Equilibrium‐phase MR angiography: Comparison of unspecific extracellular and protein‐binding gadolinium‐based contrast media with respect to image quality

The purpose of this study was to compare contrast and image quality of whole‐body equilibrium‐phase high‐spatial‐resolution MR angiography using a non‐protein‐binding unspecific extracellular gadolinium‐based contrast medium with that of two contrast media with different protein‐binding properties. 45 patients were examined using either 15 mL of gadobutrol (non‐protein‐binding, n = 15), 32 mL of gadobenate dimeglumine (weakly protein binding, n = 15) or 11 mL gadofosveset trisodium (protein binding, n = 15) followed by equilibrium‐phase high‐spatial‐resolution MR‐angiography of four consecutive anatomic regions. The time elapsed between the contrast injection and the beginning of the equilibrium‐phase image acquisition in the respective region was measured and was up to 21 min. Signal intensity was measured in two vessels per region and in muscle tissue. Relative contrast (RC) values were calculated. Vessel contrast, artifacts and image quality were rated by two radiologists in consensus on a five‐point scale. Compared with gadobutrol, gadofosveset trisodium revealed significantly higher RC values only when acquired later than 15 min after bolus injection. Otherwise, no significant differences between the three contrast media were found regarding vascular contrast and image quality. Equilibrium‐phase high‐spatial‐resolution MR‐angiography using a weakly protein‐binding or even non‐protein‐binding contrast medium is equivalent to using a stronger protein‐binding contrast medium when image acquisition is within the first 15 min after contrast injection, and allows depiction of the vasculature with high contrast and image quality. The protein‐binding contrast medium was superior for imaging only later than 15 min after contrast medium injection. Copyright © 2015 John Wiley & Sons, Ltd.