Anzalone Nicoletta, Gerevini Simonetta, Scotti Roberta, Vezzulli Paolo, Picozzi Piero
Department of Neuroradiology, Scientific Institute HS Raffaele, Milan, Italy.
Acta Radiol. 2009 Oct;50(8):933-40. doi: 10.1080/02841850903095385.
Contrast-enhanced magnetic resonance (MR) imaging with gadolinium-based contrast agents is widely used for the detection of cerebral metastases with standard contrast agents. Newer developments in MR contrast agents have led to a higher relaxivity and/or concentration for these agents.
To assess the effectiveness of a standard dose of 1.0 M gadobutrol compared with a standard dose of gadopentetate dimeglumine for the MR detection of brain metastases.
27 patients with at least one cerebral metastasis were examined twice with contrast-enhanced MR imaging, using gadobutrol at 0.1 ml/kg and gadopentetate dimeglumine at 0.2 ml/kg (i.e., identical gadolinium dosage of 0.1 mmol/kg bodyweight). The interval between examinations was 18 hours, and the order of injection was fully randomized. Images were acquired using a three-dimensional (3D) fast gradient echo sequence, and evaluated in blinded fashion by two experienced neuroradiologists in consensus in terms of the total number of lesions detected at each examination in each patient and qualitatively in terms of the lesion conspicuity observed.
A total of 67 lesions were detected after gadobutrol compared with 65 lesions detected after gadopentetate dimeglumine. In two patients, a lesion was seen only after gadobutrol. Qualitative comparison of images revealed improved lesion conspicuity after gadobutrol in 10/27 cases compared with 0/27 cases after gadopentetate dimeglumine, and equivalent conspicuity in 17/27 cases (P=0.002, gadobutrol vs. gadopentetate dimeglumine).
At equal gadolinium dosage, gadobutrol appears to offer significant advantages over gadopentetate dimeglumine for the visualization of brain metastases, with particular benefit for improving the conspicuity of detected lesions.
使用钆基造影剂的对比增强磁共振（MR）成像广泛用于标准造影剂检测脑转移瘤。MR造影剂的新进展使这些造影剂具有更高的弛豫率和/或浓度。
评估1.0M钆布醇标准剂量与钆喷酸葡胺标准剂量用于MR检测脑转移瘤的有效性。
27例至少有一个脑转移瘤的患者接受两次对比增强MR成像检查，分别使用0.1ml/kg钆布醇和0.2ml/kg钆喷酸葡胺（即相同的钆剂量为0.1mmol/kg体重）。两次检查间隔18小时，注射顺序完全随机。使用三维（3D）快速梯度回波序列采集图像，由两名经验丰富的神经放射科医生以盲法共同评估每位患者每次检查时检测到的病变总数，并对观察到的病变清晰度进行定性评估。
钆布醇检查后共检测到67个病变，钆喷酸葡胺检查后检测到65个病变。在两名患者中，仅在钆布醇检查后发现一个病变。图像的定性比较显示，钆布醇检查后10/27例病变清晰度提高，钆喷酸葡胺检查后为0/27例，17/27例病变清晰度相当（钆布醇与钆喷酸葡胺相比，P = 0.002）。
在钆剂量相等的情况下，钆布醇在脑转移瘤的可视化方面似乎比钆喷酸葡胺具有显著优势，尤其有利于提高检测到的病变的清晰度。
