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Eur J Radiol. 2018 Aug;105:204-208. doi: 10.1016/j.ejrad.2018.06.011. Epub 2018 Jun 19.

Weekly enhanced T1-weighted MRI with Gadobutrol injections in MS patients: Is there a signal intensity increase in the dentate nucleus and the globus pallidus?

Author information

1
Faculté de médecine Lyon Est, Université Claude Bernard Lyon 1, Université de Lyon, 69008, Lyon, France.
2
CREATIS, CNRS UMR 5220 - INSERM U1206, Université de Lyon, 69621, Villeurbanne, France; Nehme and Therese Tohme Multiple Sclerosis Center, American University of Beirut Medical Center, 1107 2020, Beirut, Lebanon.
3
CREATIS, CNRS UMR 5220 - INSERM U1206, Université de Lyon, 69621, Villeurbanne, France.
4
Service de Neurologie A and Eugène Devic EDMUS Foundation against Multiple Sclerosis, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, 69677, Bron, France; Observatoire Français de la Sclérose en Plaques, Université de Lyon, 69677, Bron, France.
5
Faculté de médecine Lyon Est, Université Claude Bernard Lyon 1, Université de Lyon, 69008, Lyon, France; CREATIS, CNRS UMR 5220 - INSERM U1206, Université de Lyon, 69621, Villeurbanne, France; Service de Neurologie A and Eugène Devic EDMUS Foundation against Multiple Sclerosis, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, 69677, Bron, France.
6
Observatoire Français de la Sclérose en Plaques, Université de Lyon, 69677, Bron, France.
7
Faculté de médecine Lyon Est, Université Claude Bernard Lyon 1, Université de Lyon, 69008, Lyon, France; CREATIS, CNRS UMR 5220 - INSERM U1206, Université de Lyon, 69621, Villeurbanne, France; CERMEP-Imagerie du Vivant, Université de Lyon, 69677, Bron, France.
8
Faculté de médecine Lyon Est, Université Claude Bernard Lyon 1, Université de Lyon, 69008, Lyon, France; CREATIS, CNRS UMR 5220 - INSERM U1206, Université de Lyon, 69621, Villeurbanne, France; Service de Radiologie, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, 69310, Pierre Bénite, France. Electronic address: francois.cotton@chu-lyon.fr.

Abstract

BACKGROUND AND PURPOSE:

Gadolinium-based contrast agents (GBCAs) administration have drastically improved the accuracy of Multiple Sclerosis (MS) diagnosis by highlighting any damage to the brain blood barrier, thereby differentiating between active and non-active lesions. Following multiple administrations of GBCAs, several MS studies have reported a signal intensity (SI) increase on unenhanced T1-weighted images in certain brain regions such as the dentate nucleus (DN) and the globus pallidus (GP). Our aim was therefore to determine the accumulation of macrocyclic GBCAs on enhanced T1-weighted images SI in the DN and the GP of MS patients injected eight times.

MATERIALS AND METHODS:

Five MS patients underwent eight weekly consecutive MRI scans. Enhanced 3D T1-weighted images with Gadobutrol as a macrocyclic GBCA, were acquired. A ROI-based approach was applied for the evaluation of SI in the DN to middle cerebellar peduncle (DN-MCP) and GP to semi-oval white matter (GP-SOWM) ratios. An analysis of variance on repeated measures was used for the statistical analysis of each ratio.

RESULTS:

No DN-MCP and GP-SOWM SI ratio differences were observed over the eight-weeks period using the macrocyclic GBCA.

CONCLUSION:

Iterative and weekly injections of macrocyclic GBCAs are not associated with T1 signal increase in the DN and GP of MS patients. These results would suggest a no gadolinium accumulation in the brain using macrocyclic GBCA even after several close injections and promote the use of a macrocylcic GBCA rather than linear agents for MS patients.

KEYWORDS:

Dentate nucleus; Deposition; Gadolinium-based contrast agents; Globus pallidus; Magnetic resonance imaging; Multiple sclerosis

PMID:
30017281
DOI:
10.1016/j.ejrad.2018.06.011
[Indexed for MEDLINE]

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