Akihiko Kanki1, Tsutomu Tamada1, Ayumu Kido1, Kazuya Yasokawa1, Tomohiro Sato1, Daigo Tanimoto1, Minoru Hayashida1, Akira Yamamoto1, and Katsuyoshi Ito1
1Radiology, Kawaski Medical school, Kurashiki, Japan
Synopsis
The purpose of our study was to clarify the
relationship between transient severe motion in arterial phase imaging (TSMA)
and changes in SpO2 after contrast media administration during gadoxetic acid-enhanced
MRI or CT. As the
results, the decrease in SpO2 in arterial phase compared with other
phases was less than 1% in both contrast media. The incidence of TSMA was 0% in
iodinated contrast media and was 8.2% in gadoxetic acid, respectively. Our
study suggests that the cause of TSM in dynamic gadoxetic acid-enhanced MR
imaging of the liver may be the ringing artifacts rather than the
respiratory-related motion artifacts.
Purpose:
The incidence of transient
severe motion in arterial phase imaging (TSMA) after intravenous
gadolinium-based contrast media administration ranges between 4.8% and 18.3%
for gadoxetic acid compared with a 0.5% to 2% incidence for gadobenate dimeglumine1-5. Although the cause of this phenomenon is
unknown, it is thought that transient decrease of arterial oxygen saturation (SpO2) in the arterial-phase causes TSMA1, 3-7. In addition, no studies regarding the
TSMA in CT have been reported to date. The aim of this study was to clarify the
relationship between TSMA and changes in SpO2 and heart rate (HR) after contrast media
administration during MRI or CT.
Methods
and Materials: A total of
87 MR (1.5-T or 3-T MR scanners) or CT examinations (64- multidetector CT
scanner) in 87 patients were evaluated, 61 performed with gadoxetic acid and 26
performed with iodinated contrast media (a weight-based dose in both contrast
agents). All dynamic contrast-enhanced imaging (DCEI) were obtained at
breath-hold four vascular phase acquisitions including nonenhanced-, arterial-,
portal- and late (or equilibrium)-phases. The SpO2 and HR in all patients were measured every
one second during the dynamic study via an index finger using a pulse oximetry
at spine position. Reviewers extracted the segmental data of SpO2 and HR in each phase from consecutive data
in DCE-CT or DCE-MRI, and calculated the mean value of SpO2 and HR in each phase. In addition, reviewers
scored for respiratory motion in each phase by using a standard scoring system
(1=no, 2=minimal, 3=moderate, 4=severe, 5=extensive motion artifact). Gadoxetatic
acid or iodinated contrast media administrations
associated with an unenhanced score of 1–2, an arterial score of 4–5, and
portal or late (or equilibrium) -phase scores of 1–3 were considered to be
exhibiting TSMA.
Results: In patients with gadoxetic acid, mean SpO2
of arterial-phase was significantly lower than the 3 other phases (P = 0.045 to
P < 0.001). Mean SpO2 of arterial-phase in patients with
iodinated contrast media was also lower than noncontrast- and portal-phases (P
= 0.014 to P = 0.052). However, the decrease in SpO2 in arterial
phase compared with other phases was less than 1% in both contrast media. The
HR in patients with gadoxetic acid or iodinated contrast media was highest in
the portal-phase, and mean HR of portal-phase was significantly higher than the
3 other phases (P = 0.001 to P < 0.001). The incidence of TSM was 0% in
patients with iodinated contrast media and was 8.2% (5/61 patients; TSM group)
in patients with gadoxetic acid, respectively. In addition, there was no
significant difference in mean SpO2 of AP between the TSM group
(97.5%±1.08%) and non-TSM group (96.4%±1.85%) (p = 0.219).
Conclusions: The slight decrease in SpO2
in the arterial-phase is not associated with TSMA in dynamic gadoxetic
acid-enhanced MR imaging of the liver.
Acknowledgements
No acknowledgement found.References
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