Linear gadolinium-based contrast agent (gadodiamide and gadopentetate dimeglumine)-induced high signal intensity on unenhanced T1-weighted images in pediatric patients

Background Recent studies of adults have found an association between hyperintensity of the dentate nucleus (DN) and globus pallidus (GP) on T-1-weighted images (T1WI) and a history of linear gadolinium-based contrast agent (GBCA) administration. Several reports have also focused on this phenomenon in pediatric patients; however, data in the current literature remains limited. Purpose/Hypothesis To evaluate the associations between DN and GP T-1-signal increase and previous administration of linear GBCAs in pediatric patients. Study Type Single-center, retrospective, cross-sectional study. Population We included pediatric patients with histories of >= 5 linear GBCA (gadodiamide and gadopentetate dimeglumine) administrations (the ">= 5 Linear GBCA administrations" group), 1-4 administrations (the "1-4 Linear GBCA administrations" group), and no history of GBCA administration (the "No GBCA administration" group). Each group included 42 patients. Therefore, 126 patients (male:female, 72:54; median age, 16 [range, 4-18] years) were included in this study. Field Strength/Sequence 1.5T/ Spin-echo unenhanced T-1-weighted imaging. Assessment Unenhanced T-1-weighted images were quantitatively analyzed by two radiologists. The DN-to-pons and GP-to-thalamus signal intensity ratios (DN-to-pons and GP-to-thalamus ratios, respectively) were compared. Statistical Tests Wilcoxon test with the Bonferroni correction and intraclass correlation coefficients. Results The DN-to-pons ratio increased as the number of GBCA administrations increased (P < 0.0063). The GP-to-thalamus ratio of the ">= 5 Linear GBCA administrations" group was significantly higher than those of the other two groups (P < 0.0001). The GP-to-thalamus ratio of the "1-4 Linear GBCA administrations" group did not differ significantly from that of the "No GBCA administration" group (P = 1.000). The DN-to-pons and GP-to-thalamus ratios' interobserver intraclass correlation coefficients were excellent (0.8236) and good (0.6738), respectively. Data Conclusion High signal intensities in the DN and GP on T1WI were associated with previous linear GBCA administration in pediatric patients.