Effect of Age on High T1 Signal Intensity of the Dentate Nucleus and Globus Pallidus in a Large Population Exposed to Gadodiamide

Abstract

In this study, we confirm that the number of previous gadodiamide injections is a powerful predictor of the signal intensity increase of the Dn/Po and Gp/Th ratios on unenhanced T1w images and demonstrate that aging influences the T1 signal intensity of DN and GP in Gd-naïve and in Gd-exposed subjects.

Absence of dentate nucleus resting‐state functional connectivity changes in nonneurological patients with gadolinium‐related hyperintensity on T1‐weighted images

“…The pattern of a visually symmetrical hyperintense DN on unenhanced T 1 ‐weighted images was assessed for each patient and control subject. The quantitative analysis of the relative signal intensity of the DN was conducted as previously described . Oval regions of interest (ROIs) were manually drawn on the axial unenhanced T 1 ‐weighted images of the central pons, the right and left DN by consensus of two experienced neuroradiologists (C.C.Q., 15 years of experience; C.A.M., 8 years of experience).…”

“…The quantitative analysis of the relative signal intensity of the DN was conducted as previously described. [2][3][4] Oval regions of interest (ROIs) were manually drawn on the axial unenhanced T 1 -weighted images of the central pons, the right and left DN by consensus of two experienced neuroradiologists (C.C.Q., 15 years of experience; C.A.M., 8 years of experience). To reduce measurements variability, ROIs were generated on axial T 1 -weighted sequences by using axial FLAIR as reference.…”

“…GBCAs with a linear structure have shown higher propensity to brain long‐term retention than those with a cyclic structure and higher kinetic and thermodynamic stability …”

“…H IGH SIGNAL INTENSITY of deep cerebellar and deep brain nuclei on unenhanced T 1 -weighted images [1][2][3][4][5][6][7] as well as changes of T 1 relaxometry values 8 may reflect the presence of long-term retained or deposited gadolinium in the brain [9][10][11] in patients exposed to cumulative doses of gadolinium-based contrast agents (GBCAs). In the cerebellum, the dentate nuclei (DN) and the cortex are the areas where gadolinium predominantly retains and/or accumulates.…”

“…12,13 GBCAs with a linear structure have shown higher propensity to brain long-term retention than those with a cyclic structure and higher kinetic and thermodynamic stability. [1][2][3][4][5][6][7] The most influential regulatory agencies and institutions in medicine and radiology worldwide, including the European Medicine Agency (EMA), 14 US Food and Drug Administration (FDA), 15 American College of Radiology together with the American Society of Neuroradiology, 16 as well as the International Society for Magnetic Resonance in Medicine (ISMRM) 17 have debated on different aspects of this issue, but consistently concluded that no adverse effects on brain function have been identified to date. However, there remains concern on the eventual increased risk of neurocognitive consequences of gadolinium deposition in the brain.…”