Wolansky L J, Finden S G, Chang R, Conigliari M, Lee H J, Shaderowsky P D, Cook S D
Department of Radiology of UMDNJ-New Jersey Medical School, Newark 07103, USA.
Clin Imaging. 1998 Nov-Dec;22(6):385-92. doi: 10.1016/s0899-7071(98)00072-2.
Enhancement of lesions in multiple sclerosis (MS) has been investigated using standard and high doses of gadolinium. The purposes of this study are to compare the relative merits of single and triple dose as well as examine the merits of delayed triple-dose images in a large group of patients. Thirty-seven patients with multiple sclerosis underwent contrast enhanced brain magnetic resonance imaging (MRI). After noncontrast images, a single dose (0.1 mmol/kg) of gadoteridol was administered. Subsequently, axial T1-weighted images were obtained immediately after administration, and again after a delay of approximately 20 minutes. After an additional 0.2-mmol/kg dose was administered, to provide a total cumulative dose of 0.3 mmol/kg of gadoteridol, immediate and delayed axial T1-weighted image sequences were repeated. The contrast-noise ratio (C/N) was calculated for each identified, enhancing lesion in each series. Furthermore, blinded readings were performed to determine the lesion detection rate. Of the forty definite lesions that underwent all four sequences, triple-dose delayed images exhibited the highest contrast-noise ratio in a significantly larger number of lesions (p < 0.0001). Triple-dose immediate and delayed scans resulted in significantly higher contrast-noise ratios (6.47 and 9.99, respectively) when compared with those of the single dose scans (3.4 for immediate scans and 5.24 for delayed) (p < 0.01). The lesion detection rate was highest for triple dose delayed (95%), followed by triple-dose immediate (83%), single-dose delayed (68%) and finally, single-dose immediate scans (43%). Triple-dose immediate was noted to have a significantly increased (p < 0.0002) lesion detection rate with respect to the standard-dose immediate scans and standard-dose delayed scans (p < 0.02). In four lesions (10% of the total number of lesions), detection occurred only with the triple-dose delayed image sequence. Triple-dose 0.3 mmol/kg gadolinium with delayed imaging resulted in the highest lesion conspicuity and the highest lesion identification rate. There was a trend of progressively increasing detection rates from single-dose immediate scans to triple-dose delayed scans. Triple-dose delayed scans resulted in significantly higher (p < 2 x 10(-8) contrast noise ratios than all other sequences of this study.
已使用标准剂量和高剂量钆对比剂对多发性硬化症（MS）病灶强化情况进行了研究。本研究的目的是比较单剂量和三剂量钆对比剂的相对优点，并在一大组患者中检验延迟三剂量图像的优点。37例多发性硬化症患者接受了对比增强脑磁共振成像（MRI）检查。在获取平扫图像后，给予单剂量（0.1 mmol/kg）钆特醇。随后，给药后立即及大约延迟20分钟后分别获取轴位T1加权图像。再给予额外0.2 mmol/kg剂量，使钆特醇总累积剂量达到0.3 mmol/kg，然后重复立即及延迟轴位T1加权图像序列采集。计算每个系列中每个已识别强化病灶的对比噪声比（C/N）。此外，进行盲法读片以确定病灶检出率。在接受所有四个序列检查的40个明确病灶中，三剂量延迟图像在显著更多的病灶中表现出最高的对比噪声比（p < 0.0001）。与单剂量扫描相比，三剂量立即扫描和延迟扫描的对比噪声比显著更高（分别为6.47和9.99），单剂量立即扫描和延迟扫描的对比噪声比分别为3.4和5.24（p < 0.01）。病灶检出率最高的是三剂量延迟扫描（95%），其次是三剂量立即扫描（83%）、单剂量延迟扫描（68%），最后是单剂量立即扫描（43%）。三剂量立即扫描相对于标准剂量立即扫描和标准剂量延迟扫描的病灶检出率显著增加（p < 0.0002）（p < 0.02）。在4个病灶（占病灶总数的10%）中，仅在三剂量延迟图像序列中检测到病灶。0.3 mmol/kg钆对比剂三剂量延迟成像导致病灶显示度最高和病灶识别率最高。从单剂量立即扫描到三剂量延迟扫描，检出率有逐渐增加的趋势。三剂量延迟扫描的对比噪声比显著高于本研究的所有其他序列（p < 2×10⁻⁸）。
