Anatomic assessment of pulmonary veins and left atrium - comparison of magnetic resonance angiography with gadoteric aci
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Anatomic assessment of pulmonary veins and left atrium - comparison of magnetic resonance angiography with gadoteric acid, the blood pool contrast agent B22956/1 and a non-contrast enhanced imaging approach Szilard Rona*, Volker Rasche, Georg Grossmann, Sascha Stiller, Nico Merkle From 2011 SCMR/Euro CMR Joint Scientific Sessions Nice, France. 3-6 February 2011 Introduction Pulmonary vein isolation (PVI) is the utmost method to treat patients suffering from symptomatic drug-refractory atrial fibrillation (AF). Non-invasive imaging of the left atrium (LA) and pulmonary veins prior to PVI plays an important role in procedural planning and guiding. Purpose To compare the feasibility and image quality of three magnetic resonance angiographic methods using the blood pool contrast agent B22956/1 (Bracco), the extravascular contrast agent gadoteric acid (Dotarem®, Guerbet) and a non-contrast protocol to evaluate the left atrium and pulmonary veins. Methods We compared 3 different MRI methods. First a noncontrast enhanced T2-prep steady state free precession (SSFP)-sequence, second, a high resolution IR-SSFP sequence with the blood pool contrast agent B22956/1 and third, a breath hold IR-SSFP atriography using the extravascular contrast agent gadoteric acid. Fourteen healthy volunteers (B22956/1-IR-SSFP) and 20 consecutive patients (T2-prep SSFP-sequence and IR-SSFP sequence with gadoteric acid) with history of paroxysmal AF scheduled for PVI were involved in the study. Signal-to-noise ratio (SNR) of blood in the left atrium
and contrast-to-noise ratio (CNR) between left atrial blood and myocardium was assessed in all of the three groups. Furthermore, image quality was assessed by two observers.
Results Regarding SNR there was no significant difference among the three sequences (13,7±3,1 for B22956/1 vs. 11,2±3,2 for gadoteric acid vs. 11,4±4,3 for T2-prepSSFP group, respectively). CNR significantly improved for B22956/1 compared with T2-prep-SSFP (14,8±3,6 vs. 7,1±3,6; p
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