Rofo 2009; 181 - A7
DOI: 10.1055/s-0028-1124038

High Spatial Resolution and High Contrast Visualization of Brain Arteries and Veins: Impact of Blood-Pool Contrast Agent and Water-Selective Excitation Imaging

E Spuentrup 1, JE Jacobs 1, J Kleimann 1, W Möller-Hartmann 1, G Brinker 2, M Loehr 2, RI Ernestus 2, KJ Lackner 1
  • 1Department of Radiology, University of Cologne, Cologne, Germany
  • 2Department of Neurosurgery, University of Cologne, Cologne, Germany

Purpose: To assess the impact of a blood-pool contrast agent (Gadofosveset) and water-selective excitation for high spatial resolution and high contrast visualization of brain arteries and veins.

Materials and Methods: 48 patients (46±17 years old) scheduled for brain MRI including the assessment of the brain vessels (arteries and veins, i.e. prior to brain surgery etc) were included. 24 patients received standard extracellular Gd-DOTA (Dotarem®, 0.1mmol/kgBW) and 24 received the blood-pool contrast agent Gadofosveset (Vasovist®). All patients were investigated with two high spatial resolution gradient echo sequences: A standard RF spoiled gradient echo sequence (HR-FFE, TR/TE 5.1/2.3ms, FA30°) and a fat-suppressed gradient echo sequence with water selective excitation (FS-FFE, 1331 binominal prepulse resulting in a fat suppression and subsequent water selective excitation, TR/TE 8.8/3.9ms, FA 30°). Identical geometry data for both sequences were used (280 0.6mm thick slices (including zero filling) covering the entire brain, 0.6×0.6mm2 in plane resolution). Data were acquired in random order 10 minutes after contrast agent administration to allow for imaging in the equilibrium phase. To obtain similar scanning durations, for the FS-FFE parallel imaging with SENSE 2 was utilized resulting in a 4:43min scanning time, while for the HR-FFE SNESE without acceleration (SENSE 1, 5:27min scanning time) was applied. All studies were carried out on a clinical 3T whole body MR scanner (3T Achieva, Philips Healthcare, Best, The NL) using the 8 channel head coil.

CNR between the vessels (arteries and veins) and the surrounding tissue (white and gray matter was assesses and compared using Students t-test. Visualization of the lesion (tumors n=31, thrombi n=3) in the HR-FFE vs. the FS-FFE sequence was subjectively compared.

Results: CNR in the FS-FFE was significantly superior compared to the HR-FFE for both the contrast agents used (Gd-DOTA and Gadofosveset): CNRarteries vs. gray matter 66±15 and 76±15 vs. 36±11 and 49±10, CNRveins vs. gray matter 51±14 and 66±13 vs. 40±12 and 54±10, CNRarteries vs. white matter 60±14 and 70±14 vs. 33±12 and 46±11, CNRveins vs. white matter 45±14 and 60±12 vs. 37±12 and 51±11, p<0.05 for all comparisons. Lesions were superiorly visualized on the FS-FFE sequence. Furthermore, all CNR values were superior using Gadofosveset compared with Gd-DOTA (p<0.05).

Conclusion: The use of the blood-pool contrast agent Gadofosveset in conjunction with water selective excitation imaging allows for improved high spatial resolution and high contrast visualization of all the brain vessels including the veins.