Acute Transient Dyspnea in Arterial Gadoxetate-Enhanced Liver Magnetic Resonance Imaging: Depends on Arterial Phase Timing and Potential Risk Factors

Author(s): Kromrey ML, Schorn F, Liedtke KR, Ittermann T, Plodeck V4, Kühn JP

Purpose: To investigate the frequency, influence of arterial phase timing and risk factors for TSM artifacts in arterial phase of gadoxetate-enhanced MRI of the liver.

Materials and Methods: Between 2013-2016, gadoxetate-enhanced liver MRI of 354 patients (196 men, 158 women, mean age 60.8±14.2 years) were retrospectively enrolled. Sixty-nine patients received follow-up. Arterial phase images were evaluated regarding motion artifacts on a four-point scale (0 = no motion artifacts, 1 = minor artifacts, 2 = distinct artifacts, 3 = severe artifacts/non-diagnostic). Occurrence and artifact grading were correlated with arterial phase timing (early, true and late arterial phase), previous TSM and selected risk factors such as patients’ demographics, behaviors and laboratory data.

Results: TSM artifacts occurred in 48.6% (172/354) of the patients. 25.7% (91/354) had distinct (18.4%) or severe (7.3%) image artifacts. Significantly higher incidence of TSM was detected in the true arterial phase (58.8%) compared to early (51.6%) or late arterial phase (42.1%) (p=0.031). Severe artifacts were mainly seen in the true arterial phase (42.3%). Occurrence of TSM was correlated with BMI (p=0.001). Longitudinal analysis showed significant association between TSM at baseline and follow-up (p=0.041).

Conclusion: Severity of TSM in gadoxetic-enhanced MRI is influenced by arterial phase timing, more common in the true arterial phase compared to early or late arterial phases, and is associated with BMI and prior TSM occurrence.