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01.03.2016 | Contrast Media | Ausgabe 3/2016

European Radiology 3/2016

Increasing signal intensity within the dentate nucleus and globus pallidus on unenhanced T1W magnetic resonance images in patients with relapsing-remitting multiple sclerosis: correlation with cumulative dose of a macrocyclic gadolinium-based contrast agent, gadobutrol

Zeitschrift:
European Radiology > Ausgabe 3/2016
Autoren:
Dragan A. Stojanov, Aleksandra Aracki-Trenkic, Slobodan Vojinovic, Daniela Benedeto-Stojanov, Srdjan Ljubisavljevic

Abstract

Objective

To evaluate correlation between cumulative dose of gadobutrol and signal intensity (SI) within dentate nucleus and globus pallidus on unenhanced T1-weighted images in patients with relapsing-remitting multiple sclerosis (RRMS).

Methods

Dentate nucleus-to-pons and globus pallidus-to-thalamus SI ratios, and renal and liver functions, were evaluated after multiple intravenous administrations of 0.1 mmol/kg gadobutrol at 27, 96–98, and 168 weeks. We compared SI ratios based on the number of administrations, total amount of gadobutrol administered, and time between injections.

Results

Globus pallidus-to-thalamus (p = 0.025) and dentate nucleus-to-pons (p < 0.001) SI ratios increased after multiple gadobutrol administrations, correlated with the number of administrations (ρ = 0.263, p = 0.046, respectively) and depended on the length of administration (p = 0.017, p = 0.037, respectively). Patients receiving gadobutrol at 27 weeks showed the greatest increase in both SI ratios (p = 0.006; p = 0.014, respectively, versus 96–98 weeks). GGT increased at the end of the study (p = 0.004).

Conclusion

In patients with RRMS, SI within the dentate nucleus and globus pallidus increased on unenhanced T1-weighted images after multiple gadobutrol injections. Administration of the same total amount of gadobutrol over a shorter period caused greater SI increase.

Key points

Gadolinium deposition may occur within the human brain after multiple gadolinium contrast administrations
Increasing T1W signal intensity occurs within the dentate nucleus and globus pallidus
Increasing signal intensity may be a consequence of multiple administrations of gadobutrol
Administration of gadobutrol over a shorter period causes greater signal intensity increase

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