From the Departmental Faculty of Medicine and Surgery, Università Campus Bio-Medico di Roma, Rome, Italy.
Department of Radiology, Antwerp University Hospital, Edegem, Belgium.
Invest Radiol. 2020 Jan;55(1):25-29. doi: 10.1097/RLI.0000000000000604.
The aim of this study was to assess the signal intensity of the anterior pituitary (AP) gland on unenhanced T1-weighted images in patients with history of serial intravenous injections of gadodiamide and normal renal function.
We included 53 patients who had undergone at least 5 injections of gadodiamide and a control group of 15 subjects who underwent at least 5 brain magnetic resonance imaging without gadolinium-based contrast agents. Using unenhanced sagittal T1-weighted images, values of mean signal intensity of the AP and of the central pons were obtained. Anterior pituitary-to-pons signal intensity ratios were calculated dividing the values of the AP by those of the pons. Then, the ratios were compared between the first and the last magnetic resonance imaging scans for all the subjects. To assess the difference between the first and the last ratios, nonparametric Wilcoxon signed-rank test with Monte Carlo resampling was applied. A P value less than 0.05 was considered as statistically significant.
The comparison between the first and the last scan revealed a statistically significant increase of AP-to-pons ratio in the last scan for the gadolinium-exposed group (P < 0.001), whereas nonsignificant results were found for the control group (P = nonsignificant).
We found an increased signal intensity of the AP on unenhanced T1-weighted images in patients with history of serial intravenous injections of gadodiamide and normal renal function, suggesting gadolinium deposition or long-term retention within the AP gland. Our findings need to be confirmed by further histochemical analysis of AP gland tissue samples.
本研究旨在评估有静脉注射钆喷酸葡胺病史且肾功能正常的患者，其垂体前叶（AP）在未增强 T1 加权图像上的信号强度。
我们纳入了 53 例至少接受过 5 次钆喷酸葡胺注射的患者，以及 15 例接受至少 5 次无钆对比剂脑部磁共振成像的对照组。使用矢状位未增强 T1 加权图像，获取 AP 和中央脑桥的平均信号强度值。通过将 AP 值除以脑桥值，计算出 AP 与脑桥的信号强度比值。然后，对所有患者的首次和末次磁共振成像扫描的比值进行比较。为了评估首次和末次比值之间的差异，我们应用非参数 Wilcoxon 符号秩检验结合蒙特卡罗重采样法。P 值小于 0.05 被认为具有统计学意义。
首次和末次扫描之间的比较显示，在末次扫描时，接受过钆喷酸葡胺暴露的组中 AP 与脑桥的比值有统计学意义的增加（P < 0.001），而对照组则无显著差异（P = 无显著意义）。
我们发现有静脉注射钆喷酸葡胺病史且肾功能正常的患者，其垂体前叶在未增强 T1 加权图像上的信号强度增加，提示 AP 中存在钆沉积或长期滞留。我们的发现需要通过对 AP 组织样本的进一步组织化学分析来证实。
