Gadopentetate Dimeglumine, Çocukların Beyinlerinde Gadolinyum Birikimine Neden Olur Mu?

Amaç: Kontrastlı manyetik rezonans görüntüleme (MRG) için tekrarlayan gadopentetate dimeglumine uygulanan pediyatrik hastalarda dentat çekirdek (DN) ve globus pallidus’ta (GP) ağırlıklı (T1A) sinyal yoğunluğu (SI) farklılıklarını belirlemek. Gereç ve Yöntem: Bu retrospektif çalışmaya, kontrast madde olarak en az iki kez intravenöz olarak gadopentetate dimeglumine uygulanan (0.1 mmol/kg) ve kontrastlı beyin MRG yapılan çocuk hastalar dahil edildi. SI ölçümleri, kontrastsız T1A görüntülerinde bilateral dentat çekirdekler (DN) ve globus pallidi (GP) ve beyin omurilik sıvısı (BOS) üzerine beş ROI alanı çizilerek yapıldı. SI karşılaştırması için Student t testi kullanıldı. SI ile gadolinyum uygulama sayısı arasındaki korelasyonu değerlendirmek için Pearson korelasyonu hesaplandı. Bulgular: Toplam 31 çocuk (yaş aralığı: 3-17 yıl; ortalama 10.6±4.3 yıl) çalışmaya dahil edildi. T1 SI oranları açısından birinci ve üçüncü MRG taramaları arasında anlamlı bir fark yoktu: sağ ve sol DN/CSF, sağ ve sol GP/CSF (P =0.543, P =0.599, P =0.803, P =0.730 , sırasıyla). İkiden fazla gadopentetate dimeglumine uygulanan 18 hasta mevcuttu ve ortalama uygulama sayısı 5±3'tü. İlk ve son MRG taramaları arasında T1 S1 oranları arçısından anlamlı bir fark saptandı; sağ ve sol DN/CSF, sağ ve sol GP/CSF (sırasıyla P=0.0004, P=0.0008, P=0.0001, P=0.014). Gadopentetate dimeglumine uygulamasının sayısı ile sağ ve sol DN/CSF, sağ ve sol GP/CSF (sırasıyla r=0.13, r=0.13, r=0.09 ve r=0.12) SI değerleri arasındaki korelasyon zayıftı. Sonuç: Bu seride iki kez gadopentetate dimeglumine uygulaması sonrası DN ve GP ‘de anlamlı T1 SI artışı olmazken çoklu uygulama sonrası anlamlı T1 SI artışı bulundu.

Anahtar Kelimeler:

kontrast madde, beyin MRG, linear, gadolinium birikimi

Does Gadopentetate Dimeglumine Induce Gadolinium Accumulation in the Brains of Children?

Aim: To determine T1-weighted (T1W) signal intensity (SI) differences in the dentate nucleus (DN) and globus pallidus (GP) following contrast enhanced magnetic resonance imaging (MRI) with multiple gadopentetate dimeglumine administrations in a group of pediatric patients. Methods and materials: This retrospective study included children with at least two enhanced brain MRIs. All patients received gadopentetate dimeglumine intravenously (0.1 mmol/kg). SI measurements were done by drawing five region of interests (ROI) on dentate nuclei (DN) and globus pallidi (GP) bilaterally and cerebro-spinal fluid (CSF) in unenhanced T1W images. Student t-test was used for comparison of SI. Pearson correlation was calculated for the correlation between the SI and the number of gadolinium administrations. Results: A total of 31 children (age range: 3-17 years; mean 10.6±4.3 years) were included. There was no significant difference between the first and the third MRI scans by means of the T1 SI ratios: right and left DN/CSF, right and left GP/CSF (P =0.543, P =0.599, P =0.803, P =0.730, respectively). 18 patients received more than two gadopentetate dimeglumine, the mean number of administrations was 5±3. A significant difference was detected between first and last MRI scans; right and left DN/CSF, right and left GP/CSF (P=0.0004, P=0.0008, P=0.0001, P=0.014 respectively). Correlation between the number of gadopentetate dimeglumine administrations and the SI for right and left DN/CSF, right and left GP/CSF (r=0.13, r=0.13, r=0.09 and r=0.12, respectively) was poor. Conclusion: There was no significant T1 SI increase for children with at least two gadopentetate dimeglumine administrations but after multiple administrations, significant T1 SI increase was found in this series.

Keywords:

contrast agent, brain MRI, linear, gadolinium accumulation,

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