From the Department of Radiology (T.K., M.O., H.O., K. Toyoda, T.H., K. Takeshita, S.F.) and Department of Radiological Technology, Faculty of Medical Technology (J.K.), Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8605, Japan.
Radiology. 2015 Jun;275(3):803-9. doi: 10.1148/radiol.14140364. Epub 2015 Jan 27.
PURPOSE: To assess whether an association exists between hyperintensity in the dentate nucleus (DN) on unenhanced T1-weighted magnetic resonance (MR) images and previous administration of gadolinium-based contrast agents (GBCAs) that contain different types of gadolinium chelates. MATERIALS AND METHODS: The institutional review board approved this study. Written informed consent was waived because this was a retrospective study. Evaluated were 127 cases among 360 consecutive patients who underwent contrast agent-enhanced brain MR imaging. Two radiologists conducted visual evaluation and quantitative analysis on unenhanced T1-weighted MR images by using regions of interest. DN-to-cerebellum (DN/cerebellum) signal intensity ratios were calculated and the relationship between DN/cerebellum and several factors was evaluated, including the number of previous linear chelate and/or macrocyclic GBCA administrations by using a generalized additive model. The Akaike information criterion was used in model selection. Interobserver correlation was evaluated with paired t tests and the Lin concordance correlation coefficient. RESULTS: The images of nine patients (7.1%) showed hyperintensity in the DN. Twenty-three patients (18.1%) received linear GBCAs (median, two patients; maximum, 11 patients), 36 patients (28.3%) received macrocyclic GBCAs (median, two patients; maximum, 15 patients), 14 patients (11.0%) received both types of GBCA (linear [median, two patients; maximum, five patients] and macrocyclic [median, three patients; maximum, eight patients]), and 54 patients (42.5%) had no history of administration of gadolinium chelate. Interobserver correlation was almost perfect (0.992 [95% confidence interval: 0.990, 0.994]). The DN/cerebellum ratio was associated with linear GBCA (P < .001), but not with macrocyclic GBCA exposure (P = .875). According to the Akaike information criterion, only linear GBCA was selected for the final model, and the DN/cerebellum ratio had strong association only with linear GBCA. CONCLUSION: Hyperintensity in the DN on unenhanced T1-weighted MR images is associated with previous administration of linear GBCA, while the previous administration of macrocyclic GBCAs showed no such association.
目的：评估未增强 T1 加权磁共振（MR）图像中齿状核（DN）高信号与先前使用含有不同类型钆螯合物的钆基对比剂（GBCA）之间是否存在关联。 材料与方法：该研究获得机构审查委员会批准。由于这是一项回顾性研究，故免除了书面知情同意。对 360 例连续接受对比增强脑 MR 成像的患者中的 127 例进行评估。两名放射科医生使用感兴趣区域对未增强 T1 加权 MR 图像进行了视觉评估和定量分析。计算了 DN 与小脑（DN/cerebellum）信号强度比，并使用广义加性模型评估了 DN/cerebellum 与几个因素之间的关系，包括先前线性螯合物和/或大环 GBCA 给药次数。选择模型时使用了 Akaike 信息准则。使用配对 t 检验和 Lin 一致性相关系数评估了观察者间的相关性。 结果：9 名患者（7.1%）的图像显示 DN 高信号。23 名患者（18.1%）接受了线性 GBCA（中位数为 2 名患者；最大为 11 名患者），36 名患者（28.3%）接受了大环 GBCA（中位数为 2 名患者；最大为 15 名患者），14 名患者（11.0%）同时接受了这两种类型的 GBCA（线性[中位数为 2 名患者；最大为 5 名患者]和大环[中位数为 3 名患者；最大为 8 名患者]），54 名患者（42.5%）无钆螯合物给药史。观察者间的相关性几乎是完美的（0.992[95%置信区间：0.990，0.994]）。DN/cerebellum 比值与线性 GBCA 相关（P<0.001），但与大环 GBCA 暴露无关（P=0.875）。根据 Akaike 信息准则，仅线性 GBCA 被选入最终模型，且 DN/cerebellum 比值仅与线性 GBCA 具有强烈的关联。 结论：未增强 T1 加权 MR 图像中 DN 的高信号与先前使用线性 GBCA 有关，而先前使用大环 GBCA 则无此关联。
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