Rossi Espagnet Maria Camilla, Bernardi Bruno, Pasquini Luca, Figà-Talamanca Lorenzo, Tomà Paolo, Napolitano Antonio
Neuroradiology Unit, Imaging Department, Ospedale Pediatrico Bambino Gesù, IRCCS, Piazza S. Onofrio 4, 00165, Rome, Italy.
Neuroradiology Unit, Azienda Ospedaliera Sant'Andrea, University Sapienza, Via di Grottarossa 1035, Rome, Italy.
Pediatr Radiol. 2017 Sep;47(10):1345-1352. doi: 10.1007/s00247-017-3874-1. Epub 2017 May 19.
Few studies have been conducted on the relations between T1-weighted signal intensity changes in the pediatric brain following gadolinium-based contrast agent (GBCA) exposure.
The purpose of this study is to investigate the effect of multiple administrations of a macrocyclic GBCA on signal intensity in the globus pallidus and dentate nucleus of the pediatric brain on unenhanced T1-weighted MR images.
This retrospective study included 50 patients, mean age: 8 years (standard deviation: 4.8 years), with normal renal function exposed to ≥6 administrations of the same macrocyclic GBCA (gadoterate meglumine) and a control group of 59 age-matched GBCA-naïve patients. The globus pallidus-to-thalamus signal intensity ratio and dentate nucleus-to-pons signal intensity ratio were calculated from unenhanced T1-weighted images for both patients and controls. A mixed linear model was used to evaluate the effects on signal intensity ratios of the number of GBCA administrations, the time interval between administrations, age, radiotherapy and chemotherapy. T-test analyses were performed to compare signal intensity ratio differences between successive administrations and baseline MR signal intensity ratios in patients compared to controls. P-values were considered significant if <0.05.
A significant effect of the number of GBCA administrations on relative signal intensities globus pallidus-to-thalamus (F[8]=3.09; P=0.002) and dentate nucleus-to-pons (F[8]=2.36; P=0.021) was found. The relative signal intensities were higher at last MR examination than at baseline (P<0.001).
Quantitative analysis evaluation of globus pallidus:thalamus and dentate nucleus:pons of the pediatric brain demonstrated an increase after serial administrations of macrocyclic GBCA. Further research is necessary to fully understand GBCA pharmacokinetic in children.
关于钆基造影剂（GBCA）暴露后小儿脑内T1加权信号强度变化之间关系的研究较少。
本研究旨在探讨多次给予大环GBCA对小儿脑苍白球和齿状核在未增强T1加权磁共振图像上信号强度的影响。
本回顾性研究纳入了50例肾功能正常的患者，平均年龄8岁（标准差：4.8岁），这些患者接受了≥6次相同大环GBCA（钆喷酸葡胺）注射，以及59例年龄匹配的未接触GBCA的对照组患者。从患者和对照组的未增强T1加权图像中计算苍白球与丘脑的信号强度比以及齿状核与脑桥的信号强度比。采用混合线性模型评估GBCA给药次数、给药间隔时间、年龄、放疗和化疗对信号强度比的影响。进行t检验分析，以比较患者连续给药之间的信号强度比差异以及与对照组相比患者的基线磁共振信号强度比。如果P值<0.05，则认为具有统计学意义。
发现GBCA给药次数对苍白球与丘脑的相对信号强度（F[8]=3.09；P=0.002）和齿状核与脑桥的相对信号强度（F[8]=2.36；P=0.021）有显著影响。最后一次磁共振检查时的相对信号强度高于基线水平（P<0.001）。
对小儿脑苍白球：丘脑和齿状核：脑桥的定量分析评估显示，连续给予大环GBCA后信号增强。有必要进行进一步研究以全面了解儿童体内GBCA的药代动力学。
