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Gadobutrol for magnetic resonance imaging of chronic myocardial infarction: intraindividual comparison with gadopentetate dimeglumine.
Gadoptrol 用于慢性心肌梗死的磁共振成像: 与 gadopentetate dimetglumine 的个体内比较。

摘要

OBJECTIVES:To compare 0.15 mmol/kg gadobutrol with 0.20 mmol/kg gadopentetate dimeglumine with regard to late gadolinium enhancement (LGE) of infarcted myocardium at magnetic resonance (MR) imaging.
MATERIALS AND METHODS:Twenty patients with history of chronic myocardial infarction underwent 2 cardiac MR examinations at 1.5 Tesla. For the evaluation of myocardial infarction, late gadolinium enhancement (LGE) imaging was performed with an inversion recovery-prepared gradient-echo sequence 15 minutes after administration of either gadobutrol (r1 = 5.2 mmol(-1)s(-1)) or gadopentetate dimeglumine (r1 = 4.1 mmol(-1)s(-1)). The dose of the contrast agents was adjusted based on the relaxivity of both contrast agents. Hence, gadobutrol and gadopentetate dimeglumine were administered at 0.15 mmol/kg and 0.20 mmol/kg, respectively. Contrast-to-noise ratios (CNR) between infarcted myocardium and remote myocardium (CNR remote) and between infarcted myocardium and left ventricular lumen (CNR lumen) were assessed by 2 independent readers. Additionally, infarct size was assessed semiautomatically by using a threshold of 5 standard deviations above the mean signal intensity of remote myocardium.
RESULTS:Subendocardial or transmural LGE was present in 16 of 20 (80%) patients. The optimal inversion time for LGE imaging did not differ significantly between gadobutrol and gadopentetate dimeglumine (275 ± 21 milliseconds [range, 240-320 milliseconds] and 282 ± 23 milliseconds [range, 240-330 milliseconds], respectively; P = 0.32). The CNR remote after administration of gadobutrol (40.0 ± 4.6; 95% confidence interval [CI]: 30.3; 49.7) and gadopentetate dimeglumine (40.6 ± 4.6; 95% CI: 30.9; 50.3) did not show significant differences (P = 0.90), whereas gadobutrol yielded a significantly higher CNR lumen (6.2 ± 3.6; 95% CI: -1.5; 13.9) compared with gadopentetate dimeglumine (0.8 ± 3.6; 95% CI: -6.9; 8.5). Infarct size after administration of gadobutrol (23.7 ± 4.7 mL; 95% CI: 13.6; 33.7) and gadopentetate dimeglumine (23.7 ± 4.7 mL;95% CI: 13.7; 33.8) was not statistically different (P = 0.94). There was an excellent correlation between gadobutrol- and gadopentetate dimeglumine-enhanced assessment of infarct size (Spearman r = 0.99 and r = 0.97 for reader 1 and 2, respectively).
CONCLUSION:This pilot study shows that 0.15 mmol/kg gadobutrol is an effective contrast agent for LGE imaging with better delineation of infarcted myocardium from left ventricular lumen than 0.20 mmol/kg gadopentetate dimeglumine.

译文

目的: 比较磁共振 (MR) 成像下 0.15 毫摩尔/千克加多布特和 0.20 毫摩尔/千克加多戊二酸二葡胺对梗死心肌的晚期钆增强 (LGE)。
材料和方法: 20 名有慢性心肌梗死病史的患者在 1.5 特斯拉时接受了 2 次心脏磁共振检查。为了评估心肌梗死,晚期钆增强 (LGE) 给药 15 分钟后,用反转恢复准备的梯度回波序列进行成像 (r1 = 5.2 mmol (-1) s (-1)) 或加多戊二酸二葡胺 (r1 = 4.1 mmol (-1) s (-1))。对比剂的剂量是根据两种对比剂的反散率来调整的。因此,gadobutrol 和 gadopentetate dimeglumine 分别以 0.15 mmol/kg 和 0.20 mmol/kg 给药。由 2 名独立读者评估梗死心肌和远端心肌之间以及梗死心肌和左心室腔之间的对比噪声比 (CNR)。此外,通过使用高于远程心肌平均信号强度 5 个标准差的阈值,可以半自动评估梗死面积。
结果: 20 例患者中有 16 例 (80%) 存在心内膜下或跨壁 LGE。对于 LGE 成像的最佳反转时间在加多布洛和加多戊二酸地葡胺 (275 ± 21 毫秒 [范围,240-320 毫秒] 和 282 ± 23 毫秒 [范围, 240-330 毫秒],分别; P = 0.32)。CNR 远程管理后的 gadobutrol (40.0 ± 0.4.6; 95% 置信区间 [CI]: 30.3; 49.7) 和 guadoentetate dimeglumine (40.6 ± 0.4.6; 95% CI: 30.9; 50.3) 没有显示出显著的差异 (P = 0.90),然而 gadobutrol 产生了显著更高的 CNR 管腔 (6.2 ± 3.6;95% 置信区间:-1.5; 13.9) 与 gadopentetate dimeglumine (0.8 ± 3.6; 95% 置信区间:-6.9; 8.5) 比较。服用加多宝后的梗死面积 (23.7 ± 4.7 毫升; 95% CI: 13.6; 33.7) 和 gadopentetate dimeglumine (23.7 ± 4.7 毫升; 95% CI: 13.7; 33.8) 无统计学差异 (P = 0.94)。Gadobutrol-和 gadopentetate dimeglumine-增强的梗死面积评估之间有极好的相关性 (对于 reader 1 和 2,Spearman r = 0.99 和 r = 0.97)。
结论: 这项初步研究表明,0.15 毫摩尔/千克加多布特是 LGE 成像的有效对比剂,比 0.20 毫摩尔/千克加多戊二酸二甲葡胺更好地从左心室腔勾画梗死心肌。

Gadopentetate Dimeglumine

神经 造影剂 治疗药物
概述  :  

钆喷酸葡胺(Gd-DTPA)是目前核磁共振成像(MRI)增强检查中最常用的顺磁性造影剂,进入体内后能缩短组织中质子的T1及T2驰豫时间,从而增强图像的清晰度和对比度。用于中枢神经(脑及脊髓)、腹、胸、盆腔、四肢等人体脏器和组织的磁共振成像。不良反应的发生机制自1988年开始,钆喷酸葡胺注射液在美国经过FDA批准应用于临床,不良反应发生率范围在0.17%~2.4%。本文检索到的国内近十年的发表文献不良反应发生率为0.12%~1.17%,低于国外钆喷酸葡胺注射液的不良反应发生率。Gd-DTPA

gadopentetate

释    义   钆喷酸

例    句   Objective:To revalue the bad reaction and safety of gadopentetate dimeglumine MRI contrast. 目的:评价磁共振成像钆对比剂的不良反应和安全性。


dimeglumine

释    义   二甲葡胺

例    句   Gadopentetate dimeglumine causes one case of serious laryngeal oedema and shock.钆喷酸葡胺引起严重过敏性休克喉水肿1例。

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