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To perform a quantitative and qualitative comparison of gadobutrol and gadoterate in three-station contrast enhanced magnetic resonance angiography (CE-MRA) of the lower limbs.In this prospective randomized controlled trial, 52 patients with leg ischemia were randomly assigned to one of two groups receiving either gadobutrol (1.0 mmol Gd/mL, 15 mL) or gadoterate (0.5 mmol Gd/mL, 30 mL). Three-station 3D CE-MRAs from the pelvis to the ankles were performed with moving-table technique on a 1.5T MR scanner. Injection time was identical in both groups. Signal-to-noise (SNR) and contrast-to-noise ratios (CNR) were calculated for 816 arteries. Contrast quality in 1196 vessel segments was evaluated separately by two blinded readers on a three-point scale.Mean SNR (61.8 ± 7.8 for gadobutrol vs. 61.9 ± 9.1 for gadoterate, P = 0.257), CNR (52.8 ± 9.1 vs. 52.8 ± 10.7, P = 0.154), and qualitative ranking (1.41 vs. 1.44, P = 0.21) for all vessels did not differ significantly between the two patient groups. The overall quality was good in 90.4% with gadoterate and 94.2% with gadobutrol (P = 0.462).High-concentration gadobutrol allows neither a higher CNR nor any qualitative advantage over the ordinary unspecific Gd agent gadoterate when the same Gd load and injection times are used in multistation CE-MRA of the peripheral arteries. J. Magn. Reson. Imaging 2008;27:1399–1405. © 2008 Wiley-Liss, Inc.