From the Departments of Radiology (Y.C., J.J., J.K., Y.N., N.Y.S., K.J.A., B.S.K.) and Neurosurgery (S.S.J.), Seoul Saint Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Korea; and Department of Radiology, Eunpyeong Saint Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea (Y.N.).
Radiology. 2020 Oct;297(1):143-150. doi: 10.1148/radiol.2020192579. Epub 2020 Jul 21.
Background The relationship between administration of macrocyclic gadolinium-based contrast agents and T1-weighted signal intensity (SI) change of the globus pallidus (GP) and dentate nucleus (DN) is, to the knowledge of the authors, not known. Purpose To determine if quantitative susceptibility mapping (QSM) can detect changes in magnetic susceptibility of the GP and DN after serial administration of macrocyclic gadobutrol in patients with primary brain tumors. Materials and Methods Patients diagnosed with primary brain tumors from August 2014 to February 2019 were eligible for this single-center retrospective study. Among 501 consecutive adult patients who were given at least one administration of gadobutrol, those who were previously administered an unknown or linear gadolinium-based contrast agent were excluded. Brain MRI scans with three-dimensional gradient-recalled-echo image phase data for QSM processing were reviewed. Regions of interest were drawn on the GP and DN on the basis of semiautomatic thresholding. Univariable generalized estimation equations were used to determine the associations between MRI measures (SI on T1-weighted images and magnetic susceptibility on QSM) and number of gadobutrol doses. Potential confounding factors were adjusted for in multivariable generalized estimating equation. Results Ninety patients (mean age, 51 years ± 17 [standard deviation]; 51 men) with 199 MRI scans were analyzed. In models adjusted for repeated observations between injections, the number of injections of gadobutrol was associated with the magnetic susceptibility of the GP (1.4 × 10 ppm/number of gadobutrol injections; = .01) and DN (8.1 × 10 ppm/number of gadobutrol injections; = .03). After adjustment for confounders, the number of gadobutrol injections remained an independent predictor of increased magnetic susceptibility in the GP (1.3 × 10 ppm/number of gadobutrol injections; 95% confidence interval: 0.39 × 10, -2.4 × 10; = .006). There were no associations between number of gadobutrol injections and SI or magnetic susceptibility in the DN. Conclusion The magnetic susceptibility of the globus pallidus increased after serial administration of gadobutrol. © RSNA, 2020 See also the editorial by Wang and Prince in this issue.
目前尚不清楚大环类钆对比剂给药与苍白球（GP）和齿状核（DN）的 T1 加权信号强度（SI）变化之间的关系。目的：确定定量磁化率映射（QSM）是否可以检测到原发性脑肿瘤患者连续给予大环类钆布醇后 GP 和 DN 磁化率的变化。材料与方法：本单中心回顾性研究纳入了 2014 年 8 月至 2019 年 2 月期间诊断为原发性脑肿瘤的患者。在 501 例连续接受至少一次钆布醇给药的成年患者中，排除了先前接受未知或线性钆对比剂给药的患者。对 QSM 处理的三维梯度回波图像相位数据进行脑 MRI 扫描复查。根据半自动阈值法在 GP 和 DN 上绘制感兴趣区。使用单变量广义估计方程确定 MRI 测量值（T1 加权图像上的 SI 和 QSM 上的磁化率）与布醇剂量之间的相关性。在多变量广义估计方程中对潜在混杂因素进行调整。结果：共分析了 90 例（平均年龄，51 岁±17[标准差]；51 例男性）199 次 MRI 扫描。在调整了注射之间重复观察的模型中，布醇注射次数与 GP（1.4×10 ppm/布醇注射次数； =.01）和 DN（8.1×10 ppm/布醇注射次数； =.03）的磁化率相关。调整混杂因素后，布醇注射次数仍是 GP 磁化率增加的独立预测因素（1.3×10 ppm/布醇注射次数；95%置信区间：0.39×10，-2.4×10； =.006）。布醇注射次数与 DN 中的 SI 或磁化率之间无相关性。结论：连续给予布醇后，苍白球的磁化率增加。©RSNA，2020 本期亦见 Wang 和 Prince 的社论。
