Virapongse C, Mancuso A, Quisling R
Radiology. 1986 Dec;161(3):785-94. doi: 10.1148/radiology.161.3.3786734.
During Food and Drug Administration phase II and III clinical trials for gadolinium DTPA, the paramagnetic agent was used to study 11 patients with 20 subacute and chronic cerebral infarcts. Five patients had numerous periventricular and deep white-matter lesions, probably due to chronic ischemic disease. Magnetic resonance (MR) imaging was performed 4-30 days after the ictus, preceded by computed tomography (CT) in all but one case. In most cases, the nonenhanced spin-echo (SE) images, obtained at 500-msec repetition times and 30-msec echo times, failed to demonstrate the infarct, and in general the gadolinium-enhanced SE 500/30 images matched the contrast material-enhanced CT scans in pattern. Periventricular lesions and small, deep, white-matter infarcts that were chronic and asymptomatic were not enhanced by gadolinium MR. However, three small, symptomatic capsular and brain-stem infarcts showed definite enhancement. Usually the enhancement was visible at 3 minutes, increasing to a peak at 30 minutes. At 55 minutes, the enhancement increased in the medium-aged infarcts (8-14 days), while it decreased in the late infarcts (15-30 days). The T2 relaxation time-weighted pulse sequences were most sensitive for demonstrating all infarcts, but without the aid of a contrast agent, they were frequently poor in specificity.
在食品药品监督管理局对钆喷酸葡胺进行的II期和III期临床试验中，这种顺磁性造影剂被用于研究11例患有20处亚急性和慢性脑梗死的患者。5例患者有大量脑室周围和深部白质病变，可能是由于慢性缺血性疾病所致。除1例患者外，所有患者在发病后4至30天进行了磁共振（MR）成像，之前均进行了计算机断层扫描（CT）。在大多数情况下，在500毫秒重复时间和30毫秒回波时间获得的非增强自旋回波（SE）图像未能显示梗死灶，一般来说，钆增强SE 500/30图像在模式上与造影剂增强CT扫描相匹配。脑室周围病变以及慢性无症状的小的深部白质梗死灶在钆增强MR检查中未强化。然而，3处有症状的小的囊腔和脑干梗死灶显示出明确的强化。通常在3分钟时可见强化，在30分钟时增强至峰值。在55分钟时，中年梗死灶（8 - 14天）的强化增加，而晚期梗死灶（15 - 30天）的强化则减少。T2弛豫时间加权脉冲序列对显示所有梗死灶最敏感，但在没有造影剂辅助的情况下，其特异性往往较差。
