钆喷酸葡胺是否会导致儿童脑部钆潴留？一项病例对照研究。
Does Gadoterate Meglumine Cause Gadolinium Retention in the Brain of Children? A Case-Control Study.
作者信息
Topcuoglu Elif Dilara, Topcuoglu Osman Melih, Semiz Oysu Aslihan, Bukte Yasar
机构信息
University of Health Sciences Umraniye Training and Research Hospital, Department of Radiology, Istanbul, Turkey.
Yeditepe University Hospital, Department of Radiology, Istanbul, Turkey.
出版信息
J Magn Reson Imaging. 2020 May;51(5):1471-1477. doi: 10.1002/jmri.26954. Epub 2019 Oct 30.
BACKGROUND
Accumulation of macrocyclic gadolinium agents in children's brains remain to be determined.
PURPOSE
To demonstrate whether there is an intracranial macrocyclic gadolinium deposition after multiple contrast-enhanced MRI with gadoterate meglumine in a pediatric population.
STUDY TYPE
Retrospective case-control.
POPULATION
In all, 45 children (age range: 5-17 years; mean, 13.7 ± 3.4 years) for the study group and 45 healthy children (age range: 5-17 years; mean, 13.7 ± 3.4 years) for the control group.
FIELD STRENGTH/SEQUENCE: T - and T -weighted axial images on a 1.5T scanner.
ASSESSMENT
Children with at least three enhanced brain MRIs and an age- and sex-matched control group with an unenhanced brain MRIs were compared in terms of T signal intensity (SI). All patients in the study group received gadoterate meglumine intravenously (0.1 mmol/kg). SI measurements were made by drawing six regions of interest (ROIs): dentate nuclei (DN), pons, globus pallidi (GP), frontal white matter (FWM), thalamus (T), clivus, and cerebrospinal fluid (CSF) for both groups on unenhanced T -weighted images.
STATISTICAL TESTS
Student's t-test was used for comparison of SI. The Pearson correlation was calculated for the correlation between the SI and the number of gadolinium administrations.
RESULTS
A significant difference was detected between two groups for DN/CSF, pons/CSF, GP/CSF, thalamus/CSF, and FWM/CSF (P < 0.001, P < 0.001, P = 0.002, P = 0.002, P = 0.024, respectively). There was no significant difference between the two groups for clivus/CSF (P = 0.15). A good correlation between the number of gadoterate meglumine administrations and the SI for DN/CSF, pons/CSF, GP/CSF, and T/CSF (r = 0.80, r = 0.73, r = 0.91, and r = 0.90, respectively) was found.
DATA CONCLUSION
A significant T SI increase reflecting gadolinium retention in the brain was detected for children with at least three gadoterate meglumine administrations in this series. The number of administrations correlated well with the increased SI.
LEVEL OF EVIDENCE
3 Technical Efficacy Stage: 5 J. Magn. Reson. Imaging 2020;51:1471-1477.
背景
大环钆剂在儿童大脑中的蓄积情况仍有待确定。
目的
证实儿科人群在多次使用钆喷酸葡胺进行对比增强磁共振成像（MRI）后是否存在颅内大环钆沉积。
研究类型
回顾性病例对照研究。
研究对象
研究组共45名儿童（年龄范围：5 - 17岁；平均年龄13.7 ± 3.4岁），对照组为45名健康儿童（年龄范围：5 - 17岁；平均年龄13.7 ± 3.4岁）。
场强/序列：在1.5T扫描仪上采集T加权和T加权轴向图像。
评估
对至少接受过三次脑部增强MRI检查的儿童与年龄和性别匹配、未进行脑部MRI增强检查的对照组进行T信号强度（SI）比较。研究组所有患者均静脉注射钆喷酸葡胺（0.1 mmol/kg）。在未增强的T加权图像上，通过绘制六个感兴趣区域（ROI）进行SI测量，这六个区域分别为两组的齿状核（DN）、脑桥、苍白球（GP）、额叶白质（FWM）、丘脑（T）、斜坡和脑脊液（CSF）。
统计检验
采用学生t检验比较SI。计算SI与钆剂给药次数之间的Pearson相关性。
结果
两组在DN/CSF、脑桥/CSF、GP/CSF、丘脑/CSF和FWM/CSF方面存在显著差异（分别为P < 0.001, P < 0.001, P = 0.002, P = 0.002, P = 0.024）。两组在斜坡/CSF方面无显著差异（P = 0.15）。发现钆喷酸葡胺给药次数与DN/CSF、脑桥/CSF、GP/CSF和T/CSF的SI之间具有良好的相关性（r分别为0.80、0.73、0.91和0.90）。
数据结论
在本系列中，至少接受过三次钆喷酸葡胺给药的儿童检测到反映大脑中钆潴留的显著T SI升高。给药次数与升高的SI具有良好的相关性。
证据水平
3 技术效能阶段：5 《磁共振成像杂志》2020年；51:1471 - 1477。
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