三种不同剂量钆双胺静脉推注的效果：在一项盲法阅片者研究中对局部脑血容量图的评估

Effects of three different doses of a bolus injection of gadodiamide: assessment of regional cerebral blood volume maps in a blinded reader study.

作者信息

Bruening R, Berchtenbreiter C, Holzknecht N, Essig M, Wu R H, Simmons A, Heuck A, Maschek A, Meusel M, Williams S C, Cox T, Knopp M V, Reiser M

机构信息

Institute of Clinical Radiology, Klinikum Grosshadern, University of Munich, Germany.

出版信息

AJNR Am J Neuroradiol. 2000 Oct;21(9):1603-10.

PMID:11039338

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8174869/

Abstract

BACKGROUND AND PURPOSE

Reconstruction of first-pass bolus information to derive regional cerebral blood volume (rCBV) maps is commonly performed in many centers; however, various protocols with different doses of paramagnetic contrast injections have been reported. We evaluated the dose dependency of rCBV maps in a brain tumor population by using three different doses of gadodiamide injection to evaluate their diagnostic accuracy in blinded reader sessions.

METHODS

Eighty-three patients with intraaxial brain tumors (72 gliomas) were studied at three centers and randomized to receive a bolus injection of 0.1, 0.2, or 0.3 mmol/kg per body weight of gadodiamide. rCBV maps were generated from T2*-weighted gradient-echo echoplanar sequences at 1.5 T. Data processing was performed according to the indicator dilution theory.

RESULTS

The mean contrast-to-noise ratio (CNR) was significantly different between gadodiamide doses of 0.1 and 0.2 mmol/kg (CNR = 8.7 and 15.7) and between 0.1 and 0.3 mmol/kg (CNR = 17.7). No significant difference was found between doses of 0.2 and 0.3 mmol/kg. Sensitivity for the differentiation of benign and malignant brain tumors was 80%, 95%, and 91%, and specificity was 45%, 54%, and 43% by blinded readings at 0.1, 0.2, and 0.3 mmol/ kg, respectively, as compared with histologic findings. Nonblinded readings had a sensitivity of 83%, 100%, and 90% and a specificity of 82%, 100%, and 73% at 0.1, 0.2, and 0.3 mmol/kg, respectively.

CONCLUSION

A dose of 0.2 mmol/kg of gadodiamide is recommended for reconstruction of rCBV maps if data are acquired with the T2*-weighted protocol described.

摘要

背景与目的

在许多中心，重建首过团注信息以获取局部脑血容量（rCBV）图是一项常规操作；然而，已有报道采用了不同剂量顺磁性对比剂注射的各种方案。我们通过使用三种不同剂量的钆双胺注射液，在脑肿瘤患者群体中评估了rCBV图的剂量依赖性，并在盲法阅片环节评估了它们的诊断准确性。

方法

在三个中心对83例脑内肿瘤患者（72例胶质瘤患者）进行研究，并随机分为三组，分别接受每体重0.1、0.2或0.3 mmol/kg的钆双胺团注。通过1.5 T的T2*加权梯度回波平面序列生成rCBV图。数据处理按照指示剂稀释理论进行。

结果

钆双胺剂量为0.1和0.2 mmol/kg时平均对比噪声比（CNR）有显著差异（CNR分别为8.7和15.7），0.1和0.3 mmol/kg时也有显著差异（CNR为17.7）。0.2和0.3 mmol/kg剂量之间未发现显著差异。与组织学结果相比，在0.1、0.2和0.3 mmol/kg剂量下，盲法阅片区分良性和恶性脑肿瘤的敏感性分别为80%、95%和91%，特异性分别为45%、54%和43%。非盲法阅片在0.1、0.2和0.3 mmol/kg剂量下的敏感性分别为分别为83%、100%和90%，特异性分别为82%、100%和73%。