Department of Radiology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, 3333 Burnet Ave., MLC 5031, Cincinnati, OH, 45229, USA.
Division of Biostatistics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Pediatr Radiol. 2021 Mar;51(3):457-470. doi: 10.1007/s00247-020-04860-5. Epub 2021 Jan 5.
Gadolinium deposition occurs following repeated administration of gadolinium-based contrast media. However, few studies have evaluated factors that lead to increased detection of deposition or the individual differences among patients.
To measure the effect of repeated dosages of gadopentetate dimeglumine on pediatric brains and to determine the factors that influence signal intensity changes.
A retrospective study evaluated magnetic resonance imaging (MRI) in patients <18 years of age who received >5 doses of gadopentetate dimeglumine. Regions of interest were placed in 30 locations in the brain on axial precontrast T1 images. Signal intensity ratios were evaluated throughout the brain. The effect of increasing gadopentetate dimeglumine exposure on signal intensity ratios was assessed using linear mixed models adjusted for gender, age, imaging sequence type (fast spin echo or gradient echo), MRI manufacturer (General Electric, Philips or Siemens), and field strength (1.5 tesla [T] or 3 T). Finally, the variance of the random slope in the linear mixed models was tested to determine if there were differences in the rate of signal intensity ratio change among individuals.
Fifty patients (M:F=25:25; mean age at first imaging: 6.4 years) with a mean of 21.5 gadopentetate dimeglumine administrations (range: 6-86) were included. There were significant increases in T1 signal in the globus pallidus, dentate nucleus and pulvinar with an increasing number of contrast administrations. Patient gender, age, and MRI field strength were not associated with changing signal intensity ratios. However, MRI sequence type and vendor significantly impacted some measured signal intensity ratios. Finally, significant differences in the slopes of the ratios were present among patients for multiple locations.
Repeated administration of gadopentetate dimeglumine is associated with T1 hyperintense signal in the dentate nucleus, globus pallidus and pulvinar. Detection is significantly affected by MRI sequence type and scanner vendor. Even when accounting for these differences, there are individual differences in the slope of signal intensity change suggesting a patient-level effect influences gadolinium deposition.
在重复使用基于钆的造影剂后，会发生钆沉积。然而，很少有研究评估导致沉积检测增加的因素或患者之间的个体差异。
测量重复使用钆喷替酸葡甲胺对儿科大脑的影响，并确定影响信号强度变化的因素。
一项回顾性研究评估了接受 >5 次钆喷替酸葡甲胺剂量的<18 岁患者的磁共振成像（MRI）。在轴向预对比 T1 图像上，在大脑的 30 个位置放置感兴趣区。评估整个大脑的信号强度比。使用线性混合模型评估增加的钆喷替酸葡甲胺暴露对信号强度比的影响，该模型调整了性别、年龄、成像序列类型（快速自旋回波或梯度回波）、MRI 制造商（通用电气、飞利浦或西门子）和磁场强度（1.5 特斯拉[T]或 3T）。最后，测试线性混合模型中随机斜率的方差，以确定个体之间信号强度比变化率是否存在差异。
共纳入 50 名患者（男：女=25:25；首次成像时的平均年龄为 6.4 岁），平均接受 21.5 次钆喷替酸葡甲胺给药（范围：6-86）。随着造影剂给药次数的增加，苍白球、齿状核和丘脑髓质的 T1 信号显著增加。患者性别、年龄和 MRI 场强与信号强度比的变化无关。然而，MRI 序列类型和供应商显著影响了一些测量的信号强度比。最后，对于多个位置，患者之间的比值斜率存在显著差异。
重复使用钆喷替酸葡甲胺与齿状核、苍白球和丘脑髓质的 T1 高信号有关。检测结果受 MRI 序列类型和扫描仪供应商的显著影响。即使考虑到这些差异，信号强度变化斜率仍存在个体差异，这表明患者个体差异会影响钆沉积。
