Korean J Radiol.  2009 Oct;10(5):447-454. 10.3348/kjr.2009.10.5.447.

MR Diagnosis of a Pulmonary Embolism: Comparison of P792 and Gd-DOTA for First-Pass Perfusion MRI and Contrast-Enhanced 3D MRA in a Rabbit Model

• Keilholz S
• Bozlar U
• Fujiwara N
• Mata JF
• Berr SS
• Corot C
• Hagspiel K

• KMID: 1093959
• DOI: http://doi.org/10.3348/kjr.2009.10.5.447

Abstract

OBJECTIVE
To compare P792 (gadomelitol, a rapid clearance blood pool MR contrast agent) with gadolinium-tetraazacyclododecanetetraacetic acid (Gd-DOTA), a standard extracellular agent, for their suitability to diagnose a pulmonary embolism (PE) during a first-pass perfusion MRI and 3D contrast-enhanced (CE) MR angiography (MRA). MATERIALS AND METHODS: A perfusion MRI or CE-MRA was performed in a rabbit PE model following the intravenous injection of a single dose of contrast agent. The time course of the pulmonary vascular and parenchymal enhancement was assessed by measuring the signal in the aorta, pulmonary artery, and lung parenchyma as a function of time to determine whether there is a significant difference between the techniques. CE-MRA studies were evaluated by their ability to depict the pulmonary vasculature and following defects between 3 seconds and 15 minutes after a triple dose intravenous injection of the contrast agents. RESULTS: The P792 and Gd-DOTA were equivalent in their ability to demonstrate PE as perfusion defects on first pass imaging. The signal from P792 was significantly higher in vasculature than that from Gd-DOTA between the first and the tenth minutes after injection. The results suggest that a CE-MRA PE could be reliably diagnosed up to 15 minutes after injection. CONCLUSION: P792 is superior to Gd-DOTA for the MR diagnosis of PE.

Keyword

Pulmonary embolism; P792; Angiography, perfusion

MeSH Terms

Animals
Contrast Media/administration & dosage
Heterocyclic Compounds/administration & dosage/*diagnostic use
Imaging, Three-Dimensional
Injections, Intravenous
Magnetic Resonance Angiography/*methods
Magnetic Resonance Imaging/*methods
Organometallic Compounds/administration & dosage/*diagnostic use
Pulmonary Embolism/*diagnosis
Rabbits

Figure

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  Fig. 1 Gd-DOTA (0.1 mmol·kg-1 bw) (top row) and P792-enhanced (0.013 mmol·kg-1 bw) (bottom row) images of normal rabbit lungs at time of peak contrast (A), and 1 minute (B), 5 minutes (C) and 10 minutes (D) after injection.

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  Fig. 2 Average washout curves for Gd-DOTA (diamonds) and P792 (squares) in aorta (A), pulmonary artery (B), right lung (C) and left lung (D). (Dose: Gd-DOTA 0.1 mmol·kg-1 bw, P792 0.013 mmol·kg-1 bw.) Data points for left and right lungs were obtained in rabbits without pulmonary artery occlusion.

• 

  Fig. 3 Gd-DOTA (top row) and P792-enhanced (bottom row) perfusion images of rabbit with obstructed pulmonary artery at time of peak contrast (A) and one minute (B) after injection of contrast agent. Note that fillin of occluded lung occurs for both agents at one minute, likely by systemic collaterals. (Dose: Gd-DOTA 0.1 mmol·kg-1 bw, P792 0.013 mmol·kg-1 bw.)

• 

  Fig. 4 Gd-DOTA (top row) and P792-enhanced (bottom row) images of two different rabbits, acquired at 3 seconds (A), 30 seconds (B), 1 (C), 3 (D), 5 (E), 10 (F) and 15 minutes (G) after contrast injection. (Dose: Gd-DOTA 0.3 mmol·kg-1 bw, P792 0.039 mmol·kg-1 bw.) All images are filmed at identical window settings.

• 

  Fig. 5 P792-enhanced (0.013 mmol·kg-1 bw) images of rabbit during balloon occlusion of left pulmonary artery at time of first pass (A), as well as 5 minutes (B) and 15 minutes (C) after injection.

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