Gadolinium as a CT Contrast Agent: An Experimental Study for the Effects of Injection Parameters in the Rabbit Brain Model

ABSTRACT

PURPOSE: We wanted to investigate the use of gadolinium based contrast agent (Gd-DTPA) for computed tomography (CT), and we also wanted to assess the effects of valuable injection parameters on enhancement in an experimental rabbit brain model. MATERIALS AND METHODS: In vitro, attenuation measurements of serial dilutions of Gd-DTPA and iopromide were compared. In five rabbits, single level dynamic gadolinium-enhanced brain CT studies were obtained using different injection parameters. A comparison CT scan after iopromide administration was performed. The time-attenuation curves of the brain vessel and parenchyma were obtained and the magnitude of enhancement (Hmax) and the time to peak enhancement (Tmax) were analyzed. RESULTS: In vitro, the attenuation coefficient of undiluted Gd-DTPA (2,578 HU) was higher than that of iopromide (1,761 HU) at equimolar concentrations. In 5 rabbits, the time-attenuation curve demonstrated a distinct pattern with peak enhancement only in the brain vessel, but not in the brain parenchyma. There was increasing linear relationship between the injection rate of Gd-DTPA and Hmax, and a declining linear relationship with Tmax. The higher the concentration of Gd-DTPA, the higher Hmax was, but no significant difference was found for the Tmax. Higher volumes of Gd-DTPA revealed a higher Hmax and a delayed Tmax. CONCLUSION: Enhancement of the brain parenchyma on gadolinium-enhanced CT is minimal, while enhancement of the brain vessels is distinctive. The most important factor affecting Hmax of the vessel is the concentration of the contrast medium and the most important factor affecting Tmax of the vessel is volume of the contrast medium. The gadolinium-based contrast agent may be an reasonable alternative contrast agent for brain CT, and especially in cerebral vessels, and it may also be advantageous for brain parenchyma of those patients with BBB dysfunction.