Cranial MR imaging with Gd-DTPA in neonates and young infants: preliminary experience

Area of Science:

• Neuroradiology
• Pediatric Imaging
• Pharmacology

Background:

• Gadopentetate dimeglumine (Gd-DTPA) is a contrast agent used in magnetic resonance (MR) imaging.
• Its use in neonates and young infants (less than 6 weeks old) requires safety and efficacy evaluation.
• Understanding contrast enhancement patterns in this age group is crucial for accurate diagnosis.

Purpose of the Study:

• To assess the preliminary safety and efficacy of gadopentetate dimeglumine in neonates and young infants.
• To compare contrast enhancement patterns and time courses in infants with those in older children and adults.
• To determine the diagnostic utility of Gd-DTPA in routine cranial MR imaging for this population.

Main Methods:

• Prospective administration of gadopentetate dimeglumine (0.1 mmol/kg) to 15 neonates and young infants.
• Routine cranial MR imaging performed before and after contrast administration.
• Evaluation of image quality, enhancement patterns, and time course of contrast material.

Main Results:

• Gd-DTPA enhanced MR images revealed significant abnormalities in 4 out of 15 patients (27%) not visible on pre-contrast scans.
• The standard adult dose provided bright enhancement of normal intracranial structures.
• Vivid contrast enhancement persisted for several hours due to reduced glomerular filtration and renal clearance rates in newborns.

Conclusions:

• Gadopentetate dimeglumine administration is safe and effective for cranial MR imaging in neonates and young infants.
• Gd-DTPA enhances diagnostic yield by revealing abnormalities missed on non-contrast imaging.
• The prolonged enhancement in infants suggests a potentially extended imaging window for diagnosis.