A 3 mL low-dose gadolinium-based contrast agent combined with 3D-TWIST sequence yields diagnostic accuracy equivalent to standard-dose CE-MRV in patients weighing &lt;70 kg: a non-randomized controlled study

Sun Yan; Chen Jie; Zhang Yusheng; Chen Lin; Tan Weiyue; Zhuang Qixiang; Liu Kefu

doi:10.16016/j.2097-0927.202604075

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A 3 mL low-dose gadolinium-based contrast agent combined with 3D-TWIST sequence yields diagnostic accuracy equivalent to standard-dose CE-MRV in patients weighing <70 kg: a non-randomized controlled study

Monographic Reports | 更新时间：2026-09-16

- A 3 mL low-dose gadolinium-based contrast agent combined with 3D-TWIST sequence yields diagnostic accuracy equivalent to standard-dose CE-MRV in patients weighing <70 kg: a non-randomized controlled study
- Journal of Army Medical University Vol. 48, Issue 17, Pages: 2408-2417(2026)
- 作者机构：
  
  南京医科大学附属苏州医院放射科，江苏苏州
- 作者简介：
  
  Liu Kefu，E-mail：lkf77@126.com
- 基金信息：
  
  the Sports Research Project of Suzhou Sports Bureau(TY2025-422)
- DOI：10.16016/j.2097-0927.202604075
  CLC： R445.2;R743;R981.1
- Received：21 April 2026，
  
  Revised：2026-06-06，
  
  Accepted：08 July 2026，
  
  Published：15 September 2026
- 稿件说明：
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孙岩，陈劼，张羽生，等.3 mL低剂量钆对比剂联合3D-TWIST序列在<70 kg人群中CE-MRV诊断准确率与标准剂量等效：一项非随机对照研究［J］.陆军军医大学学报，2026，48（17）：2408-2417.DOI：,10.16016/j.2097-0927.202604075.

Sun Y，Chen J，Zhang Y S，,et al.A 3 mL low-dose gadolinium-based contrast agent combined with 3D-TWIST sequence yields diagnostic accuracy equivalent to standard-dose CE-MRV in patients weighing <70 kg： a non-randomized controlled study［J］.J Army Med Univ，2026，48（17）：2408-2417.DOI：,10.16016/j.2097-0927.202604075.
孙岩，陈劼，张羽生，等.3 mL低剂量钆对比剂联合3D-TWIST序列在<70 kg人群中CE-MRV诊断准确率与标准剂量等效：一项非随机对照研究［J］.陆军军医大学学报，2026，48（17）：2408-2417.DOI：,10.16016/j.2097-0927.202604075. DOI：

Sun Y，Chen J，Zhang Y S，,et al.A 3 mL low-dose gadolinium-based contrast agent combined with 3D-TWIST sequence yields diagnostic accuracy equivalent to standard-dose CE-MRV in patients weighing <70 kg： a non-randomized controlled study［J］.J Army Med Univ，2026，48（17）：2408-2417.DOI：,10.16016/j.2097-0927.202604075. DOI：

摘要

目的

针对常规剂量钆对比剂在颅脑对比增强磁共振静脉成像（contrast enhanced-MRV，CE-MRV）中存在的体内沉积风险与安全性问题，探讨低剂量钆对比剂联合3D-时间分辨交叉随机轨迹成像（time-resolved angiography with interleaved stochastic trajectories，TWIST）序列在颅内静脉窦成像中的可行性，评估该方案对图像质量及诊断准确率的影响。

方法

采用前瞻性单中心的非随机对照研究，纳入2022年11月至2024年5月在南京医科大学附属苏州医院放射科西门子Skyra 3.0 T磁共振上接受检查的196名患者，所有受检者随机分为A组（

=20）、B组（

=78）、C组（

=98）。B组和C组按体质量分层以10 kg为间隔（40~

100 kg），分别对应B4~B9及C4~C9亚组。A组作为金标准：常规剂量（0.1 mmol/kg）钆喷酸葡胺原液，扫描参数为K空间中心区10%/周围区20%的3D-TWIST序列。B组：3 mL钆剂稀释至15 mL注射，扫描参数同A组。C组：3 mL钆剂稀释至15 mL注射，扫描参数为

K空间中心区40%/周围区20%的3D-TWIST序列。分别客观比较B组和C组的不同亚组与A组在颅内静脉窦最大信号强度的信噪比（signal-to-noise ratios，SNR）。主观比较由2名资深放射诊断医生进行评分，分别对A组及B组、C组不同亚组间的颅脑CE-MRV成像质量采用3分标准：1分表示不可见或无法辨别出颅静脉窦血管段，2分表示颅静脉窦血管段中等图像质量显示，3分表示图像对颅静脉窦血管段的高质量显示。进一步分别比较B组、C组不同亚组的颅静脉窦诊断正确率是否与A组间存在差异。

结果

A组与B组比较，除B4、B7亚组的下矢状窦外，A组各静脉窦的SNR均高于B组各亚组。A组与C组比较，在C4、C5、C6亚组中，除C4亚组的下矢状窦SNR高于A组（

0.002 8），其余静脉窦SNR差异均无统计学意义（

均

0.002 8）；在C7、C8、C9亚组中，除C7亚组的下矢状窦外，各静脉窦SNR均低于A组。C组各亚组SNR均高于同体质量B组各亚组。主观图像质量全部评分≥2分，A组与B4~B6、C4~C8各亚组均无差异（

均

0.004 17）。A组、B组、C组诊断正确率分别为100.00％、98.71％、100.00％，两两比较均无统计学差异（

均

0.016 7）。

结论

低剂量（3 mL）钆对比剂联合优化3D-TWIST序列（K空间中心区40%）在颅脑CE-MRV中可行，可显著降低钆沉积风险。推荐用于体质量<70 kg患者，可替代常规标准剂量方案；70~89 kg患者图像质量主观满足诊断需求，但需进一步提升SNR。

Abstract

Objective

To address the safety concerns regarding gadolinium deposition associated with standard-dose gadolinium-based contrast agents in cerebral contrast-enhanced magnetic resonance venography (CE-MRV)

this study aims to investigate the feasibility of a low-dose gadolinium protocol combined with a 3D time-resolved angiography with stochastic trajectories (TWIST) sequence for intracranial venous sinus imaging

and to evaluate its impact on image quality and diagnostic accuracy.

Methods

A prospective

single-center

non-randomized controlled study was conducted on 196 patients who underwent examinations on a Siemens Skyra 3.0 T MR scanner at Department of Radiology of Suzhou Hospital Affiliated to Nanjing Medical University from November 2022 to May 2024. All participants were divided into 3 groups: Group A (

=20)

Group B (

=78)

and Group C (

=98). Groups B and C were further stratified by body weight at 10 kg intervals (40 to

100 kg) into subgroups B4

B9 and C4

respectively. Group A serv

ed as the reference standard: standard-dose (0.1 mmol/kg) gadopentetate dimeglumine administered undiluted

with a 3D-TWIST sequence using 10% central/20% peripheral k-space sampling. Group B received 3 mL of gadolinium-based contrast agent diluted to a total volume of 15 mL

with the same acquisition parameters as Group A. Group C received 3 mL of gadolinium-based contrast agent diluted to 15 mL

with a 3D-TWIST sequence using 40% central/20% peripheral k-space sampling. Objective comparison of the signal-to-noise ratio (SNR) of the maximum signal intensity in intracranial venous sinuses was conducted between different body weight subgroups of Groups B and C versus Group A. Subjective image quality was independently assessed by 2 senior radiologists using a 3-point scoring scale: 1=intracranial venous sinus segments not visible or indistinguishable; 2=moderate image quality with discernible venous sinus segments; 3=high-quality delineation of intracranial venous sinus segments. Furthermore

pairwise comparisons of diagnostic accuracy for intracranial venous sinus evaluation were performed between different subgroups of Group B and Group C versus Group A

respectively.

Results

Comparison between Group A and Group B: Except for the inferior sagittal sinus in subgroups B4 and B7

the SNR of all venous sinuses in Group A was higher than that in each subgroup of Group B. Comparison between Group A and Group C showed that among the C4

and C6 subgroups

the SNR of the inferior sagittal sinus in the C4 subgroup was higher than that in group A (

0.002 8)

while the differences in SNR for the remaining venous sinuses were not statistically significant (all

0.002 8). In the C7

and C9 subgroups

the SNR of each venous sinus was lower than that in group A

except for the inferior sagittal sinus in the C7 subgroup. The SNR of all subgroups within group C was higher than that of the corresponding subgroups in group B with the same body weight.

All subjective image quality scores were ≥2

with no significant differences were found between group A and subgroups B4

B6 and C4

C8 (all

0.004 17). The diagnostic accuracy rates for groups A

and C were 100.00%

98.71%

and 100.00%

respectively

with no statistically significant differences between any 2 groups (all

0.016 7).

Conclusion

A low-dose (3 mL) gadolinium-based contrast agent combined with an optimized 3D-TWIST sequence (40% central k-space sampling) is feasible for cerebral CE-MRV and may substantially reduce the risk of gadolinium deposition. This protocol is recommended for patients weighing

70 kg as an alternative to the conventional standard-dose regimen. For patients weighing 70

89 kg

subjective image quality meets diagnostic requirements

however

further improvements in SNR are warranted.

关键词

Keywords

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⁰

A 3 mL low-dose gadolinium-based contrast agent combined with 3D-TWIST sequence yields diagnostic accuracy equivalent to standard-dose CE-MRV in patients weighing <70 kg: a non-randomized controlled study

DOI：10.16016/j.2097-0927.202604075

摘要

Abstract

关键词

Keywords

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