Enhancement of cerebral diseases: How much contrast agent is enough? Comparison of 0.1, 0.2, and 0.3 mmol/kg gadoteridol at 0.2 T with 0.1 mmol/kg gadoteridol at 1.5 T
Enhancement of cerebral diseases: How much contrast agent is enough? Comparison of 0.1, 0.2, and 0.3 mmol/kg gadoteridol at 0.2 T with 0.1 mmol/kg gadoteridol at 1.5 T
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DOI：
10.1097/00004424-200105000-00004
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发表时间：
2001-05-01
影响因子：
6.7
通讯作者：
Gehl, HB
中科院分区：
文献类型：
--
作者：
Brekenfeld, C;Foert, E;Gehl, HB
原理和说明。确定钆特醇（ProHance，Bracco-Byk Gulden）的临床剂量，用于评估低场磁共振（MR）扫描仪上的血脑屏障破坏，该剂量相当于高场MR扫描仪上钆特醇的标准剂量。这项前瞻性研究在四个中心进行。共138例疑似或已知脑部疾病的患者在1.5 T MR扫描仪上进行了常规头部扫描，包括增强T2加权和T1加权自旋回波序列。给予标准剂量0.1 mmol/kg的钆特醇后，延迟15 - 20分钟后重复T1加权扫描。为了继续在0.2-T MR扫描仪（Magnetom OPEN，Siemens）上进行检查，在首次注射后30 - 50分钟内开始标准剂量T1自旋回波序列。然后在两次0.1 mmol/kg剂量的钆特醇后5分钟开始两次额外的T1加权低场序列，80例增强病变患者进行了个体内比较。由两名独立的阅片员在现场和非现场对检测到的病灶总数、病灶大小和特征进行评价。与标准剂量高场序列相比，单次剂量低场序列检测到的增强病变明显较少（80/95个病变; P < 0.05），特别是转移瘤和梗死。双剂量和三剂量低场序列与标准剂量高场序列之间未发现统计学相关差异（阅片人1：P = 1;阅片人2：P = 0.8）。所有增强后序列均可检出原发性脑肿瘤，与剂量无关。在低场时，高场时0.1 mmol/kg钆特醇的临床等效剂量为0.2 mmol/kg，0.1 mmol/kg剂量的钆特醇效果较差，不建议在极低场扫描仪上使用。
RATIONALE AND OBJECTIVES. TO determine the clinical dose of gadoteridol (ProHance, Bracco-Byk Gulden) to use for the assessment of blood-brain barrier breakdown on low-field magnetic resonance (MR) scanners that corresponds to a standard dose of gadoteridol on high-field MR scanners.METHODS. This prospective study was carried out at four centers. A total of 138 patients with suspected or known brain diseases underwent a routine head scan comprising precontrast T2-weighted turbo spin-echo and T1-weighted spin-echo sequences on a 1.5-T MR scanner. After administration of a standard dose of 0.1 mmol/kg gadoteridol, the T1-weighted scan was repeated after a delay of 15 to 20 minutes, For continuing the examination on a 0.2-T MR scanner (Magnetom OPEN, Siemens), a standard-dose T1 spin-echo sequence was started within 30 to 50 minutes of the first injection. Then two additional T1-weighted low-field sequences were each started 5 minutes after two additional doses of 0.1 mmol/kg gadoteridol, Eighty patients with enhancing lesions underwent an intraindividual comparison. Evaluation of the overall numbers of lesions detected and of lesion size and character was performed on-site as well as off-site by two independent readers.RESULTS. The single-dose, low-field sequence detected significantly fewer enhancing lesions (80/95 lesions; P < 0.05), particularly metastases and infarctions, than did the standard-dose, high-field sequence. No statistically relevant differences (reader 1: P = 1; reader 2: P = 0.8) were found between the double- and triple-dose, low-field sequences and the standard-dose, high-field sequence. Primary brain tumors were detected by all postcontrast sequences irrespective of the dose.CONCLUSIONS. At low field, the clinically equivalent dose to 0.1 mmol/kg gadoteridol at high field is 0.2 mmol/kg, A dose of 0.1 mmol/kg gadoteridol is less effective and cannot be recommended for use on extremely low-field scanners.