Elster A D, Rieser G D
Department of Radiology, Bowman Gray School of Medicine, Winston-Salem, NC 27103.
AJR Am J Roentgenol. 1989 Dec;153(6):1265-8. doi: 10.2214/ajr.153.6.1265.
Gd-DTPA was administered prospectively to 65 consecutive children (ages 1 day to 18 years, mean 9.6 years) to document its utility and safety for routine cranial MR imaging. Precontrast T1- and T2-weighted scans and postcontrast T1-weighted scans were obtained. No complications or significant adverse reactions were encountered. Contrast enhancement was seen in 14 lesions from seven patients, but each of these patients had some abnormality also present on precontrast images. Contrast enhancement was thought to be extremely helpful in characterizing four primary tumors and moderately helpful in characterizing four other lesions. Absence of contrast enhancement was helpful in clarifying the nature of abnormalities seen in an additional four patients. Gd-DTPA may be used safely in children, but this study does not support its routine administration. The highest incremental diagnostic yield from its use will likely be among patients with suspected neoplasms or inflammatory diseases and among those requiring further characterization of lesions seen on precontrast scans.
前瞻性地对65例连续儿童（年龄1天至18岁，平均9.6岁）给予钆喷酸葡胺（Gd-DTPA），以记录其在常规头颅磁共振成像（MR成像）中的效用和安全性。获得了增强前的T1加权和T2加权扫描图像以及增强后的T1加权扫描图像。未遇到并发症或明显的不良反应。在7例患者的14个病变中观察到对比增强，但这些患者中的每一位在增强前图像上也都有一些异常。对比增强被认为对4个原发性肿瘤的特征性描述非常有帮助，对另外4个病变的特征性描述有一定帮助。无对比增强有助于明确另外4例患者中所见异常的性质。Gd-DTPA可在儿童中安全使用，但本研究不支持其常规使用。其使用获得的最高增量诊断收益可能出现在疑似肿瘤或炎症性疾病的患者以及需要对增强前扫描中所见病变进行进一步特征性描述的患者中。
