多次注射钆对比剂后小脑齿状核T1WI信号变化的研究

Cerebellar Dentate Nucleus Signal Changes on T1-weighted MR Images after Multiple Gadolinium-based Contrast Agent Administrations

目的测量统计多次使用钆对比剂后小脑齿状核平扫T1WI上的信号变化,探索多次钆对比剂使用对钆脑沉积的影响。方法搜集2013.6-2023.6行4次及以上的MRI增强的患者153例,线性-钆喷酸葡胺组122例,大环-钆特醇31例,选择第1次和末次平扫T1WI,结局事件为增强后齿状核信号的增高。记录患者年龄、性别、对比剂使用次数和间隔、疾病类型等临床特征,使用Logistic回归分析与齿状核信号增高的相关的因素。结果在153例患者中,男:女=68:85,平均56.58±14.50岁,平均接受6±4次注射,平均间隔4.25±3.77月,69例(45.1%)被观察到小脑齿状核信号增高,均发生于线性钆对比剂组。齿状核信号增高还与线性钆使用次数呈正相关(B=1.57,OR=4.82,P<0.01),与增强时间间隔呈负相关(B=-0.72,OR=0.49,P<0.01),但与其它特征无关(P>0.05)。结论小脑齿状核T1WI信号增高与线性钆对比剂注射次数和时间间隔有关,但与大环钆的使用无关。

Objective To investigate the presence of gadolinium contrast agent deposition in the brain by the analysis of signal changes on T1-weighted images(T1WI)of the cerebellar dentate nucleus following repeated administration of gadolinium contrast agent.Methods A cohort of 153 patients who received four or more enhancements of brain magnetic resonance imaging(MRI)at our medical facility between June 2013 and June 2023 was assembled.The participants were categorized into two groups:a linear contrast group consisting of 122 instances,and a macrocyclic contrast group consisting of 31 cases.The first and final T1WI scans were chosen,and the outcome event was determined as a rise in signal intensity inside the dentate nucleus subsequent to enhancement.The study collected clinical data from patients,which included variables such as age,gender,frequency of contrast medium use,interval of enhancement,disease type and so on.These variables were then subjected to logistic regression analysis to investigate their relationship with the increased signal of the dentate nucleus.Results Among 153 patients,the gender distribution consisted of 68 males and 85 females.The mean age of the participants was 56.58±14.50 years.The mean number of contrast agent utilization was 6±4,with a mean interval of 4.25±3.77 months between each usage.A total of 69 out of 153 individuals,accounting for 45.1%,exhibited an augmentation in the signal of the cerebellar dentate nucleus on T1WI.This phenomenon was exclusively identified in the group of patients who received the linear gadolinium contrast agent.Furthermore,the logistic regression analysis revealed a positive correlation between the augmentation of dentate nucleus signal and the frequency of linear contrast agent usage(B=1.57,OR=4.82,P<0.01).Moreover,there was a negative correlation between the enhancement time interval and the dentate nucleus signal enhancement(B=-0.72,OR=0.49,P<0.01).Nevertheless,the increased signal intensity observed in the dentate nucleus does not exhibit any significant correlation with other clinical characteristics(P>0.05).Conclusion The increased T1WI signal intensity in cerebellar dentate nucleus was related to the frequency and time interval of linear gadolinium contrast agent,but not related to the use of macrocyclic gadolinium contrast agent.