Elster A D, Moody D M, Ball M R, Laster D W
Department of Radiology, Bowman Gray School of Medicine, Wake Forest University Winston-Salem, NC 27103.
Radiology. 1989 Oct;173(1):231-8. doi: 10.1148/radiology.173.1.2781014.
Gadopentetate dimeglumine (gadolinium diethylenetriaminepentaacetic acid [DTPA]) was administered prospectively to 500 consecutive children and adults referred for routine cranial magnetic resonance (MR) imaging over a 4-month period. Pre- and postcontrast images were blindly and independently interpreted by two experienced neuroradiologists. Specific criteria were provided to the readers to define objectively when contrast material enhancement (or lack thereof) would be considered "radiologically helpful." Contrast-enhancing lesions were observed in 99 cases (20%). In only 15 cases (3%) did Gd-DTPA permit detection of lesions not also apparent on the precontrast studies. Contrast enhancement was considered radiologically helpful in 74 of the 99 cases. Lack of enhancement was considered helpful in 112 of the 500 cases (22%). Factors that may indicate increased usefulness of Gd-DTPA include increased patient age, definite lesion seen at computed tomography or precontrast MR imaging, prior craniotomy for tumor, and clinically documented systemic or central nervous system disease. Gd-DTPA should probably be used routinely for cranial MR imaging in most patients, except, perhaps, children and young adults with normal precontrast images.
钆喷酸葡胺（钆二乙三胺五乙酸[DTPA]）在4个月期间前瞻性地应用于500例连续转诊接受常规头颅磁共振（MR）成像检查的儿童和成人。两名经验丰富的神经放射科医生对增强前后的图像进行了盲法独立解读。向阅片者提供了具体标准，以客观界定何时造影剂增强（或未增强）可被视为“对放射学诊断有帮助”。99例（20%）观察到有强化病变。仅15例（3%）钆-DTPA能检测出平扫研究中未显示的病变。99例中有74例的强化被认为对放射学诊断有帮助。500例中有112例（22%）未强化被认为有帮助。可能提示钆-DTPA使用价值增加的因素包括患者年龄增加、CT或平扫MR成像发现明确病变、既往因肿瘤行开颅手术以及临床记录的全身性或中枢神经系统疾病。钆-DTPA可能应常规用于大多数患者的头颅MR成像检查，或许除了平扫图像正常的儿童和年轻人之外。
