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

Publication date: Available online 7 January 2019

Source: Magnetic Resonance Imaging

Author(s): Philipp Eisele, Kristina Szabo, Anne Ebert, Alexander Radbruch, Michael Platten, Stefan O. Schoenberg, Achim Gass

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.

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