Department of Neurology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81541, Munich, Germany.
TUM Neuroimaging Center, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81541, Munich, Germany.
Clin Neuroradiol. 2021 Mar;31(1):235-243. doi: 10.1007/s00062-020-00882-6. Epub 2020 Feb 13.
Through analysis of T1-weighted (T1w) images this study investigated gadolinium (Gd) deposition in the brain after administration of a linear (gadopentetic acid) and a cyclic (gadoteric acid) gadolinium-based contrast agent (GBCA) in patients with multiple sclerosis (MS), a disorder frequently requiring magnetic resonance imaging (MRI) scans over years.
A total of 3233 T1w images (unenhanced with respect to the same scanning session) of 881 MS patients were retrospectively analyzed. After spatial normalization and intensity scaling using a sphere within the pons, differences of all pairs of subsequent scans were calculated and attributed to either linear (n = 2718) or cyclic (n = 385) or no GBCA (n = 130) according to the first scan. Regional analyses were performed, focusing on the dentate nucleus, and whole brain analyses. By 1‑sample t‑tests, signal intensity increases within conditions were searched for; conditions were compared by 2‑sample t‑tests. Furthermore, recent hypotheses on the reversibility of GBCA deposition were tested.
In the dentate nucleus, a significant increase was observed only after administration of linear GBCA even after a single GBCA administration. This increase differed significantly (p < 0.001) from the other conditions (cyclic and no GBCA). Whole brain analyses revealed T1w signal increases only after administration of linear GBCA within two regions, the dentate nucleus and globus pallidus. Additional analyses did not indicate any decline of Gd deposition in the brain.
The data point towards Gd deposition in the brain after administration of linear GBCA even after a single administration.
通过分析 T1 加权（T1w）图像，本研究调查了在多发性硬化症（MS）患者中使用线性（钆喷替酸）和环状（钆特酸）基于钆的造影剂（GBCA）后，大脑中钆的沉积情况。这种疾病通常需要多年的磁共振成像（MRI）扫描。
回顾性分析了 881 例 MS 患者的 3233 张 T1w 图像（与同一扫描时段相比未增强）。在使用桥内球体进行空间归一化和强度缩放后，计算所有后续扫描对之间的差异，并根据第一次扫描将其归因于线性（n=2718）、环状（n=385）或无 GBCA（n=130）。进行了区域分析，重点关注齿状核和全脑分析。通过 1 样本 t 检验，搜索条件内的信号强度增加；通过 2 样本 t 检验比较条件。此外，还测试了最近关于 GBCA 沉积可逆性的假设。
在齿状核中，仅在给予线性 GBCA 后观察到明显的增加，即使仅给予单次 GBCA 后也是如此。这种增加与其他条件（环状和无 GBCA）有显著差异（p<0.001）。全脑分析显示，仅在给予线性 GBCA 后，在两个区域，即齿状核和苍白球中，T1w 信号增加。进一步的分析表明，大脑中的 Gd 沉积没有下降。
即使在单次给药后，数据也表明在给予线性 GBCA 后大脑中 Gd 的沉积。
