Skull base tumors: gadodiamide injection--enhanced MR imaging--drop-out effect in the early enhancement pattern of paragangliomas versus different tumors

Radiology. 1993 Aug;188(2):339-46. doi: 10.1148/radiology.188.2.8327675.

Abstract

A phase III trial was conducted in 40 patients with known or suspected skull base tumors to evaluate the safety and efficacy of high-dose gadodiamide injection for use as a paramagnetic contrast medium in conventional and dynamic magnetic resonance (MR) imaging. Contrast material enhancement was assessed dynamically with use of a gradient-recalled sequence. The time-intensity curve of selected regions of interest showed a reproducible dropout effect in the form of a dip in the curve during the early enhancement of the sigmoid sinus and jugular bulb; the same phenomenon was observed in all glomus tumors of the skull base, regardless of size or location. In contrast, schwannomas, meningiomas, and a variety of other lesions showed a continuous increase in the time-intensity curve. The drop-out sign, which is probably a result of a paramagnetic phenomenon during the early phase of enhancement, seems to be specific for glomus tumors. High-dose gadodiamide injection may show a specific dynamic pattern for glomus tumors, allowing differentiation from other tumors of the middle and posterior skull base.

Publication types

  • Clinical Trial
  • Clinical Trial, Phase III
  • Comparative Study

MeSH terms

  • Drug Combinations
  • Gadolinium DTPA
  • Glomus Jugulare Tumor / diagnosis
  • Humans
  • Image Enhancement
  • Injections
  • Magnetic Resonance Imaging*
  • Meglumine
  • Meningioma / diagnosis
  • Neurilemmoma / diagnosis
  • Organometallic Compounds
  • Pentetic Acid
  • Prospective Studies
  • Skull Neoplasms / diagnosis*

Substances

  • Drug Combinations
  • Organometallic Compounds
  • Meglumine
  • Pentetic Acid
  • gadodiamide
  • Gadolinium DTPA