Department of Radiology, Kamiiida Daiichi General Hospital.
Department of Radiology, Nagoya University Graduate School of Medicine.
Magn Reson Med Sci. 2021 Jun 1;20(2):175-181. doi: 10.2463/mrms.mp.2020-0016. Epub 2020 Jul 9.
Leakage of a small amount of intravenously administered gadolinium-based contrast agents (GBCAs) into the cerebrospinal fluid (CSF) space has been reported, even in healthy subjects without blood-brain barrier disruption. Several candidates including the choroid plexus and cortical veins have been proposed as the source of the leakage. The purpose of this study was to evaluate the distribution of intravenously administered GBCA leakage into the CSF by comparing the contrast enhancement of the cerebral cisterns to the lateral ventricles (LVs).
In 26 patients with a suspicion of endolymphatic hydrops (21-80 years old), a three-dimensional real inversion recovery (3D-real IR) image was obtained at pre-, and at 5 min, and 4 h post-intravenous administration of a single dose of GBCA (IV-SD-GBCA). In the 3D-real IR image, the signal intensities (SIs) in the anterior horn of the LV (LV), the trigone of the LV (LV), the Sylvian fissure (SyF), the ambient cistern (Amb), the prepontine cistern (PPC), the cerebellopontine angle cistern (CPA), and the vitreous (Vit) were measured. The differences in the SI at pre-, and at 5 min and 4 h post-IV-SD-GBCA were evaluated for each region. The change in the SI pre- to post-IV-SD-GBCA (SI) were calculated for each region. The differences in the SI in each region were evaluated at 5 min and 4 h post-IV-SD-GBCA. A Steel-Dwass's test was applied to correct for multiple comparisons.
The SIs of all regions at 4 h post-IV-SD-GBCA were significantly higher compared with pre-IV-SD-GBCA (P < 0.05). The SI in the SyF, Amb, PPC, and the CPA were significantly higher compared with those of the LV, LV, and the Vit at 4 h post-IV-SD-GBCA (P < 0.05).
The contrast enhancement in the cerebral cisterns was greater than that in the LVs.
已有报道称，即使在没有血脑屏障破坏的健康受试者中，也会有少量静脉内给予的基于钆的造影剂（GBCA）漏入脑脊液（CSF）空间。一些候选物，包括脉络丛和皮质静脉，已被提议作为渗漏的来源。本研究的目的是通过比较脑池与侧脑室（LV）的对比增强来评估静脉内给予 GBCA 渗漏到 CSF 中的分布。
在 26 例怀疑内淋巴积水的患者（21-80 岁）中，在静脉内单次给予 GBCA 后即刻（pre-IV-SD-GBCA）、5 分钟（5 min）和 4 小时（4 h）进行三维实时反转恢复（3D-real IR）图像采集。在 3D-real IR 图像中，测量 LV 前角（LV）、LV 三角（LV）、大脑外侧裂（SyF）、环池（Amb）、脑桥前池（PPC）、小脑脑桥角池（CPA）和玻璃体（Vit）的信号强度（SI）。评估每个区域在 pre-IV-SD-GBCA 以及 5 分钟和 4 小时后的 SI 差异。计算每个区域在 pre-IV-SD-GBCA 后的 SI 变化（SI）。评估每个区域在 IV-SD-GBCA 后 5 分钟和 4 小时的 SI 差异。采用 Steel-Dwass 检验校正多重比较。
IV-SD-GBCA 后 4 小时所有区域的 SI 均显著高于 pre-IV-SD-GBCA（P<0.05）。与 IV-SD-GBCA 后 4 小时的 LV、LV 和 Vit 相比，SyF、Amb、PPC 和 CPA 的 SI 显著升高（P<0.05）。
脑池的对比增强大于 LV。
