutrol compared to gadoterate meglumine does not translate into substantial differences in image quality in an equimolar, low-dose, time-resolved MRA protocol of the calves.