Spiral flow-generating tube for saline chaser improves aortic enhancement in Gd-EOB-DTPA-enhanced hepatic MRI.

To evaluate the effect of a spiral tube on contrast enhancement in the hepatic arterial phase (HAP) of gadoxetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI). In this retrospective study, we observed 104 patients who underwent dynamic MRI of the liver between October 2017 and December 2017. Three Gd-EOB-DTPA injection protocols were compared: (A) conventional method (undiluted Gd-EOB-DTPA, injection rate 1 ml/s, n = 36); (B) spiral dilution method (1:1 diluted Gd-EOB-DTPA with saline [off-label], injection rate 2 ml/s via spiral tube, n = 38); (C) spiral-flushed method (undiluted Gd-EOB-DTPA, injection rate 1 ml/s via spiral tube, n = 30). We regarded protocol-A as a control. The signal-to-noise ratio (SNR) of the abdominal aorta was calculated using arterial phase images. Image contrast and artefacts were evaluated by two board-certified radiologists, using a four-point scale. Statistical analyses included Dunnett's test, the Kruskal-Wallis test and the Steel test. The SNR of the aorta was significantly higher with protocol-C (25.4 ± 8.8) than protocol-A (20.8 ± 5.4, p = 0.01). There was no significant difference in SNR between protocols A and B (p = 0.47). The contrast score of protocol-C was significantly higher than that of protocol-A (p = 0.0019). There was no significant difference in contrast score between protocols A and B (p = 0.50). There was no significant difference in artefacts among the three protocols (p = 0.96). Use of a spiral tube with a slow injection protocol contributed to improved aortic contrast enhancement in the HAP of GD-EOB-DTPA-enhanced hepatic MRI. • Gadoxetic acid shows weaker arterial enhancement at recommended doses, compared with nonspecific gadolinium agents; selection of an appropriate injection protocol is important. • A spiral flow-generating tube improves the transport efficiency of the contrast media, and increases the signal-to-noise ratio of the aorta in hepatic arterial phase. • A spiral flow-generating tube does not contribute to artefact reduction in hepatic arterial phase.

Citation

Ayumi Iyama, Takeshi Nakaura, Yuji Iyama, Masafumi Kidoh, Yasunori Nagayama, Seitaro Oda, Daisuke Utsunomiya, Tomohiro Namimoto, Kosuke Morita, Koji Yuba, Yasuyuki Yamashita. Spiral flow-generating tube for saline chaser improves aortic enhancement in Gd-EOB-DTPA-enhanced hepatic MRI. European radiology. 2019 Apr;29(4):2009-2016

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PMID: 30255255

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