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Is Gd-DTPA required for routine cranial MR imaging?
A D Elster1, D M Moody, M R Ball
1Department of Radiology, Bowman Gray School of Medicine, Wake Forest University Winston-Salem, NC 27103.
Radiology
|October 1, 1989
Summary
Gadolinium diethylenetriaminepentaacetic acid [DTPA] contrast is helpful in most cranial MRI scans, aiding lesion detection and characterization. Its routine use is recommended, especially in older patients or those with known neurological conditions.
Area of Science:
- Neuroradiology
- Medical Imaging
Background:
- Gadolinium diethylenetriaminepentaacetic acid (Gd-DTPA) is a contrast agent used in magnetic resonance (MR) imaging.
- Its utility in routine cranial MR imaging requires objective evaluation.
Purpose of the Study:
- To prospectively assess the radiologic helpfulness of Gd-DTPA contrast in routine cranial MR imaging.
- To identify factors influencing the usefulness of Gd-DTPA in diagnosing intracranial lesions.
Main Methods:
- 500 consecutive adult and pediatric patients undergoing cranial MR imaging received Gd-DTPA.
- Pre- and postcontrast MR images were independently reviewed by two neuroradiologists using defined criteria for helpfulness.
- Lesion detection and enhancement characteristics were analyzed.
Main Results:
- Contrast enhancement was observed in 20% of cases, considered helpful in 74% of those instances.
- Gd-DTPA identified new lesions in only 3% of cases.
- Lack of enhancement was deemed helpful in 22% of all studies.
Conclusions:
- Gd-DTPA is radiologically helpful in a significant portion of routine cranial MR examinations.
- Increased patient age, pre-existing lesions, prior surgery, and known CNS disease correlate with increased utility.
- Routine use of Gd-DTPA is likely beneficial for most patients, with potential exceptions for young individuals with normal precontrast scans.