From the Department of Radiology and Radiological Sciences (G.M.B., M.Y., S.T.S., S.G.C., H.R.C., D.R.R.), Department of Neuroradiology.
Department of Public Health Sciences (P.J.N.), Medical University of South Carolina, Charleston, South Carolina.
AJNR Am J Neuroradiol. 2018 Mar;39(3):415-420. doi: 10.3174/ajnr.A5510. Epub 2018 Jan 18.
Previous studies have evaluated various gadolinium based contrast agents and their association with gadolinium retention, however, there is a discrepancy in the literature concerning the linear agent gadobenate dimeglumine. Our aim was to determine whether an association exists between the administration of gadobenate dimeglumine and the development of intrinsic T1-weighted signal in the dentate nucleus and globus pallidus.
In this single-center, retrospective study, the signal intensity of the globus pallidus, dentate nucleus, thalamus, and middle cerebellar peduncle was measured on unenhanced T1-weighted images in 29 adult patients who had undergone multiple contrast MRIs using exclusively gadobenate dimeglumine (mean, 10.1 ± 3.23 doses; range, 6-18 doses). Two neuroradiologists, blinded to the number of prior gadolinium-based contrast agent administrations, separately placed ROIs within the globi pallidi, thalami, dentate nuclei, and middle cerebellar peduncles on the last MR imaging examinations. The correlations between the globus pallidus:thalamus and the dentate nucleus:middle cerebellar peduncle signal intensity ratios with the number of gadolinium-based contrast agent administrations and cumulative dose were tested with either 1-tailed Pearson or Spearman correlations. A priori, < .05 was considered statistically significant.
Both the globus pallidus:thalamus and dentate nucleus:middle cerebellar peduncle ratios showed significant correlation with the number of gadolinium-based contrast agent administrations ( = 0.39, = .017, and = 0.58, = .001, respectively). Additionally, the globus pallidus:thalamus and dentate nucleus:middle cerebellar peduncle ratios showed significant correlation with the cumulative dose of gadobenate dimeglumine ( = 0.48, = .004, and = 0.43, = .009, respectively). Dentate nucleus hyperintensity was qualitatively present on the last MR imaging in 79.3%-86.2% of patients and in all patients who had received >10 doses.
At high cumulative doses (commonly experienced by patients, for example, with neoplastic disease), gadobenate dimeglumine is associated with an increase in the globus pallidus:thalamus and dentate nucleus:middle cerebellar peduncles signal intensity ratios.
既往研究评估了多种钆基对比剂及其与钆蓄积的关系，但在关于线性对比剂钆喷替酸葡甲胺的文献中存在差异。我们的目的是确定使用钆喷替酸葡甲胺进行检查是否与齿状核和苍白球内固有 T1 加权信号的发展有关。
在这项单中心回顾性研究中，29 例成年患者在接受了多次对比 MRI 检查，这些患者仅使用钆喷替酸葡甲胺（平均 10.1 ± 3.23 剂；范围 6-18 剂）。两名神经放射科医生在最后一次 MRI 检查时，对每个患者的苍白球、丘脑、齿状核和小脑上脚的 T1 加权未增强图像上的信号强度进行了盲法测量。使用单尾 Pearson 或 Spearman 相关性检验，分别测试了苍白球/丘脑和齿状核/小脑上脚信号强度比值与钆基对比剂给药次数和累积剂量之间的相关性。预先设定 <.05 为有统计学意义。
苍白球/丘脑和齿状核/小脑上脚比值均与钆基对比剂给药次数显著相关（ = 0.39， =.017，和 = 0.58， =.001）。此外，苍白球/丘脑和齿状核/小脑上脚比值与钆喷替酸葡甲胺的累积剂量显著相关（ = 0.48， =.004，和 = 0.43， =.009）。在最后一次 MRI 检查中，79.3%-86.2%的患者出现齿状核高信号，所有接受 >10 剂药物的患者均出现齿状核高信号。
在高累积剂量（例如患有肿瘤性疾病的患者经常经历的剂量）下，钆喷替酸葡甲胺与苍白球/丘脑和齿状核/小脑上脚信号强度比值的增加相关。
