Diffusion-weighted imaging of the dentate nucleus after repeated application of gadolinium-based contrast agents in multiple sclerosis

Philipp Eisele; Kristina Szabo; Anne Ebert; Alexander Radbruch; Michael Platten; Stefan O Schoenberg; Achim Gass

doi:10.1016/j.mri.2019.01.007

Diffusion-weighted imaging of the dentate nucleus after repeated application of gadolinium-based contrast agents in multiple sclerosis

Magn Reson Imaging. 2019 May:58:1-5. doi: 10.1016/j.mri.2019.01.007. Epub 2019 Jan 7.

Authors

Philipp Eisele¹, Kristina Szabo², Anne Ebert², Alexander Radbruch³, Michael Platten², Stefan O Schoenberg⁴, Achim Gass²

Affiliations

¹ Department of Neurology, Universitätsmedizin Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1 - 3, 68167 Mannheim, Germany. Electronic address: philipp.eisele@medma.uni-heidelberg.de.
² Department of Neurology, Universitätsmedizin Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1 - 3, 68167 Mannheim, Germany.
³ Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, Huefelandstrasse 55, 45147 Essen, Germany; German Cancer Research Center (DKFZ), Department of Radiology, INF280, 69120 Heidelberg, Germany.
⁴ Institute of Clinical Radiology and Nuclear Medicine, Universitätsmedizin Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1 - 3, 68167 Mannheim, Germany.

PMID: 30630068
DOI: 10.1016/j.mri.2019.01.007

Abstract

Objective: Over the last years several studies reported an increased signal intensity (SI) of the dentate nucleus (DN) on unenhanced T1-weighted images after repeated application of gadolinium-based contrast agents (GBCAs), suggesting gadolinium deposition. The aim of this study was to investigate with diffusion-weighted MRI possible tissue abnormalities of the DN in multiple sclerosis (MS) patients.

Material and methods: We retrospectively identified seventeen patients with at least six contrast-enhanced MRI examinations by using the linear GBCA gadopentate dimeglumine and twenty-three patients with the exclusive use of the macrocyclic contrast agent gadoterate meglumine followed by another 3 Tesla MRI scan including unenhanced T1-weighted and diffusion-weighted images.

Results: In the linear GBCA group, we found significant differences of the DN-to-pons SI ratio on unenhanced T1-weighted images (1.13 ± 0.05) when compared to the macrocyclic GBCA group (0.97 ± 0.03; p < 0.001). However, we found no significant differences between apparent diffusion coefficient (ADC) values of the DN in both groups (linear GBCA group: 0.82 ± 0.04 × 10^-3 mm/s²; marcocyclic GBCA group: 0.79 ± 0.04 × 10^-3 mm/s²; p = 0.15).

Conclusions: Our results do not suggest that there is any difference in ADC values in the T1-hyperintense DN, which does not indicate a difference in tissue integrity between patients exposed to macrocyclic or linear GBCAs.

Keywords: ADC; Dentate nucleus; Diffusion; Gadolinium; MRI.

MeSH terms

Adult
Cerebellar Nuclei / diagnostic imaging*
Contrast Media / chemistry*
Diffusion Magnetic Resonance Imaging*
Female
Gadolinium / chemistry*
Gadolinium DTPA / chemistry
Humans
Image Processing, Computer-Assisted / methods
Male
Meglumine / chemistry*
Middle Aged
Multiple Sclerosis / diagnostic imaging*
Organometallic Compounds / chemistry*
Pons / diagnostic imaging
Retrospective Studies

Substances

Contrast Media
Organometallic Compounds
Meglumine
Gadolinium
Gadolinium DTPA
gadoterate meglumine