Department of Radiology, Nagoya University Graduate School of Medicine.
Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine.
Magn Reson Med Sci. 2020 Dec 1;19(4):375-381. doi: 10.2463/mrms.mp.2019-0182. Epub 2020 Feb 6.
It has been reported previously that intravenously administered gadolinium-based contrast agent (GBCA) leaks into the subarachnoid space around the cortical veins at 4 h after injection in all old people over 37 years, but not in younger people up to 37 years of age in 3D-real IR images. The purpose of this study was to investigate whether there was a strict threshold of 37 years of age for the leakage of the GBCA into the subarachnoid space.
The subjects included 190 patients, that were scanned for 3D-real IR images at 4 hours after intravenous injection of GBCA as a diagnostic test for endolymphatic hydrops. The patient's age ranged from 14 to 81 years. Two experienced neuroradiologists evaluated the images to determine whether the GBCA leakage around the cortical veins was positive or negative. Any discrepancies between the two observers were discussed and a consensus was obtained.A Mann-Whitney U test and receiver operating characteristic (ROC) curve analysis were used to compare the positive and the negative group and to set the age cut-off value for the prediction of GBCA leakage.
The GBCA leakage around the cortical veins was negative in 35 patients and positive in 155 patients. The average age was 33 ± 11 years in the negative group, and 55 ± 12 years in the positive group (P < 0.01). In the ROC analysis for the age and leakage of the GBCA, an area under the curve was 0.905 and the cut-off age was 37.317 years (sensitivity of 0.942 and specificity of 0.771).
Intravenously administered GBCA leaks into the subarachnoid space around the cortical veins in most patients over 37 years of age. However, it should be noted that it can be found occasionally in patients under 37 years of age.
据报道，在注射后 4 小时的 3D-真实 IR 图像中，所有年龄超过 37 岁的老年人静脉内给予的钆基对比剂（GBCA）会漏入皮质静脉周围的蛛网膜下腔，但年龄在 37 岁以下的年轻人则没有。本研究的目的是探讨 GBCA 是否有严格的 37 岁年龄阈值进入蛛网膜下腔。
本研究共纳入 190 例患者，这些患者在静脉注射 GBCA 后 4 小时进行 3D-真实 IR 图像扫描，作为内淋巴积水的诊断性检查。患者年龄为 14 至 81 岁。两名有经验的神经放射科医生评估图像，以确定皮质静脉周围 GBCA 渗漏是否为阳性或阴性。两位观察者之间的任何差异都进行了讨论，并达成了共识。使用 Mann-Whitney U 检验和接收者操作特性（ROC）曲线分析比较阳性组和阴性组，并确定预测 GBCA 渗漏的年龄截止值。
皮质静脉周围 GBCA 渗漏阴性的患者有 35 例，阳性的患者有 155 例。阴性组患者的平均年龄为 33 ± 11 岁，阳性组患者的平均年龄为 55 ± 12 岁（P < 0.01）。在 GBCA 年龄和渗漏的 ROC 分析中，曲线下面积为 0.905，截止年龄为 37.317 岁（敏感性为 0.942，特异性为 0.771）。
大多数年龄超过 37 岁的患者静脉内给予的 GBCA 会漏入皮质静脉周围的蛛网膜下腔。然而，应当注意，在年龄在 37 岁以下的患者中偶尔也会出现这种情况。
