Eileen Kasper1, Haemi Phaedra Schemuth1, Samantha Horry1, Sonja Kinner2. 1. Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstr. 55, 45133, Essen, Germany. 2. Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstr. 55, 45133, Essen, Germany. Sonja.Kinner@uni-due.de.
Abstract
BACKGROUND: Signal increase on T1-weighted magnetic resonance imaging (MRI) in the dentate nucleus has been reported in adults after multiple injections of gadolinium-based contrast agents. Linear contrast agents are more prone to cause this increase. Studies in children are still rare and focus mostly on the analysis of one single agent. OBJECTIVE: To compare signal intensity chances in children after more than four injections of either only linear or only macrocyclic contrast agents. MATERIALS AND METHODS: Seventy children (examined from October 2001 to February 2016) were included in this retrospective study. Signal intensities in the dentate nucleus and pons were measured on non-enhanced T1-weighted images from the first and last MRI scans. A two-sample t-test compared the dentate nucleus-to-pons signal intensity ratio differences for linear versus macrocyclic gadolinium-based contrast agent applications and also the number of applications (4-8, 9-12 or >12). Patients' charts were analysed to evaluate potentially associated neurological symptoms. RESULTS: Patients had contrast-enhanced MRI using either only linear (n=16) or only macrocyclic (n=54) gadolinium-based contrast agents. In patients with >12 injections, dentate nucleus-to-pons signal intensity ratio was statistically different concerning the contrast agent class (0.16±0.125 for macrocyclic vs. 0.0005±0.13 for linear agents). For linear agents, a statistically significant increase was found between 4-8 injections (-0.051±0.087) and >12 injections (0.16±0.125). No neurological symptoms were recorded in patients with signal changes. CONCLUSION: Multiple injections of linear gadolinium-based contrast agents lead to a signal increase of the dentate nucleus in children. Signal intensity increases depend on the number of injections of linear contrast agents.
BACKGROUND: Signal increase on T1-weighted magnetic resonance imaging (MRI) in the dentate nucleus has been reported in adults after multiple injections of gadolinium-based contrast agents. Linear contrast agents are more prone to cause this increase. Studies in children are still rare and focus mostly on the analysis of one single agent. OBJECTIVE: To compare signal intensity chances in children after more than four injections of either only linear or only macrocyclic contrast agents. MATERIALS AND METHODS: Seventy children (examined from October 2001 to February 2016) were included in this retrospective study. Signal intensities in the dentate nucleus and pons were measured on non-enhanced T1-weighted images from the first and last MRI scans. A two-sample t-test compared the dentate nucleus-to-pons signal intensity ratio differences for linear versus macrocyclic gadolinium-based contrast agent applications and also the number of applications (4-8, 9-12 or >12). Patients' charts were analysed to evaluate potentially associated neurological symptoms. RESULTS:Patients had contrast-enhanced MRI using either only linear (n=16) or only macrocyclic (n=54) gadolinium-based contrast agents. In patients with >12 injections, dentate nucleus-to-pons signal intensity ratio was statistically different concerning the contrast agent class (0.16±0.125 for macrocyclic vs. 0.0005±0.13 for linear agents). For linear agents, a statistically significant increase was found between 4-8 injections (-0.051±0.087) and >12 injections (0.16±0.125). No neurological symptoms were recorded in patients with signal changes. CONCLUSION: Multiple injections of linear gadolinium-based contrast agents lead to a signal increase of the dentate nucleus in children. Signal intensity increases depend on the number of injections of linear contrast agents.
Entities:
Keywords:
Brain; Children; Dentate nucleus; Gadolinium deposition; Gadolinium-based contrast agents; Pons; Signal intensity ratio
Authors: Alexander Radbruch; Lukas D Weberling; Pascal J Kieslich; Oliver Eidel; Sina Burth; Philipp Kickingereder; Sabine Heiland; Wolfgang Wick; Heinz-Peter Schlemmer; Martin Bendszus Journal: Radiology Date: 2015-04-06 Impact factor: 11.105
Authors: Alexander Radbruch; Robert Haase; Pascal J Kieslich; Lukas D Weberling; Philipp Kickingereder; Wolfgang Wick; Heinz-Peter Schlemmer; Martin Bendszus Journal: Radiology Date: 2016-12-07 Impact factor: 11.105
Authors: Alexander Radbruch; Robert Haase; Philipp Kickingereder; Philipp Bäumer; Sebastian Bickelhaupt; Daniel Paech; Wolfgang Wick; Heinz-Peter Schlemmer; Angelika Seitz; Martin Bendszus Journal: Radiology Date: 2017-03-08 Impact factor: 11.105
Authors: Nozomu Murata; Luis F Gonzalez-Cuyar; Kiyoko Murata; Corinne Fligner; Russell Dills; Daniel Hippe; Kenneth R Maravilla Journal: Invest Radiol Date: 2016-07 Impact factor: 6.016
Authors: G K Schneider; J Stroeder; G Roditi; C Colosimo; P Armstrong; M Martucci; A Buecker; P Raczeck Journal: AJNR Am J Neuroradiol Date: 2017-06-22 Impact factor: 3.825
Authors: D R Roberts; A R Chatterjee; M Yazdani; B Marebwa; T Brown; H Collins; G Bolles; J M Jenrette; P J Nietert; X Zhu Journal: AJNR Am J Neuroradiol Date: 2016-07-28 Impact factor: 3.825
Authors: A Luana Stanescu; Dennis W Shaw; Nozomu Murata; Kiyoko Murata; Joe C Rutledge; Ezekiel Maloney; Kenneth R Maravilla Journal: Pediatr Radiol Date: 2020-01-27
Authors: Carlo C Quattrocchi; Joana Ramalho; Aart J van der Molen; Àlex Rovira; Alexander Radbruch Journal: Eur Radiol Date: 2018-11-09 Impact factor: 5.315
Authors: Felix Streckenbach; Oliver Stachs; Sönke Langner; Rudolf F Guthoff; Felix G Meinel; Marc-André Weber; Thomas Stahnke; Ebba Beller Journal: Invest Ophthalmol Vis Sci Date: 2020-12-01 Impact factor: 4.799