Relationship between transient severe motion of the liver in gadoxetic acid or iodinated contrast agent-enhanced imaging and arterial oxygen saturation and heart rate changes

Transient Severe Motion Artifact on Arterial Phase in Gadoxetic Acid-Enhanced Liver Magnetic Resonance Imaging

“…14,[21][22][23][24]27,32 Regarding the MRI techniques used for single arterial phase imaging (Table 2), images were obtained from only 1.5-T scanners in 5 studies, 12,14,15,21,29 from only 3-T scanners in 6 studies, 20,22,23,27,28,32 and from either 1.5-T or 3-T scanners in 8 studies. 7,10,13,15,18,24,25,31 The contrast agent injection speed was 1 mL/s in 9 studies 15,[21][22][23][24][25]27,28,32 and 1.5 mL/s or faster in 5 studies. 7,12,13,15,31 The volume of contrast agent was fixed (10 mL) in 5 studies regardless of the weight of the subjects, 13,15,25,27 whereas it depended on the patient's weight (0.025 or 0.05 mmol/kg) in 9 studies.…”

“…7,12,13,15,31 The volume of contrast agent was fixed (10 mL) in 5 studies regardless of the weight of the subjects, 13,15,25,27 whereas it depended on the patient's weight (0.025 or 0.05 mmol/kg) in 9 studies. 7,12,[21][22][23][24]28,31,32 Of note, weight-adjusted dose administration was adopted in a higher proportion of the Eastern studies (5 of 7 [71.4%]) included in our analysis [21][22][23][24]32 than in the Western studies (4 of 12 [33.3%]). 7,12,28,31 Dilution of contrast agent was not applied in any of the included studies except for 1 study that used diluted contrast in a part of the population.…”

“…The acquisition time of arterial phase imaging was less than 18 seconds in 7 studies, 20,22,23,25,27,29,31 but 18 seconds or more in 3 studies. 7,21,24 Eleven studies used 2 readers for the assessment of TSM, 7,12,13,15,21,22,24,25,27,31,32 and 8 studies used 3 or more readers. 10,14,15,18,20,23,28,29 Regarding the MRI techniques used for multiple arterial phase imaging (Supplementary Table 3, http://links.lww.com/RLI/A642), images were obtained from only 3-T scanners in 5 studies, 20,22,26,27,32 from only 1.5-T scanners in 1 study, 19 and from either 1.5-T or 3-T scanners in 2 studies.…”

“…In all studies, TSM was defined as (a) substantial artifact on the arterial phase (score of 4 or 5 in a 5-point scale, and score of 3 or 4 in a 4-point scale) and (b) no or mild motion artifact (score of 1 or 2) on the other phases (unenhanced, portal venous, and transitional phases), based on the predefined scoring system for the assessment of motion artifact (Supplementary Table 4, http://links.lww.com/RLI/A642). In the studies using single arterial phase imaging, a 5-point scale was used in 14 studies 10,[13][14][15]18,20,21,[23][24][25]27,29,32 and a 4-point scale in 5 studies, 7,12,22,28,31 and 15 studies 10,[12][13][14][15]18,21,[23][24][25]27,29,31,32 considered no or mild motion artifact on phases other than arterial phase (unenhanced, portal venous, and delayed phase) to be prerequisite for the diagnosis of TSM, whereas 4 studies made no consideration of motion artifacts on other phases. 7,20,22,28 Except for 1 study using a 4-point scale, 22 all the studies with multiple arterial phase imaging used a 5-point scale.…”

“…Regarding the patient selection domain, 6 studies showed a high risk of bias because of inappropriate exclusion (n = 5) 10,21,24,26,32 or selective subject enrollment (n = 1), 31 and 4 studies had an unclear risk of bias 13,18,20,23 because it was uncertain whether the subjects were consecutively enrolled. Unclear applicability of patient selection was noted in 1 study, 25 as multiple MRI examinations from the same subjects were included.…”