Linear gadolinium-based contrast agent (gadodiamide and gadopentetate dimeglumine)-induced high signal intensity on unenhanced T(1) -weighted images in pediatric patients.

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Ichikawa S, Omiya Y, Onishi H, Motosugi U

Linear gadolinium-based contrast agent (gadodiamide and gadopentetate dimeglumine)-induced high signal intensity on unenhanced T(1) -weighted images in pediatric patients.

J Magn Reson Imaging. 2019 Apr;49(4):1046-1052. doi: 10.1002/jmri.26311. Epub 2018 Oct 11.

PubMed ID
30307671 [ View in PubMed
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Abstract

BACKGROUND: Recent studies of adults have found an association between hyperintensity of the dentate nucleus (DN) and globus pallidus (GP) on T(1) -weighted images (T(1) WI) and a history of linear gadolinium-based contrast agent (GBCA) administration. Several reports have also focused on this phenomenon in pediatric patients; however, data in the current literature remains limited. PURPOSE/HYPOTHESIS: To evaluate the associations between DN and GP T(1) -signal increase and previous administration of linear GBCAs in pediatric patients. STUDY TYPE: Single-center, retrospective, cross-sectional study. POPULATION: We included pediatric patients with histories of >/=5 linear GBCA (gadodiamide and gadopentetate dimeglumine) administrations (the ">/=5 Linear GBCA administrations" group), 1-4 administrations (the "1-4 Linear GBCA administrations" group), and no history of GBCA administration (the "No GBCA administration" group). Each group included 42 patients. Therefore, 126 patients (male:female, 72:54; median age, 16 [range, 4-18] years) were included in this study. FIELD STRENGTH/SEQUENCE: 1.5T/ Spin-echo unenhanced T(1) -weighted imaging. ASSESSMENT: Unenhanced T(1) -weighted images were quantitatively analyzed by two radiologists. The DN-to-pons and GP-to-thalamus signal intensity ratios (DN-to-pons and GP-to-thalamus ratios, respectively) were compared. STATISTICAL TESTS: Wilcoxon test with the Bonferroni correction and intraclass correlation coefficients. RESULTS: The DN-to-pons ratio increased as the number of GBCA administrations increased (P < 0.0063). The GP-to-thalamus ratio of the ">/=5 Linear GBCA administrations" group was significantly higher than those of the other two groups (P < 0.0001). The GP-to-thalamus ratio of the "1-4 Linear GBCA administrations" group did not differ significantly from that of the "No GBCA administration" group (P = 1.000). The DN-to-pons and GP-to-thalamus ratios' interobserver intraclass correlation coefficients were excellent (0.8236) and good (0.6738), respectively. DATA CONCLUSION: High signal intensities in the DN and GP on T(1) WI were associated with previous linear GBCA administration in pediatric patients. LEVEL OF EVIDENCE: 3 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;49:1046-1052.

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