In vivo dentate nucleus MRI relaxometry correlates with previous administration of Gadolinium-based contrast agents

Eur Radiol. 2016 Dec;26(12):4577-4584. doi: 10.1007/s00330-016-4245-2. Epub 2016 Feb 23.

Abstract

Objectives: To evaluate changes in T1 and T2* relaxometry of dentate nuclei (DN) with respect to the number of previous administrations of Gadolinium-based contrast agents (GBCA).

Methods: In 74 relapsing-remitting multiple sclerosis (RR-MS) patients with variable disease duration (9.8±6.8 years) and severity (Expanded Disability Status Scale scores:3.1±0.9), the DN R1 (1/T1) and R2* (1/T2*) relaxation rates were measured using two unenhanced 3D Dual-Echo spoiled Gradient-Echo sequences with different flip angles. Correlations of the number of previous GBCA administrations with DN R1 and R2* relaxation rates were tested, including gender and age effect, in a multivariate regression analysis.

Results: The DN R1 (normalized by brainstem) significantly correlated with the number of GBCA administrations (p<0.001), maintaining the same significance even when including MS-related factors. Instead, the DN R2* values correlated only with age (p=0.003), and not with GBCA administrations (p=0.67). In a subgroup of 35 patients for whom the administered GBCA subtype was known, the effect of GBCA on DN R1 appeared mainly related to linear GBCA.

Conclusions: In RR-MS patients, the number of previous GBCA administrations correlates with R1 relaxation rates of DN, while R2* values remain unaffected, suggesting that T1-shortening in these patients is related to the amount of Gadolinium given.

Key points: • In multiple sclerosis, previous Gadolinium administrations correlate with dentate nuclei T1 relaxometry. • Such correlation is linked to linear Gadolinium chelates and unrelated to disease duration or severity. • Dentate nuclei T2* relaxometry is age-related and independent of previous Gadolinium administrations. • Changes in dentate nuclei T1 relaxometry are not determined by iron accumulation. • MR relaxometry can quantitatively assess Gadolinium accumulation in dentate nuclei.

Keywords: Dentate nucleus; Gadolinium; MRI contrast media; Multiple Sclerosis; Relaxometry.

MeSH terms

  • Adult
  • Cerebellar Nuclei / diagnostic imaging*
  • Contrast Media*
  • Female
  • Gadolinium*
  • Humans
  • Image Enhancement / methods*
  • Magnetic Resonance Imaging / methods*
  • Male
  • Multiple Sclerosis, Relapsing-Remitting / pathology*
  • Retrospective Studies

Substances

  • Contrast Media
  • Gadolinium