Quantitative analysis of late gadolinium enhancement in hypertrophic cardiomyopathy: comparison of diagnostic performance in myocardial fibrosis between gadobutrol and gadopentetate dimeglumine

  • Dongting Liu
  • Xiaohai MaEmail author
  • Jiayi Liu
  • Lei Zhao
  • Hui Chen
  • Lei Xu
  • Zhonghua Sun
  • Zhanming FanEmail author
Original Paper


The purpose of this study was to compare different semi-automated late gadolinium enhancement (LGE) quantification techniques using gadobutrol and gadopentetate dimeglumine contrast agents with regard to the diagnosis of fibrotic myocardium in patients with hypertrophic cardiomyopathy (HCM). Thirty patients with HCM underwent two cardiac MRI protocols with use of gadobutrol and gadopentetate dimeglumine. Contrast-to-noise ratio (CNR) between LGE area and remote myocardium (CNRremote), between LGE area and left ventricular blood pool (CNRpool), and signal-to-noise ratio (SNR) in LGE were compared. The presence and quantity of LGE were determined by visual assessment. With signal threshold versus reference mean (STRM) based thresholds of 2 SD, 5 SD, and 6 SD above the mean signal intensity (SI) of reference myocardium, the full-width at half-maximum (FWHM) technique was used. The volume and segments of the LGE area were compared between the two types of contrast agents. LGE was present in 26 of 30 (86.6%) patients in both protocols. The CNRremote of fibrotic myocardium in gadobutrol and gadopentetate dimeglumine agents was 26.82 ± 14.24 and 21.46 ± 10.59, respectively (P < 0.05). The CNRpool was significantly higher in gadobutrol (9.32 ± 7.64 vs. 6.39 ± 6.11, P < 0.05). The SNR was higher in gadobutrol (33.36 ± 14.35 vs. 27.53 ± 10.91, P < 0.05). The volume of scar size in MR images acquired with gadobutrol were significantly higher than those with gadopentetate dimeglumine (P < 0.05), and the STRM of 5 SD technique showed the greatest agreement with visual assessment (ICC = 0.99) in both examinations. There was no significant difference in fibrotic segments of the fibrotic myocardium in the LGE area (P < 0.05). This study proved that the Gadobutrol was an effective contrast agent for LGE imaging with superior delineation of fibrotic myocardium as compared to gadopentetate dimeglumine. The 5 SD technique yields the closest approximation of the extent of LGE identified by visual assessment.


Contrast agent Gadobutrol Gadopentetate dimeglumine Hypertrophic cardiomyopathy (HCM) Late gadolinium enhancement (LGE) Cardiovascular magnetic resonance (CMR) 



The authors thank Ms. Jing An of Siemens Medical Systems for technical consultation and support for this study. The study was supported by the Natural Science Foundation of China (81671647), Capital Health Research and Development of Special (2016-4-2063).

Compliance with ethical standards

Conflict of interest

Authors declared that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Science+Business Media Dordrecht 2017

Authors and Affiliations

  1. 1.Department of Radiology, Beijing Anzhen HospitalCapital Medical UniversityBeijingChina
  2. 2.Department of Medical Radiation SciencesCurtin UniversityPerthAustralia

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