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双倍剂量钆喷酸葡胺对比增强磁共振成像在脑与脊髓疾病评估中的应用

[Contrast-enhanced MR imaging using double doses of gadolinium-DTPA in evaluating brain and spinal diseases].

作者信息

Matsumoto S, Hasuo K, Uchino A, Matsuura Y, Gibo M, Fukui M, Masuda K

机构信息

Department of Radiology, Faculty of Medicine, Kyushu University.

出版信息

Nihon Igaku Hoshasen Gakkai Zasshi. 1993 May 25;53(5):503-10.

PMID:8327315
Abstract

Forty-one lesions of intracranial and spinal diseases underwent magnetic resonance (MR) imaging at both standard-dose (0.1 mmol/kg) and double-dose (0.2 mmol/kg) levels of gadolinium (Gd)-DTPA in order to reassess the optimal dose of Gd-DTPA. Each patient received an initial injection of 0.1 mmol/kg and an additional dose of 0.1 mmol/kg 5 min later. In quantitative analysis of contrast enhancement ratios of the enhancing part of the lesion, choroid plexus, cavernous sinus and pituitary stalk were significantly (P < 0.01) increased in double-dose studies. For visual comparison, we defined delineation as the extent to which the lesion may be defined; detectability was defined as the ability to visualize the lesion. With respect to delineation, double-dose studies were superior to standard-dose studies in nine of 20 intraaxial tumor (four of eight malignant gliomas, three of eight benign gliomas and two of four metastatic brain tumors) and five of six cerebral infarcts. The detectability of the lesion was improved in four cases (one astrocytoma, two metastatic brain tumors and one cerebral infarct) in double-dose studies. It was concluded that contrast-enhanced MR imaging using double doses of Gd-DTPA may be useful in the detection and evaluation of the extent of intraaxial lesions enhanced by Gd-DTPA.

摘要

为重新评估钆喷酸葡胺(Gd-DTPA)的最佳剂量,对41例颅内和脊髓疾病病变进行了标准剂量(0.1 mmol/kg)和双倍剂量(0.2 mmol/kg)Gd-DTPA的磁共振(MR)成像检查。每位患者先注射0.1 mmol/kg,5分钟后再追加0.1 mmol/kg剂量。在对病变强化部分、脉络丛、海绵窦和垂体柄的对比增强率进行定量分析时,双倍剂量研究中的这些指标均显著升高(P < 0.01)。为便于视觉比较,我们将清晰度定义为病变可被界定的程度;可检测性定义为病变可视化的能力。在清晰度方面,双倍剂量研究在20例脑内肿瘤中的9例(8例恶性胶质瘤中的4例、8例良性胶质瘤中的3例和4例脑转移瘤中的2例)以及6例脑梗死中的5例中优于标准剂量研究。在双倍剂量研究中,4例病变(1例星形细胞瘤、2例脑转移瘤和1例脑梗死)的可检测性得到改善。得出的结论是,使用双倍剂量Gd-DTPA的对比增强MR成像可能有助于检测和评估Gd-DTPA强化的脑内病变范围。

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