Dynamic and delayed contrast enhancement in upper abdominal MRI studies: Comparison of gadoxetic acid and gadobutrol

Abstract 

Objective

To prospectively compare contrast properties of extracelullar (gadobutrol) and hepatospecific (gadoxetic acid) contrast agents in upper abdominal MRI studies.

Materials and methods

Standardized (0.1ml/kg) dose of gadobutrol (56 subjects) and gadoxetic acid (51 subjects) was administered intravenously by MRI-compatible injector at 2ml/s, followed by 20ml saline flush. MR signal intensity changes (SIC) between precontrast scans and arterial phase, portal venous phase, equilibrium, and delayed scans at 10 and 20min were measured in abdominal aorta, portal vein, common bile duct, liver, and spleen. Mean SIC values for gadobutrol and gadoxetic acid were compared by a two-sample t-test with p-value <0.05 considered significant.

Results

In abdominal aorta, the mean SIC in the arterial phase did not significantly differ between gadobutrol (330%) and gadoxetic acid (295%). In portal vein, the mean SIC in the portal venous phase significantly differed between gadobutrol (267%) and gadoxetic acid (176%). Liver parenchyma enhancement was significantly higher for gadobutrol than for gadoxetic acid in both arterial phase (28 versus 13%) and portal venous phase (81 versus 46%). On the contrary, gadobutrol reached significantly lower mean SIC in the liver on delayed scans at 10min (47 versus 59%) and 20min (40 versus 67%), as well as in common bile duct at 10min (54 versus 133%) and 20min (57 versus 457%), respectively. In the spleen, mean SIC for gadobutrol was significantly higher at all phases.

Conclusion

Gadobutrol showed superior enhancement of upper abdominal structures in the dynamic phases whereas gadoxetic acid showed better enhancement of the hepatobiliary structures on delayed scans.

Keywords: Magnetic resonance imaging, Contrast media, Comparative study, Gadobutrol, Gadoxetic acid disodium, Gd-EOB-DTPA