From the Departmental Faculty of Medicine and Surgery, Center for Integrated Research, University Campus Bio-Medico di Roma, Rome, Italy.
Invest Radiol. 2014 Oct;49(10):685-90. doi: 10.1097/RLI.0000000000000072.
OBJECTIVES: The purpose of this study was to assess the association between the serial number of gadolinium-enhanced magnetic resonance imaging (MRI) examinations and the signal hyperintensity of the dentate nucleus on unenhanced T1-weighted images in patients with multiple sclerosis (MS) and those with brain metastases (BMs). MATERIALS AND METHODS: A group of 38 patients with MS and 37 patients with BM who had undergone at least 2 consecutive enhanced MRI examinations in our institution were examined for this retrospective observational study. The average T1 signal intensity of the dentate nuclei and the pons was obtained, and the dentate nuclei-to-pons (DNP) signal intensity ratio was calculated. These values were compared between patients with less than 6 and 6 enhanced MRI scans or more (eMRI). Relative changes of the DNP were plotted against the number of enhanced MRI scans (eMRIn). RESULTS: A progressive increase in the T1 signal intensity of the DNP ratio was observed both in the MS group and in the BM group. The DNP ratios of the last eMRI scans in the subgroup of patients with 6 eMRI scans or more were significantly higher than those of the first eMRI scan in the MS group (P < 0.001) and in the BM group (P < 0.01). Relative changes of the DNP showed a positive correlation with the eMRIn with a Spearman ρ of 0.96 (P < 0.001) in the MS group and that of 0.88 (P < 0.001) in the BM group. Curve regression analyses of the relative change of DNP ratios showed linear models to best fit the data with r(2) of 0.89 in the MS group and r(2) of 0.74 in the BM group. CONCLUSIONS: Our study shows that the increase in the unenhanced T1 signal intensity has a linear relationship with the eMRIn in patients with MS and BM. Indeed, we estimated a linear regression model to fit the progressive increase in T1 signal intensity of the dentate nucleus after multiple enhanced MRI scans. This finding suggests substantial dechelation of gadodiamide in patients with normal renal function, raising further concerns regarding the stability of this agent. Further comparative studies with other gadolinium chelates, specifically both linear and macrocyclic, are strongly recommended.
目的：本研究旨在评估多发性硬化症（MS）和脑转移瘤（BM）患者增强磁共振成像（MRI）检查的序列号与未增强 T1 加权图像上齿状核信号高信号之间的关系。
材料和方法：对在我院至少接受 2 次连续增强 MRI 检查的 38 例 MS 患者和 37 例 BM 患者进行了这项回顾性观察研究。获得齿状核和脑桥的平均 T1 信号强度，并计算齿状核-脑桥（DNP）信号强度比。将这些值与接受少于 6 次和 6 次以上增强 MRI 扫描的患者进行比较（eMRI）。绘制 DNP 的相对变化与增强 MRI 扫描次数（eMRIn）的关系图。
结果：MS 组和 BM 组均观察到 DNP 比值的 T1 信号强度逐渐增加。在接受 6 次或更多次 eMRI 扫描的患者亚组中，最后一次 eMRI 扫描的 DNP 比值明显高于 MS 组（P<0.001）和 BM 组（P<0.01）的第一次 eMRI 扫描。DNP 的相对变化与 eMRIn 呈正相关，在 MS 组中 Spearman ρ 为 0.96（P<0.001），在 BM 组中 Spearman ρ 为 0.88（P<0.001）。DNP 比值相对变化的曲线回归分析表明，线性模型最适合 MS 组的 r（2）为 0.89 和 BM 组的 r（2）为 0.74 的数据。
结论：我们的研究表明，MS 和 BM 患者未增强 T1 信号强度的增加与 eMRIn 呈线性关系。实际上，我们估计了一个线性回归模型来拟合多次增强 MRI 扫描后齿状核 T1 信号强度的渐进增加。这一发现表明，在肾功能正常的患者中，钆喷酸二钠的脱螯合作用明显，这进一步引起了人们对该药物稳定性的关注。强烈建议与其他顺磁造影剂（特别是线性和大环）进行进一步的比较研究。
Arch Toxicol. 2025-7-3
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