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Increased Signal Intensity in the Dentate Nucleus on Unenhanced T1-Weighted Images After Gadobenate Dimeglumine Administration

Weberling, Lukas D.*†; Kieslich, Pascal J. MSc; Kickingereder, Philipp MD*; Wick, Wolfgang MD§; Bendszus, Martin MD*; Schlemmer, Heinz-Peter MD, PhD; Radbruch, Alexander MD, JD*†

doi: 10.1097/RLI.0000000000000206
Original Articles

Objectives The aim of this study was to compare changes in signal intensity (SI) ratios of the dentate nucleus (DN) to pons and cerebrospinal fluid (CSF) on unenhanced T1-weighted magnetic resonance imaging (MRI) scans between the first and last MRI using the linear gadolinium-based contrast agent gadobenate dimeglumine.

Materials and Methods The study was approved by the ethical committee of the University of Heidelberg (S-324/2014), and written informed consent was waived due to the retrospective character of the study. Fifty patients who underwent at least 5 consecutive MRI examinations (plus an additional last MRI for reference) with the exclusive use of gadobenate dimeglumine were analyzed retrospectively. The difference of DN-to-pons and DN-to-CSF mean SI ratios was calculated on unenhanced T1-weighted images between the first and last examination. Results were compared with previously published data on gadopentetate dimeglumine and gadoterate meglumine.

Results Signal intensity ratio differences for DN-to-pons and DN-to-CSF were significantly greater than 0 (pons: 0.0399 ± 0.0307, P < 0.001; CSF: 0.1439 ± 0.1524, P < 0.001). No control variable consistently predicted the SI ratio difference for the DN-to-pons and the DN-to-CSF ratio. Compared with previously published data, the difference in SI increase between gadopentetate dimeglumine and gadobenate dimeglumine was not significant for the DN-to-pons ratio (P = 0.906). In contrast, the DN-to-CSF ratio difference was significantly lower (P < 0.001) for gadobenate dimeglumine. Dentate nucleus-to-pons (P < 0.001) and DN-to-CSF (P = 0.017) ratio differences were both significantly higher for gadobenate dimeglumine than for gadoterate meglumine.

Conclusions The present study found an increase in SI in the DN after serial injections of gadobenate dimeglumine. Further studies are needed to clarify the potential of different linear gadolinium-based contrast agents to cause SI increase in the DN.

From the *Department of Neuroradiology, University of Heidelberg Medical Center; †Department of Radiology, German Cancer Research Center, Heidelberg; ‡Department of Psychology, University of Mannheim, Mannheim; and §Neurology Clinic, University of Heidelberg, Heidelberg, Germany.

Received for publication June 17, 2015; and accepted for publication, after revision, July 21, 2015.

Correspondence to: Alexander Radbruch, MD, JD, Department of Neuroradiology, University of Heidelberg Medical Center, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany. E-mail:

Conflicts of interest and sources of funding: none declared.

Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.