High Signal Intensity in Dentate Nucleus on Unenhanced T1-weighted MR Images: Association with Linear versus Macrocyclic Gadolinium Chelate Administration

Abstract

Hyperintensity in the DN on unenhanced T1-weighted MR images is associated with previous administration of linear GBCA, while the previous administration of macrocyclic GBCAs showed no such association.

Gadolinium toxicity and treatment

“…Gadolinium presence was originally observed in bone [5,6,30] and more recently in the brain [7][8][9][31][32][33][34][35][36][37][38][39] in patients with normal renal function.…”

“…It may be that difficulty with processing and/or metabolizing metals, or over-reaction to them, may be primarily a European-origin Caucasian person's disease. As further indirect proof of GDD being a predominantly white person's genetic disease, the initial and subsequent publication of gadolinium retained in the dentate nucleus and globus pallidus was made by Kanda et al [31] on a Japanese population, hence simple storage is likely a universal phenomenon of gadolinium exposure, and especially of linear agents [33,34,[36][37][38][39]. Yet there are no major series of NSF coming from Japan, South Korea or China [51,52].…”

Contribution of metals to brain MR signal intensity: review articles

“…4) [106][107][108]. Because of the toxicity of gadolinium, residual gadolinium has been attracting increasing attention [109][110][111][112][113][114][115][116]. These regions show increased signal with the administration of linear-type GBCAs but not macrocyclic-type GBCAs; because linear-type GBCAs are more unstable , and pulvinar of thalamus (yellow arrows) are hypointense compared with a normal agematched female (Fig.…”

Technical aspects of MRI signal change quantification after gadolinium-based contrast agents' administration

“…Different ratios have been used for quantitative measurements including DN-to-pons, DN-to-middle cerebellar peduncle, DN-to-cerebellar white matter, DN-to-CSF, DN-to-corpus callosum genu (CC), GP-to-Th, GP-to-CSF, GP-to-CC, Th-to-CC, and Caudate nucleus-to-CC [1][2][3][4][5][6][7][8][9][17][18][19][20]. In a study with healthy volunteers, T1 SI of DN, pons, GP, white matter, and gray matter were all evaluated and normalized with CSF [21].…”

“…In the past 2 years several magnetic imaging (MRI) studies reported high T1 signal intensity in the dentate nucleus (DN) and/or globus pallidi (GP) in patients with normal renal function after multiple administrations of gadolinium-based contrast agents (GBCAs) suggesting gadolinium deposition [1][2][3][4][5][6][7][8][9]. The agent most commonly implicated was gadodiamide (Omniscan ® ) a non-ionic linear agent, classified according to its stability as a weak agent [10], followed by gadopentetate dimeglumine (Magnevist ® ) and gadobenate dimeglumine (MultiHance ® ), both ionic linear agents, classified as agents with intermediate stability [10].…”