Effects of gadolinium contrast agent on aortic blood flow and myocardial strain measurements by phase-contrast cardiovascular magnetic resonance

Abstract

BackgroundQuantitative blood flow and aspects of regional myocardial function such as myocardial displacement and strain can be measured using phase-contrast cardiovascular magnetic resonance (PC-CMR). Since a gadolinium-based contrast agent is often used to measure myocardial infarct size, we sought to determine whether the contrast agent affects measurements of aortic flow and myocardial displacement and strain. Phase-contrast data pre and post contrast agent was acquired during free breathing using 1.5T PC-CMR.ResultsFor aortic flow and regional myocardial function 12 and 17 patients were analysed, respectively. The difference pre and post contrast agent was 0.03 ± 0.16 l/min for cardiac output, and 0.1 ± 0.5 mm for myocardial displacement. Linear regression for myocardial displacement (MD) after and before contrast agent (CA) showed MDpostCA = 0.95MDpreCA+0.05 (r = 0.95, p < 0.001). For regional myocardial function, the contrast-to-noise ratios for left ventricular myocardial wall versus left ventricular lumen were pre and post contrast agent administration 7.4 ± 3.3 and 4.4 ± 8.9, respectively (p < 0.001). The contrast-to-noise ratios for left ventricular myocardial wall versus surrounding tissue were pre and post contrast agent administration -16.9 ± 22 and -0.2 ± 6.3, respectively (p < 0.0001).ConclusionsQuantitative measurements of aortic flow yield equal results both in the absence and presence of gadolinium contrast agent. The total examination time may thereby be reduced when assessing both viability and quantitative flow using PC-CMR, by assessing aortic flow post contrast agent administration. Phase-contrast information for myocardial displacement is also assessable both in the absence and presence of contrast agent. However, delineation of the myocardium may be difficult or impossible post contrast agent due to the lower image contrast. Acquisition of myocardial displacement should therefore be performed pre contrast agent using current PC-CMR sequences.

Effects of contrast administration on cardiac MRI volumetric, flow and pulse wave velocity quantification using manual and software-based analysis

“…33–35 Despite these findings, previous studies have found no significant difference in absolute flow quantification, a finding in contradistinction to our own finding of a slight increase in aortic flow post-contrast administration. 14 The differences in aortic flow quantification, however, were small amounting to only a 2 ml (2.5%) difference before and after contrast administration. Conversely, SA analysis resulted in no such difference.…”

Automated mitral valve vortex ring extraction from 4D‐flow MRI

“…4D‐flow data in patients were assessed after contrast agent, whereas no contrast agent was applied in healthy controls. Even though they affect the SNR of the data, measured velocities and velocity fields should not be affected by contrast agent 7,42,43 …”

“…Even though they affect the SNR of the data, measured velocities and velocity fields should not be affected by contrast agent. 7,42,43 Manual segmentation was performed with prototype software that is optimized for 4D-flow data preprocessing and visualization rather than segmentation, which explains the long manual segmentation times per subject. Segmentation time might be substantially decreased with suitable 4D-flow data segmentation software.…”

Review of journal of cardiovascular magnetic resonance 2010

“…The presence or absence of gadolinium contrast agent in the blood had no demonstrable effect on phase contrast measurements of aortic flow in this study[ 30 ]. Therefore, when assessing blood flow as well as myocardial viability, time may be saved by measuring flow after gadolinium injection and before the acquisition of late gadolinium enhancement images.…”