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Three-dimensional Dynamic Susceptibility-weighted Perfusion MR Imaging at 3.0 T: Feasibility and Contrast Agent Dose¹

¹ From the Department of Radiology, University of Bonn, Sigmund-Freud-Strasse 25, D-53105 Bonn, Germany. Received February 24, 2004; revision requested April 30; revision received May 25; accepted June 15. Address correspondence to C.K.K. (e-mail: kuhl@uni-bonn.de).

PURPOSE: To prospectively investigate if T2*-weighted dynamic susceptibility-weighted first-pass perfusion magnetic resonance (MR) imaging is feasible at 3.0 T and which dose of contrast agent is suitable for high-field-strength imaging.

MATERIALS AND METHODS: Informed consent was obtained from all participants; study protocol was approved by the institutional review board. Study included three volunteers (two men, one woman aged 35, 39, and 52 years) and 26 patients (mean age, 49 years ± 12.8 [standard deviation]; range, 19–76 years). Volunteers underwent 3.0-T perfusion MR imaging with 0.20, 0.10, and 0.05 mmol per kilogram body weight of gadopentetate dimeglumine; patients underwent imaging with 0.10- and 0.05-mmol doses. Perfusion MR imaging was performed with three-dimensional echo-shifted echo-planar imaging (repetition time msec/echo time msec, 14/21; isotropic 4 mm³ voxels; 50 dynamic volumes with 30 sections each, covering entire brain at temporal resolution of 1.5 seconds per MR image). Quality of source echo-planar images and perfusion maps was assessed; perfusion maps obtained at studies with different contrast media doses were compared. Quantitative perfusion values and diagnostic sensitivity of perfusion studies with 0.10-mmol dose were compared with results with 0.05-mmol dose. Image quality scores were compared with marginal homogeneity test for multinomial variables (Mantel-Haenszel statistics for ordered categorized values). Signal-to-noise ratio and baseline signal intensity in perfusion studies were tested (Student t test for paired samples). Mean transit time (MTT), negative integral (NI), and maximum T2* effect from region-of-interest analysis were compared (one-tailed Student t test for paired samples). Quantitative data on number of gamma-fitted pixels were compared (t test for paired samples). Difference with P = .05 (t test for paired samples) was considered significant.

RESULTS: Perfusion image quality was satisfactory even in areas close to skull base (47 of 52 images, minor distortions; remaining images, marked distortions). Perfusion imaging with 0.20-mmol dose caused almost complete signal cancellation during first pass, particularly in cortical gray matter, since mean maximum T2* effect of 98%, 99%, and 98% for gray matter was reached such that the accurate calculation of perfusion maps was impossible. With 0.10-mmol dose, the NI and maximum T2* effect were comparable to published data for 1.5-T perfusion imaging with 0.20- and 0.05-mmol doses; perfusion maps of sufficient diagnostic quality were obtained. For gray matter, mean maximum T2* effect was 25.4% ± 9.8 with 0.10-mmol dose and 17.5% ± 9.0 with 0.05-mmol dose. For white matter, mean maximum T2* effect was 15.2% ± 4.5 with 0.10-mmol dose and 7.7% ± 2.9 with 0.05-mmol dose. Difference in maximum signal intensity decrease was significant (P < .01). For NI, the difference between 0.10- and 0.05-mmol doses was significant: For gray matter, mean NI was 3.1 ± 1.60 for 0.10-mmol dose and 1.56 ± 1.16 for 0.05-mmol dose. For white matter, mean NI was 1.35 ± 0.59 with 0.1-mmol dose and 0.59 ± 0.30 with 0.05-mmol dose.

CONCLUSION: With echo-shifted multishot echo-planar imaging, dynamic susceptibility-weighted perfusion MR imaging at high field strength is feasible without relevant image distortions. Compared with contrast agent dose for 1.5 T imaging, the dose for 3.0 T can be reduced to 0.10 mmol.

© RSNA, 2005

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