1 Department of Radiology, Weill Medical College, 416 E 55th St, New York, NY 10021.
AJR Am J Roentgenol. 2016 Feb;206(2):414-9. doi: 10.2214/AJR.15.15327. Epub 2015 Dec 23.
The objective of this study was to evaluate signal changes in the dentate nucleus on unenhanced T1-weighted MR images after multiple administrations of gadopentetate dimeglumine versus gadobutrol.
Two study groups were identified, each of which included 25 consecutive patients. Each group received six or more administrations of either gadobutrol only or gadopentetate dimeglumine only, without having had exposure to any other gadolinium-based contrast agent (GBCA). The mean signal intensity (SI) in the dentate nucleus on unenhanced T1-weighted MR images was measured, with the use of the pons and the cerebellar peduncle as references to calculate the DNP SI ratio (i.e., the ratio of the SI in the dentate nucleus to the SI in the pons) and the DCP SI ratio (i.e., the ratio of the SI in the dentate nucleus to the SI in the cerebellar peduncle).
After six administrations of gadopentetate dimeglumine, the SI in the dentate nucleus on unenhanced T1-weighted MR images increased from a DCP SI ratio of 0.997 before administration to 1.034 after the last of six administrations (p = 0.0007) and then to 1.063 after all administrations (p = 0.0004). No statistically significant increase was noted in association with administration of gadobutrol, for which the DCP SI ratio was 0.995 before administration, 1.009 after the last of six administrations (p = 0.1172), and 0.992 after all administrations (p = 0.7592). The change in the DCP SI ratio after administration of gadopentetate dimeglumine correlated with the number of administrations the patient received (p < 0.0001).
Unenhanced T1 signal hyperintensity was observed in the dentate nucleus after multiple administrations of gadopentetate dimeglumine, a linear ionic agent, but not after multiple administrations of gadobutrol, a macrocyclic GBCA.
本研究旨在评估线性钆喷替酸葡甲胺多次给药后与大环类对比剂(GBCA)钆布醇在未增强 T1 加权 MR 图像上齿状核信号的变化。
本研究确定了两个研究组,每组均包括 25 例连续患者。每组均接受 6 次或更多次的钆布醇或钆喷替酸葡甲胺给药,且均未接触过任何其他 GBCA。使用脑桥和小脑脚作为参照,测量未增强 T1 加权 MR 图像上齿状核的平均信号强度(SI),以计算齿状核 SI 比值(即齿状核 SI 与脑桥 SI 的比值)和 DCP SI 比值(即齿状核 SI 与小脑脚 SI 的比值)。
在进行 6 次钆喷替酸葡甲胺给药后,未增强 T1 加权 MR 图像上齿状核的 SI 从给药前的 DCP SI 比值 0.997 增加到第 6 次给药后的 1.034(p = 0.0007),再增加到所有给药后的 1.063(p = 0.0004)。而在给予钆布醇后,并未观察到明显的统计学意义上的增加,给药前的 DCP SI 比值为 0.995,第 6 次给药后的比值为 1.009(p = 0.1172),所有给药后的比值为 0.992(p = 0.7592)。钆喷替酸葡甲胺给药后的 DCP SI 比值变化与患者接受的给药次数相关(p < 0.0001)。
在多次给予线性离子型钆喷替酸葡甲胺后,可观察到齿状核未增强 T1 信号出现高信号,但在多次给予大环类 GBCA 钆布醇后则没有观察到这种情况。