Contrast-enhanced abdominal MR angiography: Optimization of imaging delay time by automating the detection of contrast material arrival in the aorta

PURPOSE: To improve gadolinium-enhanced magnetic resonance (MR) angiogram quality by automatically synchronizing acquisition of central k-space image data with the arterial phase of contrast material bolus infusion. MATERIALS AND METHODS: A spin-echo pulse sequence with orthogonal 90 degrees and 180 degrees pulses was used to monitor signal in a single 4 x 4 x 12-cm voxel that encompassed a segment of aorta. An increase in signal that corresponded to the arrival of gadolinium was used to trigger three-dimensional, spoiled gradient-echo abdominal MR angiography in 50 adult patients. RESULTS: Arterial signal intensity increased 28-fold with automatic compared to 19-fold with manual triggering (P < .05) at an approximate dose of 0.3 mmol/kg. Automatic triggering with a lower dose (approximately 0.2 mmol/kg) resulted in 20-fold arterial enhancement, which is comparable with enhancement after manual triggering at the high dose. In addition, venous enhancement was less (1.5-fold) with automatic than with manual (3.5-fold) triggering at the same dose (P < .05). CONCLUSION Automatic triggering results in improved arterial-to-venous contrast. It increases arterial enhancement or enables MR angiograms to be obtained with less contrast material. The authors now routinely use this technique for aortorenal imaging with a gadolinium-based contrast material dose of 20 mmol (40 mL) in patients who weigh more than 50 kg and 10 mmol (20 mL) in patients who weigh less than 50 kg.